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Nematifard T, Arsalani N, Nourozi Tabrizi K, Fallahi-Khoshknab M, Borimnejad L. Improvement of family-centered care in the pediatric rehabilitation ward: a participatory action research. Front Pediatr 2024; 12:1325235. [PMID: 38978840 PMCID: PMC11228933 DOI: 10.3389/fped.2024.1325235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/02/2024] [Indexed: 07/10/2024] Open
Abstract
Background and aim The improved life expectancy of children with disability in recent years has led to their increased request for using lifelong rehabilitation services. Family-centered care (FCC) is a model with potential positive effects on the rehabilitation of children with disability. The present study aimed at improving FCC in the pediatric rehabilitation ward. Methods This participatory action research was conducted in 2021-2023 in the pediatric rehabilitation ward of a hospital in Tehran, Iran. Participants were 16 rehabilitation staff and 48 mothers recruited via convenient and purposive sampling methods. Data were collected using semi-structured interviews, focus group discussions, and the 20-item and the 27-item Measures of the Processes Of Care (MPOC). Data were analyzed using qualitative content analysis as well as the Kolmogorov-Smirnov and the Wilcoxon's tests. Findings The major barrier to the implementation of FCC was staff and family limited knowledge about the importance and the benefits of FCC and the best facilitator to change was improvement of their knowledge. Therefore, an action plan based on staff and family education was designed and implemented. Participants' positive experiences of the plan were improvement of satisfaction, knowledge, collaboration, and coordination in care and their negative experiences were educational problems and dissatisfaction with the ward atmosphere. The strengths of the plan were adequate number of staff, long enough hospital stay of children, chronic course of disability, and mothers' previous experiences. Its weaknesses were the long course of a single action plan cycle, exclusive focus on education, and the high risk of plan termination after the study. The practical problems of the study were also small physical space of the ward, transfer of some trained staff to other wards, and child discharge from the hospital. Conclusion Staff and family limited knowledge about the importance and the benefits of FCC is a major barrier to effective FCC. Continuous education as well as family and staff collaboration may improve FCC in pediatric rehabilitation ward.
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Affiliation(s)
- Taban Nematifard
- Nursing and Midwifery Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Narges Arsalani
- Iranian Research Center on Aging, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kian Nourozi Tabrizi
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Leili Borimnejad
- Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Mestre TD, Lopes MJ, Mestre DM, Ferreira RF, Costa AP, Caldeira EV. Impact of family-centered care in families with children with intellectual disability: A systematic review. Heliyon 2024; 10:e28241. [PMID: 38560242 PMCID: PMC10981057 DOI: 10.1016/j.heliyon.2024.e28241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
Background Family-Centered Care (FCC) is an approach to healthcare planning, delivery and evaluation, based on beneficial partnerships between health professionals, patients and families. FCC may be particularly relevant for families with children with intellectual disability (ID), given their needs of continuum care. Objective To identify which components of the FCC are practiced and which health outcomes are considered effective in families with children with ID. Method A systematic review guided by the PRISMA STATEMENT 2020 approach and the STROBE reporting guidelines was performed on specific databases through the EBSCOhost Web platform: MEDLINE with Full Text, CINAHL PLUS with Full Text, Academic Search Complete and Psychology and Behavioral Sciences Collection. Peer-reviewed articles published in English or Portuguese languages from 2018 to September 2023 were retrieved. Methodological quality was established using the Quality Assessment Tool for Observational, Cohort and Cross-Sectional Studies - NHLBI, NIH. Results Ten studies met the eligibility criteria and were synthetized. The results revealed nine components, reflecting the way FCC was developed: shared decision-making; family education; respect for culture; family engagement; recognition of the family's needs, characteristics and interests; specialized care support; social and emotional support; family functionality; and family seen as a unit. The health outcomes demonstrate effective gains in improving children's health through family satisfaction with health services. Also achieved psychological and social benefits, with improved family well-being and quality of life, favoring family empowerment. Conclusions The evidence suggests that FCC components involves an effective partnership between the family and health professionals as the main key in developing care plans, as well as the experience that the family unit brings to the delivery of care. FCC approach include all family members as decision-makers, providing emotional, physical and instrumental levels of support. Health outcomes emerged in three strands; for children with ID, families and health services.
