Can telemedicine address neurologic health disparities in rural Guatemala: a health promotor educational intervention study

The global burden of neurologic disease is high and its impact manifests in health disparities observed in rural communities of limited resources like those surrounding San Lucas Tolimán, Guatemala. Telehealth may be one method to close these gaps by offering a virtual neurology curriculum. The goal of this project was to determine the pervasiveness of neurologic disease in San Lucas Tolimán and to increase interest and knowledge in neurology topics for local health promotors. A neurologic needs assessment was performed during the initial site visit. This information was subsequently used to create monthly health promotor neurology-based workshops and remote consultations delivered via a telehealth platform over the following year. The 29 health promotors were surveyed before and after the neurology course to measure self-reported knowledge of variable topics as well as their interest in neurology and how effective the remote lectures were. The needs assessment identified at least 68 different patients with neurologic diseases, the most common being headaches and seizures. The health promotors' knowledge of several neurologic diseases as well as their comfort level diagnosing a condition based on a description of neurologic symptoms significantly increased following the year-long neurology course. The lectures were convenient, easy to see and hear virtually, and increased the health promotors' interest in neurology. Telehealth is an acceptable and feasible method of delivering educational neurology topics relevant to rural communities. Future, longer-term studies are needed to determine if telehealth interventions such as these impact neurologic patient outcomes.