{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:04:00Z","timestamp":1789625040200,"version":"build-2803163510"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A shortage of dermatologists in resource-limited settings often results in patients\u2019 receiving dermatologic management from other providers, who may lack expertise. In East Africa, teledermatology (TD) has recently emerged as a potential solution to improve dermatologic care and patient outcomes. In February 2023, TD was implemented at 12 ambulatory clinics in Kenya and Uganda with variable uptake. We explored the barriers and facilitators of TD uptake among primary care providers in these clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To elucidate user perceptions of factors affecting successful TD uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between August and November 2024, we conducted focus group discussions (FGDs) among providers recruited via purposive sampling. Providers included nurses, clinical officers, and physicians. FGDs were guided by the Theoretical Domains Framework, coded using an abductive approach, and analyzed using a Thematic Framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We conducted six FGDs across eight clinics with 23 participants in Kenya and 10 in Uganda. We found that TD use was generally influenced by its perceived degree of integration into routine care. Facilitating this integration was the perception of TD a professional duty that created learning opportunities for providers, improved patient care, and was supported by clinic leadership and culture. Technological integration was facilitated by factors such as TD software compatibility with providers\u2019 mobile devices. Conversely, TD was perceived as burdensome when poorly integrated into existing workflows. This included non-integration into existing electronic medical record systems, non-availability on the clinics\u2019 computers, and the absence of automated reminders about TD feedback. Participant recommendations included providing professional incentives for TD use \u2013 such as Continuing Medical Education credit \u2013 and integrating TD into the clinics\u2019 electronic medical record systems and devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among primary care providers in Kenya and Uganda, TD use was facilitated by integration into routine care and hindered by technological and structural barriers that increased workload burden. The challenges of TD non-integration represented an \u201cactivation energy\u201d that could be overcome by drivers of professional obligation, including perceptions of TD as a professional duty. Thus, enhancing TD use should target context-specific interventions, provider motivations, and technological infrastructures. Future studies should also assess patients\u2019 perspectives on TD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ced\/llag407","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:34:54Z","timestamp":1789623294000},"source":"Crossref","is-referenced-by-count":0,"title":["What Will it Take to Scale-Up Teledermatology? Providers\u2019 Perspectives in Kenya and Uganda"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6985-6072","authenticated-orcid":false,"given":"Chloe","family":"Sales","sequence":"first","affiliation":[{"name":"University of California , San Francisco ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1968-3916","authenticated-orcid":false,"given":"Toby","family":"Maurer","sequence":"additional","affiliation":[{"name":"Indiana University , Indianapolis ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonya","family":"Ahuja","sequence":"additional","affiliation":[{"name":"University of Washington , Seattle ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merridy","family":"Grant","sequence":"additional","affiliation":[{"name":"Curtin enAble Institute, Curtin University , Perth ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Chemtai","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access To Healthcare (AMPATH), Moi Teaching and Referral Hospital , Eldoret ,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celestine","family":"Lagat","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access To Healthcare (AMPATH), Moi Teaching and Referral Hospital , Eldoret ,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Frances","family":"Nalubega","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute (IDI), Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Nansereko","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute (IDI), Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Achieng","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute (IDI), Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyne","family":"Rotich","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access To Healthcare (AMPATH), Moi Teaching and Referral Hospital , Eldoret ,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Odhiambo","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access To Healthcare (AMPATH), Moi Teaching and Referral Hospital , Eldoret ,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Musinguzi","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Mulago National Referral Hospital , Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5010-1369","authenticated-orcid":false,"given":"Samson","family":"Kiprono","sequence":"additional","affiliation":[{"name":"Department of Medicine, Moi University , Eldoret ,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Felker","sequence":"additional","affiliation":[{"name":"Indiana University , Indianapolis ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid","family":"Collier","sequence":"additional","affiliation":[{"name":"University of Washington , Seattle ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Martin","sequence":"additional","affiliation":[{"name":"University of California , San Francisco ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aggrey","family":"Semeere","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute (IDI), Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,17]]},"container-title":["Clinical and Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llag407\/71164752\/llag407.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llag407\/71164752\/llag407.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:34:54Z","timestamp":1789623294000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ced\/advance-article\/doi\/10.1093\/ced\/llag407\/8808319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ced\/llag407","relation":{},"ISSN":["0307-6938","1365-2230"],"issn-type":[{"value":"0307-6938","type":"print"},{"value":"1365-2230","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"article-number":"llag407"}}