title: Attitudes Towards Implementation of Store-and-Forward Telemental Health in Humanitarian Settings: Survey of Syrian Healthcare Providers.
abstract: BACKGROUND
  Store-and-forward (S&F) telemedicine is thought to be most applicable in humanitarian settings. Unlike other kinds of telemental health (TMH), S&F requires engagement and active participation from healthcare providers in submitting text or audio-video clinical material for consultations. To implement such consultative systems there is a need to gauge providers' attitudes towards this technology.
  
  
  METHODS
  An electronic survey was sent to Syrian healthcare providers (physicians and nonphysicians) who are affiliated with humanitarian nongovernmental organizations managing Syrians affected by war. After a description of what TMH and S&F are, participants were asked about their attitudes towards such services.
  
  
  RESULTS
  Fifty-two providers responded to the electronic survey. Only results from providers inside Syria (n = 30) are presented. The majority of respondents had no experience with TMH. Half of the providers believed that mental healthcare can be provided through S&F and that there would be a benefit from such services. Respondents reported that cultural (68%), financial (84%), and technical (80%) barriers do exist for such services. When asked, providers believed that patients would agree to be audiotaped (58%) for the purpose of S&F compared with being videotaped (15%) (p = 0.007).
  
  
  CONCLUSIONS
  Electronic surveys of healthcare workers in humanitarian settings are feasible. Providers in the Syrian humanitarian setting have little experience in TMH; however, they are open to using an S&F service while acknowledging cultural, financial, and technical barriers to the implementation.
authors.affiliation: 1 Department of Psychiatry, Yale School of Medicine , New Haven, Connecticut.
authors.forename: Hussam
authors.initials: H
authors.lastname: Jefee-Bahloul
authors.affiliation: 2 Yale School of Public Health , New Haven, Connecticut.
authors.forename: Dylan
authors.initials: D
authors.lastname: Duchen
authors.affiliation: 1 Department of Psychiatry, Yale School of Medicine , New Haven, Connecticut.
authors.forename: Andres
authors.initials: A
authors.lastname: Barkil-Oteo
mesh_terms: D000328:Adult; D000533:Altruism; D001291:Attitude of Health Personnel; D004637:Emergency Services, Psychiatric / Q000458:organization & administration*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013593:Syria; D017216:Telemedicine / Q000458:organization & administration*
keywords: behavioral health; telehealth; telemedicine; telepsychiatry