title: The influence of a telehealth project on healthcare professional recruitment and retention in remote areas in Mali: A longitudinal study.
abstract: OBJECTIVE
  The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable aux Ressources Humaines en Santé) aimed to contribute to more equitable access to care and support practice in remote regions in Mali. This study explored the evolution of perceptions concerning telehealth among healthcare professionals in the four district health centres that participated in the EQUI-ResHus project and identified variables influencing their perceptions of telehealth impact on recruitment and retention of health professionals.
  
  
  METHODS
  One year after a first survey (T1), a second data collection (T2) was carried out among healthcare professionals using a 91-item questionnaire. Questions assessing telehealth use and perceptions and perceived impact on recruitment and retention of healthcare professionals were rated on a 5-point Likert scale. A total of 10 independent variables were considered for the analyses. A Wilcoxon signed-rank test was performed to detect differences between T1 and T2, and a bivariate linear regression model for repeated measures was carried out to assess the impact of independent variables on dependent variables.
  
  
  RESULTS
  There were no noticeable changes in perceptions related to telehealth influence on recruitment and retention. Only access to information and communication technology significantly differed between T1 and T2 according the Wilcoxon rank test (p = 0.001). Perceived influence of telehealth on recruitment and retention was mostly explained by attitude towards telehealth, perceived effect on recruitment and retention and barriers to recruitment and retention.
  
  
  CONCLUSIONS
  Based on our results, telehealth was perceived as having a positive influence but mostly indirect influence on healthcare professional recruitment and retention. Also, there were no major changes after 1 year of telehealth use.
authors.affiliation: Centre de recherche du CHU de Québec, Hôpital Saint-François d'Assise, Québec, QC, Canada.
authors.forename: Gisèle Irène Claudine
authors.initials: GI
authors.lastname: Mbemba
authors.affiliation: Centre d'Expertise et de recherche en Télémédecine et E-santé (CERTES), Bamako, Mali.
authors.forename: Cheick Oumar
authors.initials: CO
authors.lastname: Bagayoko
authors.affiliation: Centre de recherche du CHU de Québec, Hôpital Saint-François d'Assise, Québec, QC, Canada; Faculté des sciences infirmières, Pavillon Ferdinand-Vandry, Université Laval, Québec City, QC, Canada.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.affiliation: Faculté des sciences infirmières, Pavillon Ferdinand-Vandry, Université Laval, Québec City, QC, Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Hamelin-Brabant
authors.affiliation: Centre de recherche du CHU de Québec, Hôpital Saint-François d'Assise, Québec, QC, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Simonyan
keywords: Mali; Telehealth; health personnel; longitudinal study; recruitment and retention; rural and remote areas