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Harris SA, Harrison M, Hazell-Raine K, Wade C, Eapen V, Kohlhoff J. Patient navigation models for mental health of parents expecting or caring for an infant or young child: A systematic review. Infant Ment Health J 2023. [PMID: 37422890 DOI: 10.1002/imhj.22075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/07/2023] [Accepted: 05/11/2023] [Indexed: 07/11/2023]
Abstract
Patient navigation (PN) aims to improve timely access to healthcare by helping patients to "navigate" complex service provision landscapes. PN models have been applied in diverse healthcare settings including perinatal mental health (PMH). However, the practice models and implementation of PN programs vary widely, and their impact on engagement with PMH services has not been systematically investigated. This systematic narrative review study aimed to (1) identify and describe existing PMH PN models, (2) understand their effectiveness in improving service engagement and clinical outcomes, (3) review patient and provider perceptions, and (4) explore facilitators and barriers to program success. A systematic search of published articles/reports describing PMH PN programs/service delivery models targeting parents in the period from conception to 5 years postpartum was conducted. In total, 19 articles describing 13 programs were identified. The analysis yielded a number of commonalities and differences across program settings, target populations, and the scope of the navigator role. While there was promising evidence to support the clinical efficacy and impact on service utilization of PN programs for PMH, the current evidence base is sparse. Further research evaluating the efficacy of such services, and facilitators and barriers to their success, is warranted.
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Affiliation(s)
- Sophia A Harris
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Michelle Harrison
- Parenting Research Centre, Melbourne, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Karen Hazell-Raine
- Faculty of Health, Charles Darwin University, Darwin, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- South Western Sydney Local Health District, Liverpool, Australia
| | - Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Ogourtsova T, Majnemer A, Brown A, Filliter HJ, Wittmeier K, Hanson J, O'Donnell M. Pediatric tele-coaching fidelity evaluation: Feasibility, perceived satisfaction and usefulness of a new measure. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1057641. [PMID: 36896250 PMCID: PMC9989194 DOI: 10.3389/fresc.2023.1057641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023]
Abstract
Background To promote and ensure coaches' fidelity in delivering an online health coaching program to parents of children with suspected developmental delay, we developed and implemented a novel coaching fidelity rating tool, CO-FIDEL (COaches Fidelity in Intervention DELivery). We aimed to (1) Demonstrate CO-FIDEL's feasibility in evaluating coaches' fidelity and its change over time; and (2) Explore coaches' satisfaction with and usefulness of the tool. Methods In an observational study design, coaches (n = 4) were assessed using the CO-FIDEL following each coaching session (n = 13-14 sessions/parent-participant) during the pilot phase of a large randomized clinical trial involving eleven (n = 11) parent-participants. Outcome measures included subsections' fidelity measures, overall coaching fidelity, and coaching fidelity changes over time analyzed using descriptive and non-parametric statistics. In addition, using a four-point Likert Scale and open-ended questions, coaches were surveyed on their satisfaction and preference levels, as well as facilitators, barriers, and impacts related to the use of CO-FIDEL. These were analyzed using descriptive statistics and content analysis. Results One hundred and thirty-nine (n = 139) coaching sessions were evaluated with the CO-FIDEL. On average, overall fidelity was high (88.0 ± 6.3 to 99.5 ± 0.8%). Four coaching sessions were needed to achieve and maintain a ≥ 85.0% fidelity in all four sections of the tool. Two coaches showed significant improvements in their coaching skills over time in some of the CO-FIDEL sections (Coach B/Section 1/between parent-participant B1 and B3: 89.9 ± 4.6 vs. 98.5 ± 2.6, Z = -2.74, p = 0.00596; Coach C/Section 4/between parent-participant C1 and C2: 82.4 ± 7.5 vs. 89.1 ± 4.1, Z = -2.66; p = 0.00758), and in overall fidelity (Coach C, between parent-participant C1 and C2: 88.67 ± 6.32 vs. 94.53 ± 1.23, Z = -2.66; p = 0. 00758). Coaches mainly reported moderate-high satisfaction with and usefulness of the tool, and pointed out areas of improvement (e.g., ceiling effect, missing elements). Conclusions A new tool ascertaining coaches' fidelity was developed, applied, and shown to be feasible. Future research should address the identified challenges and examine the psychometric properties of the CO-FIDEL.
