Telerehabilitation Program in Rural South India: A Mixed-Method Analysis of the Shared-Decision Making Process

Purpose: Shared decision making (SDM) in health care teams involves partnering with the patient and family to consider treatment options, prioritizing their values and preferences while collaboratively determining the best care plan. Previous research on SDM in rural South India has only focused on adult populations receiving in-person care. This study aimed to understand parent perception of the SDM approach implemented in telerehabilitation services offered by Amar Seva Sangam Ayikudy to children with disabilities in a rural Southern Indian setting. Methods: A convergent parallel mixed-methods design was utilized. Quantitative data was collected from 187 participants using a SDM measure examining parents’ perceptions of whether SDM was implemented. Additional qualitative data was gathered through 3 virtual focus groups. Results: Most SDM measure respondents (71.7%) reported engaging in SDM, a finding also shared by parents in the focus groups. Thematic analysis of focus group responses revealed four themes: intentionally positioning the parent as an expert within the care team, building capacity and transferring knowledge, enhancing participation through in-person community resource worker support, and valuing the family context in making decisions. Additionally, parents requested more treatment sessions to address their children’s needs. Conclusions: This study enhances understanding of parent engagement in the SDM process with the team providing telerehabilitation services. These insights may guide family engagement in virtual service provision in other settings.