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Affiliation(s)
- Teresa Dionísio Mestre
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Manuel José Lopes
- Comprehensive Health Research Centre [CHRC], Portugal
- University of Évora – Health Department, Portugal
| | | | - Rogério Ferrinho Ferreira
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Ana Pedro Costa
- Comprehensive Health Research Centre [CHRC], Portugal
- Local Health Unit of Lower Alentejo [ULSBA], Beja, Portugal
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Opoku MP, Pearson E, Elhoweris H, Alhosani N, Mustafa A, Efstratopoulou M, Takriti R. Fidelity of family centered care model to early disability diagnosis and rehabilitation in the United Arab Emirates. PLoS One 2024; 19:e0301094. [PMID: 38574099 PMCID: PMC10994312 DOI: 10.1371/journal.pone.0301094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The role of parents in supporting early intervention for young children with disabilities is critical. Indeed, models of family centered care (FCC), which emphasis strong partnerships between health professionals and families in disability health services delivery are now widely associated with best practice. While FCC is consistently argued to be an appropriate model for disability service delivery, its utilization is limited primarily to Western countries such as Australia and the United States. Countries such as the United Arab Emirates (UAE) have prioritized early childhood development and are thus in search of best practices for delivery of early intervention for children and their families. OBJECTIVE The aim of this study was to explore the appropriateness of the FCC model in disability service delivery in the UAE. This study was conducted from the perspectives of health professionals who are involved in disability diagnosis, referral and ongoing support for families and children with disabilities. METHOD A total of 150 health professionals were recruited from health facilities, rehabilitation centers and schools in the Emirates of Abu Dhabi. The 27-item Measure of Process of Care for Service Providers (MPOC-SP) was used for data collection. The data were subjected to confirmatory factor analysis to confirm applicability of the model to this context. Multivariate analysis of variance and moderation analysis were also conducted, to ascertain the relationship between participants' satisfaction levels with their ability to diagnose, refer and provide on-going support and their likelihood of practicing key components of FCC. RESULT Computation of confirmatory factor analysis provided support for applicability of the MPOC-SP in the UAE context. Further inspection showed moderate to large correlations between the four components of FCC measured by MPOC-SP, providing further support for utilization of FCC in disability health service delivery in the UAE. CONCLUSION The study concludes with a call to policymakers in the UAE to consider developing disability health policy based on key components of FCC. This could be supplemented by development of training modules on FCC to upskill health professionals involved in disability diagnosis and rehabilitation.
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Affiliation(s)
- Maxwell Peprah Opoku
- Department of Special and Gifted Education, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Emma Pearson
- Curriculum & Methods of Instruction, United Arab Emirates University, Al Ain, United Arab Emirates
- Froebel Department of Primary and Early Childhood Education, Maynooth University, Maynooth, Ireland
| | - Hala Elhoweris
- Department of Special and Gifted Education, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Najwa Alhosani
- Curriculum & Methods of Instruction, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ashraf Mustafa
- Department of Special and Gifted Education, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maria Efstratopoulou
- Department of Special and Gifted Education, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rachael Takriti
- Curriculum & Methods of Instruction, United Arab Emirates University, Al Ain, United Arab Emirates
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Alharbi AA, Albalwi AA. Exploring the Influential Factors Impacting the Provision of Family-Centered Care for Children with Cerebral Palsy in Saudi Arabia. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1868. [PMID: 38136070 PMCID: PMC10741779 DOI: 10.3390/children10121868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
Family-centered care is widely considered as best practice in pediatric rehabilitation. We aimed to investigate parents' perception of the family-centeredness of health care services for their children with cerebral palsy (CP) using the Arabic Measure of Processes of Care-20 (AR-MPOC-20). We also explored factors related to the child (sex, secondary impairments, and gross motor classification system level) and environment (family and residential region) that may influence the family-centeredness of services in Saudi Arabia. This was a cross-sectional study of 223 children with CP (age 6 months-18.2 years, M = 6.2 + 3.7 years) and their parents. Generally, parents perceived services as less family-centered. The lowest average score was for 'Providing General Information' (M = 2.9 ± 1.5), while 'Respectful and Supportive Care' had the highest average (M = 4.6 ± 1.8). Factors influencing the provision of family-centered care included being a female child and a mother's educational level. In addition, all subscales of AR-MPOC-20 differed by region, p < 0.001, except for 'Providing Specific Information' which did not significantly differ by region p = 0.163. Clinicians should consider the families' need for information regarding their children's condition and available services, with special attention to the mothers of female children and mothers with low levels of education.