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Affiliation(s)
- Tatiana Ogourtsova
- Jewish Rehabilitation Hospital, Laval, QC, Canada.,Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Annette Majnemer
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,Montreal Children's Hospital, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Amelie Brown
- Montreal Children's Hospital, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Helen Jillian Filliter
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada.,Autism Team, IWK Health Centre, Halifax, NS, Canada
| | - Kristy Wittmeier
- Rehabilitation Centre for Children, Winnipeg, MB, Canada.,Department of Pediatrics and Child Health Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Jessica Hanson
- Jewish Rehabilitation Hospital, Laval, QC, Canada.,Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Maureen O'Donnell
- Provincial Health Services Authority BC, Vancouver, BC, Canada.,Faculty of Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Hurtubise K, Pratte G, Hamel C, Clapperton I, Camden C. Rethinking early intervention rehabilitation services for children with motor difficulties: engaging stakeholders in the conceptualization of telerehabilitation primary care. Disabil Rehabil 2022; 44:6749-6758. [PMID: 34473587 DOI: 10.1080/09638288.2021.1972173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Rehabilitation services for children with mild motor difficulties are limited. Telehealth could be a novel avenue through which to provide these services. With the input of various stakeholder groups, this study aimed to develop a logic model for a new primary care telerehabilitation intervention and to identify influencing implementation factors. METHODS AND MATERIALS A participatory research design was used. A logic model, developed in consultation with five healthcare managers, was discussed with four stakeholder groups. Focus groups were conducted with clinicians (n = 9), pediatric healthcare managers (n = 5), and technology information consultants (n = 2), while parents (n = 4) were interviewed to explore their perceptions of the proposed intervention, and factors influencing implementation. Transcribed discussions were analyzed using reflexive thematic analysis. RESULTS Stakeholders supported the delivery of telerehabilitation services for children with mild motor difficulties. Although agreement was generated for each logic model component, important recommendations were voiced related to service relevance and sustainability, parent and community capacity building, and platform dependability, security, and support. Identified factors influencing the implementation encompassed consumer, provider, technological, systemic and contextual barriers and facilitators. Strategies to address them were also suggested. CONCLUSION This study demonstrates the value of, and a process to engage stakeholders in the designing of pediatric telerehabilitation services and its implementation.IMPLICATIONS FOR PRACTICEPediatric telerehabilitation service are complex interventions which operate in complicate systems.Designing telerehabilitation services with stakeholders is recommended, yet how to do so often not clear.This study demonstrated that the development of a logic model can provide a systematic framework to helps guide the co-design process with stakeholders.Resulting recommendation underscored a broader vision for the intervention and identified crucial factors and strategies required for its successful implementation and sustainability.
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Affiliation(s)
- Karen Hurtubise
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Gabrielle Pratte
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Caroline Hamel
- Centre Intégré Universitaire de Santé et Services Sociaux de l'Estrie Centre Hospitalier de l'Université de Sherbrooke, Sherbrooke, Canada
| | - Irma Clapperton
- Centre Intégré Universitaire de Santé et Services Sociaux de l'Estrie Centre Hospitalier de l'Université de Sherbrooke, Sherbrooke, Canada
| | - Chantal Camden
- Faculté de médecine et sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada.,Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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Bui TA, Pohl M, Rosenfelt C, Ogourtsova T, Yousef M, Whitlock K, Majnemer A, Nicholas D, Demmans Epp C, Zaiane O, Bolduc FV. Identifying Potential Gamification Elements for A New Chatbot for Families With Neurodevelopmental Disorders: User-Centered Design Approach. JMIR Hum Factors 2022; 9:e31991. [PMID: 35984679 PMCID: PMC9440405 DOI: 10.2196/31991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chatbots have been increasingly considered for applications in the health care field. However, it remains unclear how a chatbot can assist users with complex health needs, such as parents of children with neurodevelopmental disorders (NDDs) who need ongoing support. Often, this population must deal with complex and overwhelming health information, which can make parents less likely to use a software that may be very helpful. An approach to enhance user engagement is incorporating game elements in nongame contexts, known as gamification. Gamification needs to be tailored to users; however, there has been no previous assessment of gamification use in chatbots for NDDs. OBJECTIVE We sought to examine how gamification elements are perceived and whether their implementation in chatbots will be well received among parents of children with NDDs. We have discussed some elements in detail as the initial step of the project. METHODS We performed a narrative literature review of gamification elements, specifically those used in health and education. Among the elements identified in the literature, our health and social science experts in NDDs prioritized five elements for in-depth discussion: goal setting, customization, rewards, social networking, and unlockable content. We used a qualitative approach, which included focus groups and interviews with parents of children with NDDs (N=21), to assess the acceptability of the potential implementation of these elements in an NDD-focused chatbot. Parents were asked about their opinions on the 5 elements and to rate them. Video and audio recordings were transcribed and summarized for emerging themes, using deductive and inductive thematic approaches. RESULTS From the responses obtained from 21 participants, we identified three main themes: parents of children with NDDs were familiar with and had positive experiences with gamification; a specific element (goal setting) was important to all parents, whereas others (customization, rewards, and unlockable content) received mixed opinions; and the social networking element received positive feedback, but concerns about information accuracy were raised. CONCLUSIONS We showed for the first time that parents of children with NDDs support gamification use in a chatbot for NDDs. Our study illustrates the need for a user-centered design in the medical domain and provides a foundation for researchers interested in developing chatbots for populations that are medically vulnerable. Future studies exploring wide range of gamification elements with large number of potential users are needed to understand the impact of gamification elements in enhancing knowledge mobilization.
