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Fortune J, Manikandan M, Harrington S, Hensey O, Kerr C, Koppe S, Kroll T, Lavelle G, Long S, MacLachlan M, Nolan D, Norris M, O'Reilly J, Owens M, Walsh A, Walsh M, Ryan JM. Understanding the use of digital technologies to provide disability services remotely during the COVID-19 pandemic; a multiple case study design. BMC Health Serv Res 2024; 24:323. [PMID: 38468253 DOI: 10.1186/s12913-024-10652-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/29/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Using digital technologies to provide services and supports remotely may improve efficiency and accessibility of healthcare, and support people with disabilities to live independently. This study aimed to explore the experience of using digital technologies to access and provide disability services and supports during the Covid-19 pandemic, from the perspective of people with disabilities, families and service providers. METHODS Using a multiple case study design, we purposively sampled three cases based on service user characteristics and geographical reach of the service. We conducted semi-structured interviews with 40 service users and service providers. Topic guides and analysis were informed by the Consolidated Framework for Implementation Research (CFIR). Analysis followed a largely deductive approach, using the CFIR constructs as a coding framework. A summary memo was developed for each case. Influence and strength of each construct was rated to identify constructs that influenced implementation of digital technologies. Ratings were compared across services to identify facilitators and barriers to implementation. RESULTS Service users and providers were positive about using digital technologies to access and provide disability services and supports remotely. Advantages over in-person delivery included reduced travel time, increased opportunity for peer support and peer learning, more choice and opportunity to participate in activities, and an enhanced sense of self while accessing services from the secure environment of their home. The urgency to identify new modes of service delivery to meet the needs of service users during Covid-19 was a strong facilitator but did not necessarily result in successful implementation. Other factors that were strong facilitators were the use of adaptations to enable service users to access the online service, service users' willingness to try the online service, service users' persistence when they encountered challenges, and the significant time and effort that service providers made to support service users to participate in the online service. Barriers to implementation included the complexity of accessing online platforms, poor design quality of online platforms, and organisations prioritising in-person delivery over online services. CONCLUSIONS These findings may allow service providers to leverage facilitators that support implementation of online disability services and supports.
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Affiliation(s)
- Jennifer Fortune
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Manjula Manikandan
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Thilo Kroll
- School of Nursing, Midwifery and Health Systems, UCD IRIS, University College Dublin, Dublin, Ireland
| | - Grace Lavelle
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Malcolm MacLachlan
- National Clinical Programme for People with Disability, Health Service Executive, Dublin, Ireland
- Assisting Living & Learning Institute and Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Meriel Norris
- College of Health, Medicine and Life Sciences, Brunel University London, London, Uxbridge, UB83PH, UK
| | | | - Mary Owens
- Central Remedial Clinic, Dublin, Ireland
| | - Aisling Walsh
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michael Walsh
- National Clinical Programme for People with Disability, Health Service Executive, Dublin, Ireland
| | - Jennifer M Ryan
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
- College of Health, Medicine and Life Sciences, Brunel University London, London, Uxbridge, UB83PH, UK.
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Labrie D, Lapierre N, Mortenson WB, Allaire AS, Schmouth MÈ, Routhier F. Exploratory study on the adaptation of online services offered to people with disabilities, in the context of the COVID-19 pandemic. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38462813 DOI: 10.1080/17483107.2024.2326593] [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: 01/04/2023] [Accepted: 02/26/2024] [Indexed: 03/12/2024]
Abstract
Aim: During the COVID-19 pandemic, many community organizations offering services to people with disabilities (PWD) changed their service delivery, switching from in-person to remote services. However, little is known about what it was like for organizations to quickly pivot their service delivery. The study explored barriers and facilitators to access community services for PWD and identified potential improvements to these services.Methods: The study used a mixed method, multiple case study design, which included a convenience sample of 27 participants recruited from four community organizations delivering services to PWD. Participating staff and members participated in six different focus groups and completed a questionnaire about their level of satisfaction regarding the evolution of the services. Inductive thematic analysis was conducted on the focus group data and the data from the questionnaires were descriptively analyzed.Results: The thematic analyses revealed four themes: "Succeeding in adapting the interventions to continue providing services", "Enjoying a lot of new things about the new online modality", "Key elements that have facilitated the transition" and "Facing some difficulties implementing online services". The median satisfaction score demonstrated that the participants were satisfied with the services. The success of these organizational changes relied on the adoption of new methods and approaches to service delivery.Conclusion: Through this study, barriers and facilitators that the organizations and their beneficiaries have experienced during the pandemic were identified as well as suggestions for improvement. The organizations consider maintaining online services beyond the pandemic to offer PWD easier access to community services.