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Affiliation(s)
- Ahmad Abdullah Alharbi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia;
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Smart E, Nalder E, Trentham B, King G. "What their expectations could be": a narrative study of mothers and service providers in paediatric rehabilitation. Disabil Rehabil 2023; 45:3238-3251. [PMID: 36191330 DOI: 10.1080/09638288.2022.2127935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To better understand and visualise how and why mothers' and service providers' expectations for therapy can change over time spanning their journeys and careers in the paediatric rehabilitation system. METHODS Narrative analysis was used to construct two parallel collective stories that illustrate and explain phases and turning points of developing expectations. Five mothers and nine service providers participated in interviews discussing their expectations when new and more experienced with therapy. RESULTS Each collective story had five chapters illustrating how expectations became more relational, controllable, and informed. For mothers, the chapters were: (1) expecting therapy to be a saviour; (2) being turned away and alone; (3) expecting to advocate from necessity; (4) finding new solutions in the environment; and (5) expecting to combine mother and service provider expertise. For service providers, the chapters were: (1) expecting to rescue and fix; (2) searching for an alternative sense of professional worth; (3) expecting to lose control; (4) being the authentic self before expected self; and (5) expecting the unexpected. CONCLUSIONS Mothers' experiences with feeling alone and learning ways to modify their child's environments, and service providers' experiences with feeling inadequate and embracing authenticity, were essential to the developmental trajectories of expectations.Implications for Rehabilitation:Mapping expectations for therapy on a line graph shaped as a wave shows promise in reflecting the developmental trajectory of mothers' and service providers' expectations over time.Service providers should become aware of how to work with three distinct groups of mothers as determined by the phase of expectations for therapy they are currently experiencing (i.e., hyped, disillusioned, or enlightened).Therapy programmes can optimise expectations for therapy through redesigns that emphasise elements of networking, self-compassion, ethics, and authenticity.
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Affiliation(s)
- Eric Smart
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Barry Trentham
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Gillian King
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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Morera-Balaguer J, Lillo-Navarro C, de Oliveira-Sousa SL, Montilla-Herrador J, Escolar-Reina P, Rodríguez-Nogueira Ó, Medina-Mirapeix F. Parents of children with disabilities' perceptions regarding the quality of interaction with Health professionals working in early intervention: A qualitative descriptive study. J Clin Nurs 2023; 32:6519-6532. [PMID: 36380463 DOI: 10.1111/jocn.16580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to explore the perceptions of parents of children with physical disabilities concerning the quality of their interaction with health professionals in early intervention programs. BACKGROUND Despite the consensus on the need for Patient and Family-Centered Care, there are still difficulties when executing such care. The quality of interaction among patients, families, and professionals is essential to facilitate the implementation of the programs. DESIGN A qualitative descriptive study with thematic analysis using a Modified Grounded Theory approach. METHODS Data were collected through seven focus groups with 28 parents of children with physical disabilities who were undergoing early intervention programs in three centres. The study followed the COREQ guidelines and checklist. RESULTS Two themes emerged from the experiences: 'exchange of information and education', which included all the activities, procedures, exercises and skills taught by the professionals to help parents care for their child; and 'interpersonal skills', which focused on the way the professional relates with the child and the parents. Several subthemes emerged within each theme. CONCLUSIONS This study identified which elements of the professional-parent interaction are considered by parents when evaluating the quality of their interaction with the health care provider of their children. RELEVANCE TO CLINICAL PRACTICE The results of this study bring to light certain behaviours and interactions that health professionals should consider in order to improve the perceptions of parents of children with disabilities regarding the quality of interaction in the context of early childhood intervention. PATIENT OR PUBLIC CONTRIBUTION Parents contributed to the data collected. Early intervention professionals were involved in participant checking to ensure the rigour of the study.