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Affiliation(s)
- Truong An Bui
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Megan Pohl
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Cory Rosenfelt
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Tatiana Ogourtsova
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital - Centre intégré de santé et de services sociaux de Laval (CISSS Laval), Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC, Canada
- School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences, Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Mahdieh Yousef
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Kerri Whitlock
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Annette Majnemer
- School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences, Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - David Nicholas
- Central and Northern Alberta Region, Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Carrie Demmans Epp
- EdTeKLA Research Group, Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | - Osmar Zaiane
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | - François V Bolduc
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Gardiner E, Wong V, Lin G, Miller AR. Terminology and descriptions of navigation and related practices for children with neurodisability and their families: a scoping review. BMC Health Serv Res 2022; 22:214. [PMID: 35177039 PMCID: PMC8851781 DOI: 10.1186/s12913-022-07617-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with neurodisability (ND) represent a significant population with a demonstrated need for coordinated support. Patient navigation has a primary focus on: facilitating access to and connection amongst fragmented systems; as well as the provision of educational and emotional support. Given the distinct needs of children with ND and their families, programs built upon such core concepts could be of great benefit. The diversity of terminology encompassing navigation-related concepts and activities (e.g., care coordination, case management, family support), however, presents challenges to both practice and research. This scoping review examined the terminology and descriptions provided within published articles on navigation-type models for children with ND and their families. METHODS The scoping review was conducted according to the Joanna Briggs Institute methodology. A preliminary search was completed on PubMed (NCBI), MEDLINE (Ovid) and CINAHL (EBSCO) to identify initial search terms, upon which a full search strategy was developed and executed in MEDLINE (Ovid) and CINAHL (EBSCO). After screening records according to our inclusion and exclusion criteria, a full-text review of relevant articles was conducted and data extracted using a researcher-developed tool. Under close supervision by the research team, study selection was primarily performed by one author. RESULTS Of the 2597 papers identified, 33 were included in the final review. From the included papers, a total of 49 terms were extracted, 20 of which were unique. Across the diversity of terminology observed, articles provided detailed and rich descriptions characterized by four central domains, namely: (i) what navigation-related resources, supports and services aim to facilitate and (ii) provide; (iii) descriptions of their intended outcomes; as well as (iv) guiding principles. CONCLUSIONS This scoping review addresses a gap in our knowledge related to the specification of patient navigation and related supports as applied to the specific context of children with ND and their families. Given the particular needs of this population, we propose an empirically-informed integrative model that synthesizes the findings from this scoping review. We suggest that this framework can be used as a guide to the mindful characterization of how supports aiming to connect children and families to needed service are termed and described within future research and in practice.
