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Hong S, Lee Y, Park W. Evaluating the delivery of physical activity for people with developmental disabilities using an online knowledge translation approach: part 1 - web accessibility. Disabil Rehabil Assist Technol 2024:1-9. [PMID: 38436068 DOI: 10.1080/17483107.2024.2322637] [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: 09/06/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
Background: Knowledge-to-action gap exists in delivering physical activity (PA) to people with developmental disabilities via online platforms. Although web-based platforms have great potential in facilitating the delivery of PA for this target group, the lack of knowledge regarding web accessibility poses a challenge in accessing PA-related information online.Objective: This study evaluates the delivery of PA in terms of web accessibility. It also aims to identify barriers and facilitators in delivering PA knowledge to people with developmental disabilities online to improve web accessibility for the target user group.Methods: The study employs a concurrent nested design incorporating both quantitative (web usability questionnaire) and qualitative data (in-depth interviews). Fifteen pairs of individuals consisting of a person with developmental disabilities and a primary caregiver participated in the study, and three web-based platforms were selected for web accessibility tests and in-depth interviews.Results: The nested analysis provides a quantitative comparison of web accessibility and identifies barriers and facilitators of delivering PA for the target user group from the web accessibility perspective. Conclusion: The study findings could inform the development of accessible online platforms that distribute health-related knowledge to populations with developmental disabilities. Additionally, they could help enhance the design of other platforms intended for these populations.
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Affiliation(s)
- San Hong
- Department of Industrial Engineering, Seoul National University, Seoul, Republic of Korea
| | - Yongho Lee
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Woojin Park
- Department of Industrial Engineering, Seoul National University, Seoul, Republic of Korea
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Barriers and enablers to the implementation of healthy lifestyle interventions for people with disability living in supported accommodation: A systematic review using the consolidated framework for implementation research. Disabil Health J 2023; 16:101442. [PMID: 36740546 DOI: 10.1016/j.dhjo.2023.101442] [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: 09/08/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND People with disability living in supported accommodation often experience significant health disparities, despite the availability of additional support. Healthy lifestyle interventions have been identified as one key health promotion strategy. Implementation science offers an opportunity to explore the factors that influence the efficacy and sustainability of these interventions, yet its application in this context has been underutilized. OBJECTIVE This systematic review synthesized the barriers and enablers to the implementation of healthy lifestyle interventions delivered to people with disability living in supported accommodation settings. METHODS A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search for relevant literature published between January 2011 and November 2021 was conducted across six databases. The findings of included studies were coded and analyzed according to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR) via deductive content analysis. RESULTS Five studies were included, and their findings were mapped to 21 out of 38 constructs under the CFIR. Interventions from each study delivered health promotion education and training to staff and/or people with disability. The most prominent determinants that influenced implementation success included an intervention's relevance and its flexibility to adapt to the needs of people with disability, alongside organizational resourcing, and stakeholder endorsement in supporting implementation. CONCLUSIONS The CFIR provided a systematic approach to explore the implementation of healthy lifestyle interventions. However, further research that is grounded in and guided by implementation science theories is warranted. Despite the scarcity of literature, several compelling, yet preliminary recommendations were drawn from the findings.
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Taggart L, Doherty AJ, Chauhan U, Hassiotis A. An exploration of lifestyle/obesity programmes for adults with intellectual disabilities through a realist lens: Impact of a 'context, mechanism and outcome' evaluation. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:578-593. [PMID: 33342030 DOI: 10.1111/jar.12826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 07/16/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obesity is higher in people with intellectual disabilities. AIMS There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond 'what works' and examine the 'context, mechanisms and outcomes' (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these programmes could be implemented within practice. METHOD We explored six-review papers and the individual lifestyle/obesity programmes that these papers reviewed using the CMO framework. RESULTS There were few theoretically underpinned, multi-component programmes that were effective in the short to long-term and many failed to explore the 'context and mechanisms'. We developed a logic model and engaged in two co-production workshops to refine this model. DISCUSSION Using a realist approach, programmes need to be underpinned by both individual and systems change theories, be multi-component, have a closer understanding of the interplay of the 'context and mechanisms', and co-designed using a logic model framework.