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Affiliation(s)
| | - Carmen Lillo-Navarro
- Department of Pathology and Surgery and Center for Translational Research in Physical Therapy (CEIT), University Miguel Hernandez, Alicante, Spain
| | - Silvana-Loana de Oliveira-Sousa
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Joaquina Montilla-Herrador
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Pilar Escolar-Reina
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Óscar Rodríguez-Nogueira
- University of León, Health Sciences School, Nursing and Physical Therapy Department, León, Spain
| | - Francesc Medina-Mirapeix
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigacion Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
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Villegas VC, Bosak DL, Salgado Z, Phoenix M, Parde N, Teplicky R, Khetani MA. Diversified caregiver input to upgrade the Young Children's Participation and Environment Measure for equitable pediatric re/habilitation practice. J Patient Rep Outcomes 2023; 7:87. [PMID: 37639038 PMCID: PMC10462549 DOI: 10.1186/s41687-023-00627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Practitioner and family experiences of pediatric re/habilitation can be inequitable. The Young Children's Participation and Environment Measure (YC-PEM) is an evidence-based and promising electronic patient-reported outcome measure that was designed with and for caregivers for research and practice. This study examined historically minoritized caregivers' responses to revised YC-PEM content modifications and their perspectives on core intelligent virtual agent functionality needed to improve its reach for equitable service design. METHODS Caregivers were recruited during a routine early intervention (EI) service visit and met five inclusion criteria: (1) were 18 + years old; (2) identified as the parent or legal guardian of a child 0-3 years old enrolled in EI services for 3 + months; (3) read, wrote, and spoke English; (4) had Internet and telephone access; and (5) identified as a parent or legal guardian of a Black, non-Hispanic child or as publicly insured. Three rounds of semi-structured cognitive interviews (55-90 min each) used videoconferencing to gather caregiver feedback on their responses to select content modifications while completing YC-PEM, and their ideas for core intelligent virtual agent functionality. Interviews were transcribed verbatim, cross-checked for accuracy, and deductively and inductively content analyzed by multiple staff in three rounds. RESULTS Eight Black, non-Hispanic caregivers from a single urban EI catchment and with diverse income levels (Mdn = $15,001-20,000) were enrolled, with children (M = 21.2 months, SD = 7.73) enrolled in EI. Caregivers proposed three ways to improve comprehension (clarify item wording, remove or simplify terms, add item examples). Environmental item edits prompted caregivers to share how they relate and respond to experiences with interpersonal and institutional discrimination impacting participation. Caregivers characterized three core functions of a virtual agent to strengthen YC-PEM navigation (read question aloud, visual and verbal prompts, more examples and/or definitions). CONCLUSIONS Results indicate four ways that YC-PEM content will be modified to strengthen how providers screen for unmet participation needs and determinants to design pediatric re/habilitation services that are responsive to family priorities. Results also motivate the need for user-centered design of an intelligent virtual agent to strengthen user navigation, prior to undertaking a community-based pragmatic trial of its implementation for equitable practice.
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Affiliation(s)
- Vivian C Villegas
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | - Dianna L Bosak
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | - Zurisadai Salgado
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | - Michelle Phoenix
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, USA
| | - Natalie Parde
- Department of Computer Science, University of Illinois Chicago, Chicago, IL, USA
| | - Rachel Teplicky
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, USA
| | - Mary A Khetani
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA.
- Department of Occupational Therapy, University of Illinois Chicago, 1919 West Taylor Street, Room 316A, Chicago, IL, 60612-7250, USA.