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Affiliation(s)
- Emily Gardiner
- BC Children's Hospital Research Institute, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada. .,Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Vivian Wong
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.,Sunny Hill Health Centre at BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Grace Lin
- School of Medicine, Queen's University, 15 Arch Street, Kingston, ON, K7L 3N6, Canada
| | - Anton R Miller
- BC Children's Hospital Research Institute, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.,Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
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Schlichting T, Martins da Silva K, Silva Moreira R, Marques de Moraes MV, Cicuto Ferreira Rocha NA, Boyd RN, Neves Dos Santos A. Telehealth Program for Infants at Risk of Cerebral Palsy during the Covid-19 Pandemic: A Pre-post Feasibility Experimental Study. Phys Occup Ther Pediatr 2022; 42:490-509. [PMID: 35341469 DOI: 10.1080/01942638.2022.2057209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Aim: To verify the effects of a telerehabilitation program for infants at high risk for Cerebral Palsy (CP) during the COVID-19 pandemic.Method: Longitudinal study. Infants were aged 3-18 months corrected age, at risk of developmental delay. The General Movement Assessment or a neurologic examination were performed to identify the risk of CP. Motor function was assessed using the Gross Motor Function Measure-88 (GMFM-88) and the Alberta Infant Motor Scale (AIMS). Caregivers of infants at high risk of CP applied a home-based program supervised by a Physical therapist, five times a week over 12 weeks. The program included guidance for optimal positioning, optimization of goal-directed activities, environmental enrichment, and educational strategies.Results: 100 infants at risk for delayed motor development were recruited. Eighteen infants were classified at high risk of CP, and 10 families completed telerehabilitation (83% final retention rate). No adverse events were reported. Adherence to the telecare program was high (90%). The costs were low. We found increased scores for all dimensions and the total score of the GMFM-88, and the AIMS percentile at the end of the intervention. Most infants presented a clinically significant change for the GMFM-88.Conclusions: The telecare program was feasible.
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Affiliation(s)
- Tatiane Schlichting
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Kaitiana Martins da Silva
- Interdisciplinary Post-Graduation Program in Health Sciences, Federal University of São Paulo, Santos, São Paulo, Brazil
| | - Rafaela Silva Moreira
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | | | | | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Adriana Neves Dos Santos
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
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Aldiss S, Gibson F, Geoghegan S, Jewitt A, Elliott TK, Williams A, Wray J, Oulton K. 'We don't know what tomorrow will bring': Parents' experiences of caring for a child with an undiagnosed genetic condition. Child Care Health Dev 2021; 47:588-596. [PMID: 33709393 DOI: 10.1111/cch.12866] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/21/2020] [Accepted: 02/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Families and healthcare professionals caring for a sick or disabled child without a definitive diagnosis face unique challenges, particularly in relation to managing uncertainty, access to healthcare and coordination of care. There has been little research exploring the impact this has on families, their support needs or their experience of health services. METHODS This qualitative interview study included interviews with 14 mothers of children with undiagnosed genetic conditions. Transcripts were analysed using thematic analysis. RESULTS Four themes emerged, uncovering overlapping patterns in the data: (1) living with complexity amidst uncertainty-'We don't know what tomorrow will bring'; (2) parental role-'I do everything I can'; (3) parental role-'Not coping is not an option'; and (4) support needs-'There's lots of help that just isn't out there'. CONCLUSIONS The results clearly demonstrate the stresses faced when caring for a child with an undiagnosed genetic condition. Some themes are shared with the experience of other families caring for children with complex needs. However, parents were doing all they could for their child in the context of a life of uncertainty, with the absence of a clear diagnosis clearly causing additional stress that impacted on the whole family. Impact on their emotional and physical well-being was evident; they described times of feeling stressed, worried and anxious. They were confused due to being overloaded with information and frustrated by a lack of care coordination. Parents did not appear to prioritize their own well-being and held back their emotions to protect themselves and others. As a result, they had many unmet needs, particularly relating to emotional support.
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Affiliation(s)
- Susie Aldiss
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Faith Gibson
- School of Health Sciences, University of Surrey, Guildford, UK.,Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Sophie Geoghegan
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Jewitt
- Clinical Genetics Team, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tara Kerr Elliott
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Williams
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Ogourtsova T, O'Donnell M, De Souza Silva W, Majnemer A. Health coaching for parents of children with developmental disabilities: a systematic review. Dev Med Child Neurol 2019; 61:1259-1265. [PMID: 30883717 DOI: 10.1111/dmcn.14206] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2019] [Indexed: 11/28/2022]
Abstract
AIM To determine the level of evidence on the effectiveness of health coaching for parents of children with disabilities. METHOD A systematic review approach, comprised of a comprehensive, librarian-guided literature search; transparent study selection and data extraction; quality assessment; and synthesis of sufficiently similar data (per population, intervention nature, and overall level of evidence for each outcome using standard definitions) was undertaken. RESULTS Twenty-eight studies (13 randomized clinical trials) were included. Three health coaching approaches were identified: child-targeted (most commonly applied), parent-targeted, and a mixed approach. Overall, there is an insufficient-to-limited level of evidence regarding the effectiveness of these approaches. INTERPRETATION High-quality clinical trials using the parent-targeted coaching approach are warranted. WHAT THIS PAPER ADDS Health coaching parents of children with disabilities is an emergent practice. Child-targeted, parent-targeted, or mixed health coaching approaches exist. The child-targeted health coaching approach is currently most applied. Parents of children with autism spectrum disorder are the most common recipients.
