PROJECT SUMMARY/ABSTRACT Telehealth is defined as the remote provision of health care and education. Its use greatly increased as a result of the COVID-19 pandemic and is expected to continue being widely used. The problem is the lack of understanding on how to best offer telehealth to adolescents. This study will interview 105 adolescents to ask about their perspectives on the benefits of, challenges with, and suggestions for improving telehealth. Pediatric research regarding perspectives on telehealth focused primarily on parents/caregivers who offered opinions on behalf of their adolescents. Our preliminary qualitative study using surveys and interviews with parents/caregivers revealed that it was important to interview adolescents to better understand how to improve telehealth. We identified studies in the U.S.A. that interviewed 15 to 38 adolescents on benefits and challenges of telehealth but not on suggestions for improvement. We have established relationships with pediatrician offices that have participated in research with us in the past and that will assist with recruitment of adolescents in Genesee County, Michigan. A total of 105 individuals aged 14 to 17 will participate in a 1-hour online or telephone interview to offer their perspectives on telehealth. Questions as part of the interview will build on concepts in the “Telemedicine and doctor-patient communication” theoretical framework. Parents/caregivers will complete a survey to provide the socio- demographic information of their adolescent and household. Adolescents should have used any telehealth at least once over the past year to be eligible to participate. Qualitative analyses of the interview transcripts and quantitative analyses of surveys will take place. Four university students will be a part of the research team. Students will receive training on qualitative research and ethical issues, develop study materials, conduct interviews, perform qualitative and quantitative data analyses, and engage in manuscript writing for publication. They will present in at least one national conference. Through interviewing adolescents, the specific aims are to: 1) Describe the benefits of, challenges with, and suggestions for improving synchronous (i.e., video visits) and asynchronous (i.e., mobile applications) telehealth; 2) Compare benefits, challenges, and suggestions between adolescents of different socio- demographic groups; 3) Based on the findings from aims 1-2, develop a conceptual framework on factors that promote effective communication between adolescents and healthcare providers and subsequently improve health outcomes through telehealth. Understanding telehealth perspectives among adolescents can develop youth-specific health care improvements such as more effective communication with the healthcare provider. Future randomized- controlled trials developed based on the suggestions offered by the adolescents in the proposed study have great potential in improving youth’s satisfaction with health care and health outcomes.

PROJECT NARRATIVE This qualitative study will interview adolescents aged 14 to 17 years to ask about their perspectives on the benefits of, challenges with, and suggestions for improving telehealth such as video and telephone consultations. Parents rather than adolescents offered their views on telehealth in most prior research. Understanding the perspectives of adolescents can help improve communication with healthcare providers during remote visits and ultimately youth’s health.