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Rizk S, Kaelin VC, Sim JGC, Murphy NJ, McManus BM, Leland NE, Stoffel A, James L, Barnekow K, Papautsky EL, Khetani MA. Implementing an Electronic Patient-Reported Outcome and Decision Support Tool in Early Intervention. Appl Clin Inform 2023; 14:91-107. [PMID: 36724883 PMCID: PMC9891850 DOI: 10.1055/s-0042-1760631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE The aim of the study is to identify and prioritize early intervention (EI) stakeholders' perspectives of supports and barriers to implementing the Young Children's Participation and Environment Measure (YC-PEM), an electronic patient-reported outcome (e-PRO) tool, for scaling its implementation across multiple local and state EI programs. METHODS An explanatory sequential (quan > QUAL) mixed-methods study was conducted with EI families (n = 6), service coordinators (n = 9), and program leadership (n = 7). Semi-structured interviews and focus groups were used to share select quantitative pragmatic trial results (e.g., percentages for perceived helpfulness of implementation strategies) and elicit stakeholder perspectives to contextualize these results. Three study staff deductively coded transcripts to constructs in the Consolidated Framework for Implementation Research (CFIR). Data within CFIR constructs were inductively analyzed to generate themes that were rated by national early childhood advisors for their relevance to longer term implementation. RESULTS All three stakeholder groups (i.e., families, service coordinators, program leadership) identified thematic supports and barriers across multiple constructs within each of four CFIR domains: (1) Six themes for "intervention characteristics," (2) Six themes for "process," (3) three themes for "inner setting," and (4) four themes for "outer setting." For example, all stakeholder groups described the value of the YC-PEM e-PRO in forging connections and eliciting meaningful information about family priorities for efficient service plan development ("intervention characteristics"). Stakeholders prioritized reaching families with diverse linguistic preferences and user navigation needs, further tailoring its interface with automated data capture and exchange processes ("process"); and fostering a positive implementation climate ("inner setting"). Service coordinators and program leadership further articulated the value of YC-PEM e-PRO results for improving EI access ("outer setting"). CONCLUSION Results demonstrate the YC-PEM e-PRO is an evidence-based intervention that is viable for implementation. Optimizations to its interface are needed before undertaking hybrid type-2 and 3 multisite trials to test these implementation strategies across state and local EI programs with electronic data capture capabilities and diverse levels of organizational readiness and resources for implementation.
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Affiliation(s)
- Sabrin Rizk
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, United States
| | - Vera C. Kaelin
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Julia Gabrielle C. Sim
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Natalie J. Murphy
- Department of Health Systems, Management, and Policy, University of Colorado, Aurora, Colorado, United States
| | - Beth M. McManus
- Department of Health Systems, Management, and Policy, University of Colorado, Aurora, Colorado, United States
| | - Natalie E. Leland
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Ashley Stoffel
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, United States
| | - Lesly James
- Department of Occupational Therapy, Lenoir-Rhyne University, Columbia, South Carolina, United States
| | - Kris Barnekow
- Department of Occupational Therapy, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, United States
| | - Elizabeth Lerner Papautsky
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Mary A. Khetani
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, United States,Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada,Address for correspondence Mary A. Khetani, ScD, OTR/L Department of Occupational Therapy, University of Illinois Chicago1919 West Taylor Street, Room 316A, Chicago, IL 60612-7250United States
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Popova ES, O'Brien JC, Taylor RR. Communicating With Intention: Therapist and Parent Perspectives on Family-Centered Care in Early Intervention. Am J Occup Ther 2022; 76:23327. [PMID: 35861628 DOI: 10.5014/ajot.2022.049131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Responsive communication is critical to ensuring family-centered care in early intervention (EI). The Intentional Relationship Model (IRM) offers a framework for examining therapist-parent communication and offers strategies for supporting therapist responsiveness. OBJECTIVE To explore family-centered care and therapists' communication in EI using the IRM. DESIGN Prospective descriptive study. SETTING Illinois EI program. PARTICIPANTS Convenience sample of 101 therapists and 19 parents enrolled in an EI program. Therapist disciplines included developmental (n = 24), occupational (n = 32), physical (n = 17), and speech (n = 28) therapy. OUTCOMES AND MEASURES Demographic questionnaire, Early Interventionist Self-Efficacy Scale, Early Intervention Parenting Self-Efficacy Scale, Measure of Processes of Care (MPOC)-Short Form, MPOC-Service Provider, Clinical Assessment of Modes (CAM), and Clinical Assessment of Suboptimal Interaction-Short Form (CASI-SF). RESULTS Therapists used family-centered practices specific to relationship building more frequently than information sharing (especially sharing of general information). Therapists used the empathizing, encouraging, and instructing modes most frequently in their interactions with families. Participants' scores on the MPOC, CAM, and CASI-SF were significantly correlated. CONCLUSIONS AND RELEVANCE Therapist-parent interactions were aligned with family-centered care. Opportunities for practitioners were identified in (1) sharing specific and general information and (2) expanding the use of collaborating, problem-solving, and advocating modes. What This Article Adds: In this study, we explored how the IRM can inform family-centered practices in EI through examination of therapists' interpersonal competency and therapeutic mode use.