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Affiliation(s)
- Tatiana Ogourtsova
- Department of Pediatrics, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.,School of Physical and Occupational Therapy, McGill University Faculty of Medicine, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Center, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Maureen O'Donnell
- Department of Pediatrics, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.,Child Health BC, Vancouver, British Columbia, Canada
| | - Wagner De Souza Silva
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University Faculty of Medicine, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Center, Montreal Children's Hospital, Montreal, Quebec, Canada
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Majnemer A, O'Donnell M, Ogourtsova T, Kasaai B, Ballantyne M, Cohen E, Collet JP, Dewan T, Elsabbagh M, Hanlon-Dearman A, Filliter JH, Lach L, McElroy T, McGrath P, McKellin W, Miller A, Patel H, Rempel G, Shevell M, Wittmeier K. BRIGHT Coaching: A Randomized Controlled Trial on the Effectiveness of a Developmental Coach System to Empower Families of Children With Emerging Developmental Delay. Front Pediatr 2019; 7:332. [PMID: 31440489 PMCID: PMC6694748 DOI: 10.3389/fped.2019.00332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/23/2019] [Indexed: 11/24/2022] Open
Abstract
Background: In preschool-aged children with, or at elevated risk for, developmental disabilities, challenges and needs arise from vulnerabilities linked to critical and newly emerging cognitive, speech, motor, behavioral, and social skills. For families, this can be a stressful period as they witness the gradual unfolding of their child's differences and await to receive care. Nationally and internationally, service delivery models during this critical period are not standardized nor are they nimble or sufficient enough, leading to long wait times, service gaps and duplications. Given these struggles, there is a need to examine whether "health coaching", a structured educational program that is deliverable by different and more accessible means, can be effective in empowering families, by delivering information, providing social supports, and decreasing the demands on the overwhelmed health and developmental services. The primary objective is to evaluate the feasibility and the effectiveness of a coaching intervention (in comparison to usual and locally available care), for parents of children with emerging developmental delays. Method/Design: A multi-centered pragmatic randomized controlled trial design will be used. Families will be recruited from a representative sample of those awaiting publicly-funded regional child health services for children with developmental delays in four Canadian provinces. The target sample size is 392 families with children aged 1.5 to 4.5 years at recruitment date. Families will be randomly assigned to receive either the BRIGHT Coaching intervention (coach supported, hardcopy and online self-managed educational resources: 14 sessions, 2 sessions every 4 weeks for 6-9 months) or usual care that is locally available. In addition to the feasibility and acceptability measures, outcomes related to family empowerment, parental satisfaction and efficacy with caregiver competency will be evaluated at baseline, post-treatment (8 months), and follow-up (12 months). Discussion: This manuscript presents the background information, design, description of the interventions and of the protocol for the randomized controlled trial on the effectiveness of BRIGHT Coaching intervention for families of children with emerging developmental delays. Trial Registration: ClinicalTrials.gov, U.S. National Library of Medicine, National Institutes of Health #NCT03880383, 03/15/2019. Retrospectively registered.
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Affiliation(s)
- Annette Majnemer
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Maureen O'Donnell
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Child-Health BC, Vancouver, BC, Canada
| | - Tatiana Ogourtsova
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada.,Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Bahar Kasaai
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | | | - Eyal Cohen
- Hospital for Sick Children, Toronto, ON, Canada
| | - Jean-Paul Collet
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Mayada Elsabbagh
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Ana Hanlon-Dearman
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Jillian Helen Filliter
- IWK Health Centre, Halifax, NS, Canada.,Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Lucyna Lach
- McGill University Health Centre, Montreal, QC, Canada
| | - Theresa McElroy
- Child-Health BC, Vancouver, BC, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - William McKellin
- Rare Disease Foundation, Vancouver, BC, Canada.,Department of Anthropology, University of British Columbia, Vancouver, BC, Canada
| | - Anton Miller
- Child and Family Research Institute, Vancouver, BC, Canada
| | - Hema Patel
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada.,McGill University Health Centre, Montreal, QC, Canada
| | - Gina Rempel
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Winnipeg, Winnipeg, MB, Canada
| | - Michael Shevell
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada.,McGill University Health Centre, Montreal, QC, Canada
| | - Kristy Wittmeier
- University of Manitoba, Winnipeg, MB, Canada.,Winnipeg Health Sciences Centre, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
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