SAFE-T System Research

Multidisciplinary Perspectives on the Implementation of a Comprehensive Sexual Assault Telehealth Program in Rural Communities: A Qualitative Study

Miyamoto, S., Wright, E.N., Thiede, E., Perkins, D.F., Bittner, C. & Dorn, L.


Access to quality sexual assault (SA) care in rural communities is limited by challenges surrounding building and sustaining a skilled SA nurse examiner workforce. Telehealth can facilitate access to expert care while cultivating a local sexual assault response. The Sexual Assault Forensic Examination Telehealth (SAFE-T) Center aims to decrease disparities in SA care by providing expert, live, interactive mentoring, quality assurance, and evidence-based training via telehealth. This study examines multidisciplinary perceptions of pre-implementation barriers and SAFE-T program impact using qualitative methods. Implications for the implementation of telehealth programs to support access to quality SA care are considered.


According to stakeholders, SAFE-T provided valuable solutions to address community, workforce, clinical and patient needs for SA care. Understanding stakeholder needs, perspectives on meeting those needs, and overall program impact is essential to improve implementation of future sites, and to provide effective knowledge for preparing and launching SA telehealth partnerships. Our data also suggest there is value in the comprehensive program elements that extend beyond clinical consultation including training, advocacy and guidance for system-level change to support nurses and connect them to a supportive network of colleagues. Based on our study, local nurses, hospital administrators, victim advocates, and law enforcement see improved clinical care and compassionate, trauma-informed support of patients due to SAFE-T.

Future research should follow these stakeholders across time with questions relevant to the status of SAFE-T at each site and the patients seen. Knowing what the changing involvement is across time for some community stakeholders not represented here (i.e., DA’s) also would be beneficial. Further, as new sites are added it would be important to see if findings are similar to what is reported here. Gathering data about community differences (e.g., population, demographics, etc.) of those sites may contribute to understanding similarities or differences and in turn, modifications in the program.