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Affiliation(s)
- Evguenia S Popova
- Evguenia S. Popova, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Rush University, Chicago, IL;
| | - Jane C O'Brien
- Jane C. O'Brien, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, University of New England, Portland, ME
| | - Renée R Taylor
- Renée R. Taylor, PhD, is Professor, Department of Occupational Therapy, University of Illinois at Chicago
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Cross A, Soper AK, Tomas V, Grahovac D, Brocklehurst J, Kay D, Baptiste S, Gorter JW, Rosenbaum P. Exploring 10 years of dissemination of the F-words for Child Development: A multifaceted case study. Child Care Health Dev 2022; 48:751-762. [PMID: 35128716 DOI: 10.1111/cch.12983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is growing interest in exploring how to move research findings into practice. Since 2014, a team of families and researchers has been working to promote and study the dissemination of the "F-words for Child Development" (Function, Family, Fitness, Fun, Friends, and Future). This case study describes our dissemination strategies and uses the Diffusion of Innovation theory to understand the factors contributing to the uptake of the F-words-a function-promoting, strengths-based, and family-centred innovation in child health and development. METHODS Between November 2011 and November 2021, we collected data from multiple sources: our dissemination strategies, including affiliated documents/artefacts (e.g., videos and presentations) and evaluation data (e.g., surveys and Google/video analytics). We used a two-step analysis: (1) a chronological time series to describe the processes involved along with indicators of dissemination over time (e.g., increase knowledge and awareness); and (2) Diffusion of Innovation theory to explore the factors that contributed to the uptake of the F-words. RESULTS Multifaceted dissemination strategies were essential to raise awareness and increase families' and service providers' knowledge of the F-words. These included three primary strategies: (i) development and distribution of educational materials; (ii) presentations at educational meetings; and (iii) educational outreach visits. Additional strategies, such as the use of mass media, collaboration with early adopters/champions, and the involvement of family members further supported dissemination efforts. Diffusion of Innovation factors (innovation characteristics, time, social systems, and communication channels) all contributed to the uptake of this innovation. CONCLUSIONS Purposeful planned dissemination practice, to increase knowledge and awareness of an innovation, is an important step in the knowledge translation process. Over a period of 10 years, through the use of multiple dissemination strategies conducted in partnership with families and service providers, the F-words have spread globally. Diffusion of Innovation theory has served to help understand how and why the F-words are being shared and adopted around the world.
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Affiliation(s)
- Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Alice Kelen Soper
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Vanessa Tomas
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada
| | - Danijela Grahovac
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Julie Brocklehurst
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Diane Kay
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Sue Baptiste
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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11
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Benn NL, Birchard EA, Korompai EI, Davari M, Patel V, Brunton LK. Chronicling Research and Practice Evolution in Pediatric Physical Therapy. Pediatr Phys Ther 2022; 34:253-260. [PMID: 35385463 DOI: 10.1097/pep.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To observe research and practice trends in the journal, Pediatric Physical Therapy, as a proxy for the field. METHODS All issues of Pediatric Physical Therapy published from 1989 to 2019 were chronicled and summarized. Data were extracted regarding variables related to the issues and individual articles. RESULTS The most common diagnosis studied was cerebral palsy. The proportion of studies involving middle childhood and adolescent-aged participants increased over time. Cohort studies and exercise were the most common study type and intervention studied, respectively. The proportion of scientific content in the journal increased. CONCLUSION It is evident that pediatric physical therapy research has evolved over the past 30 years, both in rigor of articles published and in breadth of populations studied. WHAT THIS ADDS TO THE EVIDENCE This review adds an in-depth evaluation of trends in the literature, facilitating the profession's continued growth.
