Term of Award

Fall 2020

Degree Name

Doctor of Public Health in Public Health Leadership (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Jiann-Ping Hsu College of Public Health

Committee Chair

Gulzar Shah

Committee Member 1

Bettye Apenteng

Committee Member 2

William Mase


Purpose: Whereas telemedicine is expanding possibilities in healthcare, its potential in improving access to emergency eye care is not well explored. Acceptance by end-users is a critical condition in the adoption of telehealth technologies. This study’s objective was to predict emergency providers’ intention to use teleophthalmology for live interprofessional consultations and examine the role of transformational leadership in telemedicine acceptance. Methods: A sample of 244 eye care and emergency health professionals, using mobile or online applications across the United States, completed a cross-sectional survey. The study used the Global Transformational Leadership scale to assess the behaviors of supervisors. It applied structural equation modeling to test hypotheses based on the Technology Acceptance Model (TAM) and content analysis technique to identify prominent themes from qualitative responses. Results: The mean factor-based score of Intention to use (IU) teleophthalmology was 3.74 (Standard Deviation (SD) = 0.95). The modified TAM exhibited acceptable fit indices and explained 67.5% of the variation in the data. Perceived usefulness (PU) was the most significant predictor of behavioral intention to use the technology (standardized path coefficient (β)=0.66). Transformational leadership (β=0.37) and Subjective norms (β=0.47) exerted significant positive influences on IU and PU mediated most of these effects. Self-efficacy had an insignificant impact on PU (β=0.18, p=.105). Participants identified privacy and security concerns (61.9%), the initial cost of the technology (60.6%), and resistance from staff (57.4%) as formidable challenges to the adoption of telemedicine. Two-thirds (66.4%) of responders thought the Covid-19 pandemic would significantly impact telemedicine adoption. The participants expressed predominantly positive or cautiously optimistic views about introducing teleophthalmology to emergency departments. Conclusions: Providers of emergency eye care are likely to accept teleophthalmology for live interprofessional consultations. Transformational leadership qualities could facilitate the acceptance of telemedicine. Emergency departments adopting teleophthalmology need to assess demand, address contextual challenges, and exploit emerging opportunities. Future research should explore emergency teleophthalmology’s state-level acceptance, cost-effectiveness, and value for patients.

OCLC Number


Research Data and Supplementary Material