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Introduction: Telepractice is recognised as an effective and efficient medium of service delivery; however, despite this evidence, implementation has been inconsistent. Clinician confidence and perceptions are integral factors to the successful implementation of telepractice in routine care. This study aimed to develop, implement and evaluate a telepractice training package for clinicians in a single hospital service. Methods: Forty-one clinicians from Speech Pathology, Physiotherapy and Chronic Disease departments participated in a training package with a specific focus on staff skills training, access to resources and embedding telepractice models of care into organisational culture. Questionnaires were used to evaluate clinician self-reported skills and confidence at baseline, post-training and 6-months post-training. Thematic analysis of open-ended questions was used to glean a deeper understanding of perceived barriers and facilitators to using telepractice. Results: Participants’ perceived knowledge and confidence significantly increased from baseline to immediately post-training ( p < .001) and increased further to 6-months post-training ( p < .001). Thematic analysis revealed three main enabling themes: (a) perceived benefits to patient care; (b) training and practice; and (c) resources and support; and four main barriers: (a) staff knowledge and training; (b) staff confidence; (c) client factors; and (d) infrastructure and resources. Conclusion: The telepractice training package improved staff skills and confidence which was sustained over time. Facilitating the uptake of telepractice is multidimensional and it is integral to address all relevant factors to ensure its success.

Objective To examine associations between health risk behaviors and sexual experience with opposite-, same-, or both-sex partners in representative samples of high school students. Design We used 1995 and 1997 data from the Vermont and Massachusetts Youth Risk Behavior Surveys. Logistic regression and multiple regression analyses were used to compare health risk behaviors among students who reported sex with opposite-sex partners only (opposite-sex students), with same-sex partners only (same-sex students), and with both male and female sexual partners (both-sex students). Setting Public high schools in Vermont and Massachusetts. Participants Representative, population-based samples of high school students. The combined samples had 14 623 Vermont students and 8141 Massachusetts students. Main Outcome Measure Violence, harassment, suicidal behavior, alcohol and other drug use, and unhealthy weight control practices. Results In both states, both-sex students were significantly more likely to report health risk behaviors than were opposite-sex students. For example, both-sex students had odds 3 to 6 times greater than opposite-sex students of being threatened or injured with a weapon at school, making a suicide attempt requiring medical attention, using cocaine, or vomiting or using laxatives to control their weight. In both states, same-sex students were as likely as opposite-sex students to report most health risk behaviors. Conclusion Relative to opposite- and same-sex students, both-sex students may be at elevated risk of injury, disease, and death by experiencing serious harassment and engaging in violence, suicidal behavior, alcohol and other drug use, and unhealthy weight control practices.