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Affiliation(s)
- Natasha L Benn
- School of Physical Therapy, Western University, London ON, Canada
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12
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Gmmash AS, Wynarczuk KD, Effgen SK. Parents' Perspectives on the Application of Home Activities in Early Intervention. Phys Occup Ther Pediatr 2022; 42:416-433. [PMID: 35037552 DOI: 10.1080/01942638.2022.2025514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Aims: This study explored parents' successes, challenges, and recommendations in relation to the application of home activities in early intervention.Methods: An electronic survey was prepared with Qualtrics software and distributed to parents of children with motor delays. Three open-ended questions were included at the end of the survey. Participants were the child's primary caregiver or guardian and their child must be currently receiving early intervention services or have received early intervention services from a physical or an occupational therapist in the United States in the past 5 years. Two coders used content analysis to analyze parents' responses to open-ended questions.Results: A total of 252 participants responded to at least one of the open-ended questions that were included in the survey. Responses were grouped into codes and categories that lead to the emergence of four themes. The themes indicated parent-reported challenges, successes, and recommendations in relation to team collaboration, individualization of activities, developmental gains, and parental support.Conclusions: The results of this study suggest that more focus should be directed toward parent-therapist partnership, multidisciplinary collaboration, and personalization of activities in early intervention. Parents-reported experiences and recommendation could assist early intervention personnel in advancing services provided for children with motor delays.
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Affiliation(s)
- Afnan S Gmmash
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Kimberly D Wynarczuk
- Department of Rehabilitation Sciences, Moravian University, Bethlehem, Pennsylvania, USA
| | - Susan K Effgen
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA
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13
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Aranbarri A, Stahmer AC, Talbott MR, Miller ME, Drahota A, Pellecchia M, Barber AB, Griffith EM, Morgan EH, Rogers SJ. Examining US Public Early Intervention for Toddlers With Autism: Characterizing Services and Readiness for Evidence-Based Practice Implementation. Front Psychiatry 2021; 12:786138. [PMID: 34975582 PMCID: PMC8716593 DOI: 10.3389/fpsyt.2021.786138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/24/2021] [Indexed: 12/15/2022] Open
Abstract
As the rates of Autism Spectrum Disorder (ASD) increase and early screening efforts intensify, more toddlers with high likelihood of ASD are entering the United States' (US') publicly funded early intervention system. Early intervention service delivery for toddlers with ASD varies greatly based on state resources and regulations. Research recommends beginning ASD-specific evidence-based practices (EBP), especially caregiver-implemented intervention, as early as possible to facilitate the development of social-communication skills and general learning. Translating EBP into practice has been challenging, especially in low-resourced areas. The main goal of this study was to obtain a more comprehensive understanding of public early intervention system structure, service delivery practices, and factors influencing EBP use for children with ASD in the US. Participants (N = 133) included 8 early intervention state coordinators in 7 states, 29 agency administrators in those states, 57 early intervention providers from those agencies, and 39 caregivers of children with ASD receiving services from those providers. Online surveys gathered stakeholder and caregiver perspectives on early intervention services as well as organizational factors related to EBP implementation climate and culture. Stakeholders identified key intervention needs for young children with ASD. In general, both agency administrators and direct providers reported feeling somewhat effective or very effective in addressing most needs of children with ASD. They reported the most difficulty addressing eating, sleeping, family stress, and stereotyped behaviors. Data indicate that children from families with higher income received significantly higher service intensity. While administrators and providers reported high rates of high-quality caregiver coaching (>60%), caregivers reported low rates (23%). Direct providers with more favorable attitudes toward EBP had greater EBP use. In turn, provider attitudes toward EBP were significantly associated with implementation leadership and culture at their agency. Results suggest that publicly funded early intervention programs in the US require additional resources and training for providers and leaders to support improved implementation climate and attitudes toward ASD EBPs. Results also suggest that more state system support is needed to increase use of ASD-specific EBP use, including high-quality caregiver coaching, to better serve toddlers with ASD. Recommendations for implementation strategies are addressed.
