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First published August 23, 2006 as JAMIA PrePrint; doi:10.1197/jamia.M2146
Journal of the American Medical Informatics Association 2006;13(6):660-667
© 2006 American Medical Informatics Association

A more recent version of this article appeared on November 1, 2006
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Submitted on May 11, 2006
Accepted on August 7, 2006

Development, Validation, and Use of English and Spanish Versions of the Telemedicine Satisfaction and Usefulness Questionnaire

Suzanne Bakken RN, DNSc1*, Lorena Grullon-Figueroa MD2, Roberto Izquierdo MD3, Nam-Ju Lee RN, DNSc2, Philip Morin MS3, Walter Palmas MD4, Jeanne Teresi EdD, PhD5, Ruth S. Weinstock MD, PhD6, Steven Shea MD7, and Justin Starren MD, PhD8

Affiliation of the authors: 1 Columbia University School of Nursing, New York, New York; Department of Biomedical Informatics, Columbia University, New York, New York ; 2 Columbia University School of Nursing, New York, New York; 3 Joslin Diabetes Center and Division of Endocrinology, Diabetes and Metabolism SUNY Upstate Medical University, Syracuse, New York ; 4 Department of Medicine, Columbia University, New York, New York; 5 Research Division of the Hebrew Home for the Aged at Riverdale, Bronx, New York; Stroud Center, Columbia University, New York, New York ; 6 Joslin Diabetes Center and Division of Endocrinology, Diabetes and Metabolism SUNY Upstate Medical University, Syracuse, New York; Department of Biostatistics, Joseph Mailman School of Public Health, Columbia University, New York, New York ; 7 Department of Biomedical Informatics, Columbia University, New York, New York; Department of Medicine, Columbia University, New York, New York; Department of Radiology, Columbia University, New York, New York ; 8 Department of Biomedical Informatics, Columbia University, New York, New York; Department of Veterans Affairs, VA Medical Center, Syracuse, New York

* To whom correspondence should be addressed.

Objectives 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.

Conclusion 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.




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