A phenomenological exploration of behavioral health aides’ perceptions of telebehavioral health services with rural Alaska Native and American Indian beneficiaries in Interior Alaska

Abstract

Alaska Native Persons (ANPs) living rurally and remotely in Alaska face substantial barriers in addressing behavioral healthcare. Improved technologically driven communications and interventions via telebehavioral health services enhance service delivery alternatives and accessibility. This transcendental phenomenological study aimed to explore the perceptions of Alaska’s tribal health workers utilizing what they term video teleconference (VTC) with AN rural beneficiaries as part of their role and involvement in the Behavioral Health Aide (BHA) Program. In the past decade, the program has trained, certified, and deployed multiple providers across tribal health organizations to help mitigate high mental health rates. The largest tribal health corporation in Alaska, the Tanana Chiefs Conference (TCC), offers a BHA Program to support its beneficiaries, though no studies exist on its efficacy. A total of six key informants from TCC’s BHA Program completed individual semi-structured interviews. Six core themes emerged during qualitative data analysis that derived from the voices of the co-participants; four reflect attitudes regarding outcomes of provision of care (advantages and disadvantages) for beneficiaries and their roles as community healers, which are people get help, flexible options using VTC, Internet connectivity, and discomfort using VTC. Two additional themes embody independent experiences, including collaborative collegial support and inconsistency with VTC training. The findings suggest that TCC’s program enables Indigenous workers to provide helpful aid to their communities and beneficiaries. They appreciate their roles and benefit from employing VTC to obtain collegial and supervisory support, augmenting confidence and utilization for client care. A limited sample size and contextual factors, like the COVID-19 pandemic, influenced the outcomes of this study and are essential to consider. Ultimately, findings could reinforce support for the BHA Program and telebehavioral health services, inform TCC and its other providers, and ignite a statewide surveillance study to collect and further comprehend telebehavioral health use in Alaska.