title: Development, validation, and use of English and Spanish versions of the telemedicine satisfaction and usefulness questionnaire.
abstract: OBJECTIVE
  To describe the development and validation of low literacy English and Spanish versions of the 26-item Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ), report telemedicine satisfaction and usefulness ratings of urban and rural participants in the Informatics for Diabetes Education and Telemedicine (IDEATel) project, and explore relationships between utilization and perceptions of satisfaction and usefulness.
  
  
  METHODS
  Data sources included TSUQ, utilization data from IDEATel log files, and sociodemographic data from the annual IDEATel interview. Psychometric analyses were conducted to examine the reliability and validity of TSUQ. Data were analyzed using descriptive, correlational techniques.
  
  
  RESULTS
  The principal components factor analysis extracted two factors (Video Visits, alpha=.96, and Use and Impact, alpha=.92) that explained 63.6% of the variance in TSUQ satisfaction scores. All satisfaction and usefulness items had mean scores of greater than 4 on a 5-point scale. Those from urban areas reported significantly higher ratings on both factors than rural participants as did those who did not know how to use a computer at baseline. Mean frequency of utilization of IDEATel components was highest for blood sugar testing followed by web site for reviewing results, blood pressure testing, video visits, and ADA educational Web pages. Associations between utilization and perceptions of satisfaction and usefulness varied among IDEATel components.
  
  
  CONCLUSIONS
  Psychometric analyses support the construct validity and internal consistency reliability of TSUQ, which is available in both English and Spanish at a readability level of 8th grade. Both rural and urban participants reported high levels of satisfaction and found all IDEATel components useful. Further work is needed to examine the relationships between utilization and perceptions of satisfaction and usefulness and to explore the effects of location (urban versus rural) and ethnicity on satisfaction with telemedicine services.
authors.affiliation: Biomedical Informatics, Columbia University, 617 W. 168th Street, New York, NY 10032, USA. Suzanne.Bakken@dbmi.columbia.edu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bakken
authors.forename: Lorena
authors.initials: L
authors.lastname: Grullon-Figueroa
authors.forename: Roberto
authors.initials: R
authors.lastname: Izquierdo
authors.forename: Nam-Ju
authors.initials: NJ
authors.lastname: Lee
authors.forename: Philip
authors.initials: P
authors.lastname: Morin
authors.forename: Walter
authors.initials: W
authors.lastname: Palmas
authors.forename: Jeanne
authors.initials: J
authors.lastname: Teresi
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Justin
authors.initials: J
authors.lastname: Starren
mesh_terms: D003920:Diabetes Mellitus; D004522:Educational Status; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011594:Psychometrics; D015203:Reproducibility of Results; D012424:Rural Population; D011795:Surveys and Questionnaires; D017216:Telemedicine; D014505:Urban Population