{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:14:40Z","timestamp":1758672880091,"version":"3.44.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":44,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100018654","name":"Greater Rochester Health Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018654","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study explores how rural substance use disorder (SUD) treatment providers in New York State adapted to pandemic\u2010era policy changes by rapidly adopting virtual care, identifying both challenges and opportunities to inform future practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thematic analysis of qualitative data from individual interviews with 12 SUD treatment providers and a focus group with an additional 6 providers in rural New York State was conducted between February and May 2021, capturing experiences with virtual care during the COVID\u201019 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The pandemic drove swift virtual care adoption, overcoming some rural barriers to SUD treatment access, like limited transportation and provider shortages. Providers noted enhanced flexibility, allowing more person\u2010centered care adapting to clients\u2019 logistical challenges. However, limitations emerged, including digital access disparities, reduced client accountability, and challenges establishing therapeutic relationships\u2014especially for new clients or group sessions. Virtual care effectiveness varied by treatment stage, client demographics, and access to reliable technology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although virtual care presents opportunities to expand rural SUD treatment access, a hybrid model combining in\u2010person and virtual care may better meet diverse client needs. Addressing technological inequities and tailoring approaches to individual circumstances are essential for future interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.70049","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T05:00:36Z","timestamp":1752642036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enduring lessons from the COVID\u201019 pandemic: Advancing virtual care for substance use disorders in rural America"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0433-772X","authenticated-orcid":false,"given":"Thomas M.","family":"LaPorte","sequence":"first","affiliation":[{"name":"Center for Human Services Research University at Albany  Albany New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"McGinnis","sequence":"additional","affiliation":[{"name":"Center for Human Services Research University at Albany  Albany New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Griffin","family":"Lacy","sequence":"additional","affiliation":[{"name":"Center for Human Services Research University at Albany  Albany New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.34540"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6619a1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2022.2079140"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468\u20102667(21)00159\u20106"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.26544"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010019\u201005232\u2010y"},{"key":"e_1_2_9_8_1","unstructured":"HedegaardH Mini\u00f1oAM WarnerM.Drug overdose deaths in the United States 1999\u20132019.U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics;2020.https:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db394\u2010H.pdf"},{"volume-title":"Urban\u2013rural differences in drug overdose death rates, 2020","year":"2022","author":"Rose SM","key":"e_1_2_9_9_1"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4148\/1051\u20100834.2315"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1044389418812417"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2019.1694536"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2024.116660"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11414\u2010012\u20109299\u20106"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.4450"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.11.015"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11414\u2010018\u20109611\u20101"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022\u2010006X.73.3.540"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2196\/36263"},{"journal-title":"The Conversation","article-title":"The opioid crisis is at its worst in rural areas. Can telemedicine help?","author":"Lister JJ","key":"e_1_2_9_20_1"},{"key":"e_1_2_9_21_1","unstructured":"ManzJ LongK MetteE.States rapidly build their telehealth capacity to deliver opioid use disorder treatment.NASHP;2022.https:\/\/nashp.org\/states\u2010rapidly\u2010build\u2010their\u2010telehealth\u2010capacity\u2010to\u2010deliver\u2010opioid\u2010use\u2010disorder\u2010treatment\/"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241258390"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11469\u2010021\u201000629\u20105"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2022.03.006"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.00803"},{"key":"e_1_2_9_26_1","first-page":"1097","article-title":"Social determinants of health and continuity of medications for opioid use disorder among patients receiving treatment in rural primary care settings","volume":"10","author":"Pham H","year":"2023","journal-title":"J Addict Med"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40429\u2010024\u201000551\u20105"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.23\u201000187"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961\u2010020\u201000598\u20106"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201900444"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.03.007"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.12574"},{"key":"e_1_2_9_33_1","unstructured":"Center for Connected Health Policy.COVID\u201019 telehealth coverage policies\u2014CCHP.March 2021. Accessed November 4 2024.https:\/\/www.cchpca.org\/resources\/covid\u201019\u2010telehealth\u2010coverage\u2010policies\/"},{"key":"e_1_2_9_34_1","unstructured":"Telehealth.HHS.gov.Billing for telehealth.Telehealth.HHS.gov.https:\/\/telehealth.hhs.gov\/providers\/billing\u2010and\u2010reimbursement"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.2196\/25835"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.10.011"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2023.209157"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108514"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109049"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108152"},{"key":"e_1_2_9_41_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Telehealth for the treatment of serious mental illness and substance use disorders. Rockville MD: National Mental Health and Substance Use Policy Laboratory SAMHSA; 2021. SAMHSA Publication No. PEP21\u201006\u201002\u2010001."},{"key":"e_1_2_9_42_1","unstructured":"U.S. Department of Agriculture Economic Research Service.rural\u2010urban continuum codes (RUCC) and rural\u2010urban commuting area (RUCA) codes.U.S. Department of Agriculture Economic Research Service. Published 2023. Accessed January 31 2025."},{"key":"e_1_2_9_43_1","unstructured":"Health Resources and Services Administration.FORHP eligible areas (rural health).Health Resources and Services Administration. Published 2023. Accessed January 31 2025.https:\/\/data.hrsa.gov\/Content\/Documents\/tools\/rural\u2010health\/forhpeligibleareas.pdf"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12743"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.6700"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1080\/24740527.2020.1785856"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.2196\/18848"},{"key":"e_1_2_9_48_1","unstructured":"U.S. Department of Health and Human Services.DEA and HHS extend COVID\u201019 telemedicine flexibilities through 2024.Substance Abuse and Mental Health Services Administration (SAMHSA). Published November 15 2024. Accessed May 13 2025.https:\/\/www.samhsa.gov\/about\/news\u2010announcements\/statements\/2024\/dea\u2010hhs\u2010extend\u2010telemedicine\u2010flexiblities\u2010through\u20102025"},{"key":"e_1_2_9_49_1","unstructured":"New York State Department of Health.Telehealth Policy Manual.NYS Department of Health; May 13 2024. Accessed May 13 2025.https:\/\/www.health.ny.gov\/health_care\/medicaid\/redesign\/telehealth\/"},{"key":"#cr-split#-e_1_2_9_50_1.1","unstructured":"U.S. Congress.Infrastructure Investment and Jobs Act (Investing in a New Vision for the Environment and Surface Transportation in America Act). HR 3684 117th Cong 1st Sess. Introduced June 4 2021 by Rep Peter DeFazio et al."},{"key":"#cr-split#-e_1_2_9_50_1.2","unstructured":"enacted as Pub L No. 117\u201058 Nov 15 2021. Accessed May 13 2025.https:\/\/www.congress.gov\/bill\/117th\u2010congress\/house\u2010bill\/3684"},{"key":"e_1_2_9_51_1","unstructured":"Benton Institute for Broadband & Society.NTIA's Role in Implementing the Broadband Provisions of the 2021 Infrastructure Investment and Jobs Act. Published November 16 2021. Accessed May 13 2025.https:\/\/www.benton.org\/headlines\/ntia%E2%80%99s\u2010role\u2010implementing\u2010broadband\u2010provisions\u20102021\u2010infrastructure\u2010investment\u2010and\u2010jobs\u2010act"}],"container-title":["The Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.70049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T11:23:14Z","timestamp":1758626594000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jrh.70049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":51,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/jrh.70049"],"URL":"https:\/\/doi.org\/10.1111\/jrh.70049","archive":["Portico"],"relation":{},"ISSN":["0890-765X","1748-0361"],"issn-type":[{"type":"print","value":"0890-765X"},{"type":"electronic","value":"1748-0361"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-02-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70049"}}