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Affiliation(s)
- Aritz Aranbarri
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
- Child and Adolescent Mental Health Area, Psychiatry and Psychology, Hospital Sant Joan de Déu Barcelona, Esplugues de Llobregat, Spain
- Child and Adolescent Mental Health Research Group, Psychiatry and Psychology, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Aubyn C. Stahmer
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Meagan R. Talbott
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Marykate E. Miller
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Amy Drahota
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - Melanie Pellecchia
- Center for Mental Health, Psychiatry Department, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States
| | - Angela B. Barber
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, AL, United States
| | | | - Elizabeth H. Morgan
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
- College of Education, California State University, Sacramento, CA, United States
| | - Sally J. Rogers
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
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14
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Hall JB, Woods ML, Luechtefeld JT. Pediatric Physical Therapy Telehealth and COVID-19: Factors, Facilitators, and Barriers Influencing Effectiveness-a Survey Study. Pediatr Phys Ther 2021; 33:112-118. [PMID: 34086621 PMCID: PMC8212883 DOI: 10.1097/pep.0000000000000800] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to identify the important factors, facilitators, and barriers for telehealth effectiveness as described by pediatric physical therapists, transitioning from in-person to telehealth during the COVID-19 pandemic. METHODS Pediatric physical therapists' responses to 3 open-ended questions and 1 multipart Likert Scale question from an anonymous survey were collected and analyzed using thematic analysis and descriptive statistics. RESULTS Three overarching themes (Caregiver Engagement, Technology, and Resilience) were identified and accompanied by 3 subthemes (Personal Attributes, Equity, and COVID-Specific Considerations). Themes were supported by the Likert Scale question with Child/Caregiver Interaction, Internet Connection, and Family Factors identified as the most important factors related to telehealth effectiveness. CONCLUSIONS High caregiver engagement and access to stable technology were most important for telehealth effectiveness. The telehealth service model met a need during the pandemic; however, emerging evidence suggests that it could be considered as an effective service delivery mode postpandemic.
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Affiliation(s)
- Jamie B. Hall
- Department of Physical Therapy (Drs Hall and Ms Woods), University of Missouri, Columbia, Missouri; Child's Play Therapy, LLC (Dr Luechtefeld), Clinton, Missouri
| | - Morgan L. Woods
- Department of Physical Therapy (Drs Hall and Ms Woods), University of Missouri, Columbia, Missouri; Child's Play Therapy, LLC (Dr Luechtefeld), Clinton, Missouri
| | - Jessica T. Luechtefeld
- Department of Physical Therapy (Drs Hall and Ms Woods), University of Missouri, Columbia, Missouri; Child's Play Therapy, LLC (Dr Luechtefeld), Clinton, Missouri
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15
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García-Ventura S, Mas JM, Balcells-Balcells A, Giné C. Family-centred early intervention: Comparing practitioners' actual and desired practices. Child Care Health Dev 2021; 47:218-227. [PMID: 33270265 DOI: 10.1111/cch.12834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Spain, as in other countries, there has been a deep and intense process of change towards the adoption and use of family-centred practices (FCPs) on early intervention (EI). Despite that several international organizations have recommended FCPs be embedded in EI services, researchers on this field have highlighted a recommendation-implementation gap, as well as the need to point investigation on practitioners and intervention variables involved. Consequently, our goals were to describe and compare the practitioners' appraisals on actual and desired practices in Spain and to explore the relationships between practitioners and intervention characteristics and the use of recommended practices. METHODS A survey including practitioner and intervention characteristics measures was used to obtain data needed. The actual and desired practices were explored through the Family Orientation of Community and Agency Services Scale. The participants were 119 EI Spanish practitioners whose programmes were in the first stages of different FCP implementation projects. RESULTS Practitioners reported actual practices to be less family centred than they would like, moderately in line with FCP. They reported desired practices as quite close to recommended practices. Intervention characteristics were related to actual practices, whereas practitioner characteristics were not. CONCLUSIONS The results suggest that the recommendation-implementation gap still exists in our context, as well as in other countries. Intervention characteristics seem to be one of the key elements significantly influencing actual practices, though additional research is needed. A comprehensive framework for implementation is needed to bridge the gap between recommendation practices and the use of these practices.
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Affiliation(s)
- Simón García-Ventura
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Joana Maria Mas
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Anna Balcells-Balcells
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Climent Giné
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
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