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Affiliation(s)
- Dylane Labrie
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Nolwenn Lapierre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, Canada
| | - Anne-Sophie Allaire
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Marie-Ève Schmouth
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada
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Rechner L, Harvey K, Lancaster S, Horney J. How COVID-19 impacted people with disabilities: A qualitative study in Delaware. PUBLIC HEALTH IN PRACTICE 2023; 6:100424. [PMID: 37675127 PMCID: PMC10477798 DOI: 10.1016/j.puhip.2023.100424] [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: 04/27/2023] [Revised: 07/25/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023] Open
Abstract
Objectives The COVID-19 pandemic created unprecedented challenges for people with disabilities and their caregivers and service providers. An assessment of how the COVID-19 pandemic, and the public health response to it, inequitably impacted the health and well-being of people with disabilities is needed to improve preparedness for future public health emergencies. Interviews were conducted with the goal of documenting the impacts of COVID-19 on community-dwelling individuals in Delaware. Study design Qualitative interviews using a structured interview guide. Methods In November and December 2022, interviews were conducted with individuals with disabilities, their caregivers, governmental and non-profit service providers, and elected representatives in Delaware. Interviews focused on obtaining information related to COVID-related threats to maintaining good health, affordable and accessible housing, work, educational opportunities, transportation, and community belonging during the pandemic. Interview transcripts were inductively analyzed. Results Five themes were identified including changes to, or loss of, home-based medical and other services, changes in daily routines that impacted access to work and education, limits on access to transportation, financial strains and housing issues, and mental health concerns. Conclusions The COVID-19 pandemic impacted nearly all aspects of the lives of people with disabilities. COVID-19 presented long-term, existential threats to progress made toward independent living, meaningful work, and financial, health, and educational equity for people with disabilities.
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Affiliation(s)
- L. Rechner
- Epidemiology Program, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, United States
| | - K.E. Harvey
- Developmental Disabilities Council, 410 Federal Street, Dover, DE, 19904, United States
| | - S. Lancaster
- Developmental Disabilities Council, 410 Federal Street, Dover, DE, 19904, United States
| | - J.A. Horney
- Epidemiology Program, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, United States
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McBride-Henry K, Nazari Orakani S, Good G, Roguski M, Officer TN. Disabled people's experiences accessing healthcare services during the COVID-19 pandemic: a scoping review. BMC Health Serv Res 2023; 23:346. [PMID: 37024832 PMCID: PMC10078067 DOI: 10.1186/s12913-023-09336-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/23/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Disruptions to healthcare services during the COVID-19 pandemic are well-recognised problems. However, a dearth of research exists on disabled people's experiences with accessing these services. A scoping review was undertaken to identify and explore research on the experience of disabled people in accessing healthcare services between 2020 and 6 February 2023. METHODS PubMed, Web of Science, CINAHL, and OVID were employed to search for research that included the voice of disabled people, or their parents or caregivers. Over two distinct phases, a total of 2,201 articles were reviewed according to article titles, keywords, and abstracts. Eighty-one studies were identified that met the inclusion criteria; these were reviewed in full. RESULTS Eighteen studies specifically described the experiences of accessing healthcare or disability services, and sixty-three raised healthcare challenges as a secondary consideration. Many disabled people struggled to access healthcare services and felt they were invisible; as a result, individuals' mental health was negatively affected. Disabled people with compounding vulnerabilities were at the most risk of experiencing a lack of healthcare access. CONCLUSIONS There is an urgent need for research and policy that is responsive to disabled people's access to healthcare during the pandemic; currently many health policies are 'disability-blind' and exclude these members of the global community. Furthermore, to assist in creating disability-responsive research, funding needs to prioritise researchers within the disabled community.
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Affiliation(s)
- Karen McBride-Henry
- School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.
| | - Solmaz Nazari Orakani
- School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Gretchen Good
- School of Health Sciences, Massey University, Palmerston North, New Zealand
| | | | - Tara N Officer
- School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
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