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Affiliation(s)
- Laurence Taggart
- Institute of Nursing & Health Research, Ulster University, Co Antrim, UK
| | - Alison Jayne Doherty
- Faculty of Health & Wellbeing, University of Central Lancashire (UCLan), Preston, UK
| | - Umesh Chauhan
- Faculty of Health & Wellbeing, University of Central Lancashire (UCLan), Preston, UK
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Bergström A, Ehrenberg A, Eldh AC, Graham ID, Gustafsson K, Harvey G, Hunter S, Kitson A, Rycroft-Malone J, Wallin L. The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature. Implement Sci 2020; 15:68. [PMID: 32854718 PMCID: PMC7450685 DOI: 10.1186/s13012-020-01003-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework. METHODS This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail. RESULTS The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated. CONCLUSIONS In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.
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Affiliation(s)
- Anna Bergström
- Department of Women’s and Children’s health, Uppsala Global Health Research on Implementation and Sustainability (UGHRIS), Uppsala, Sweden
- Institute for Global Health, University College London, London, UK
| | - Anna Ehrenberg
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Ann Catrine Eldh
- Department of Medicine and Health, Linköping University, Linköping, Sweden
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
| | - Ian D. Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kazuko Gustafsson
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- University Library, Uppsala University, Uppsala, Sweden
| | - Gillian Harvey
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Sarah Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Alison Kitson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Green Templeton College, University of Oxford, Oxford, UK
| | - Jo Rycroft-Malone
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancashire, UK
| | - Lars Wallin
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Department of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Spassiani NA, Meisner BA, Abou Chacra MS, Heller T, Hammel J. What is and isn’t working: Factors involved in sustaining community‐based health and participation initiatives for people ageing with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1465-1477. [DOI: 10.1111/jar.12640] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 05/22/2019] [Accepted: 06/04/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Natasha A. Spassiani
- School of Health & Social Care Edinburgh Napier University Edinburgh UK
- Department of Disability and Human Development University of Illinois at Chicago Chicago Illinois
| | | | - Megan S. Abou Chacra
- Surrey Place Toronto Ontario Canada
- Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Tamar Heller
- Department of Disability and Human Development, University Center of Excellence in Developmental Disabilities for the State of Illinois University of Illinois at Chicago Chicago Illinois
| | - Joy Hammel
- Department of Disability and Human Development University of Illinois at Chicago Chicago Illinois
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Kuijken NMJ, Vlot-van Anrooij K, van Schrojenstein Lantman-de Valk HMJ, Leusink G, Naaldenberg J, Nijhuis-van der Sanden MW. Stakeholder expectations, roles and responsibilities in Dutch health promotion for people with intellectual disabilities. Health Promot Int 2018; 34:e59-e70. [DOI: 10.1093/heapro/day059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Summary
This two-phase, qualitative study aims to obtain an overview of stakeholders in the network of people with intellectual disabilities (ID) and their perceived facilitating and hindering factors, expectations, and perceived roles and responsibilities with regard to health promotion. In phase 1, four workshops were conducted to provide insight into involved stakeholders. In phase 2, 29 semi-structured interviews were conducted with stakeholders regarding their views on health promotion. Data were analysed using stakeholder matrices and a combination of domain and thematic analysis. Daily caregivers were identified as the most important and influential stakeholders. Interviewed stakeholders perceived barriers to a healthy lifestyle as relating mainly to the person with ID and, although they stated that people with ID need support to be able to live healthily, there was ambiguity about roles and responsibilities for providing this support. Daily caregivers are not properly facilitated to support a healthy lifestyle. Stakeholders expressed the need for a culture change towards a greater health promotion ethos in care for people with ID. A facilitating context is needed in which the social network supports autonomy and offers opportunities to adapt to physical, social and emotional challenges. Stakeholders see the importance of, and are willing to support, healthy behaviour. They are hindered by a lack of a shared vision and united system in which all stakeholders know their roles and responsibilities. Promotion of a healthy lifestyle should be part of every service provider employee’s job and propagated throughout the organization as part of its mission and vision.
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Affiliation(s)
- N M J Kuijken
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - K Vlot-van Anrooij
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - H M J van Schrojenstein Lantman-de Valk
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - G Leusink
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - J Naaldenberg
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - M W Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of healthcare (IQ healthcare), Nijmegen, The Netherlands
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Friedman C, VanPuymbrouck L. Occupational Therapy in Medicaid Home and Community-Based Services Waivers. Am J Occup Ther 2018; 72:7202205120p1-7202205120p9. [PMID: 29426389 PMCID: PMC5807402 DOI: 10.5014/ajot.2018.024273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. METHOD Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. RESULTS In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. CONCLUSION Comparisons across states strengthen the profession's ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs.
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Affiliation(s)
- Carli Friedman
- Carli Friedman, PhD, is Director of Technical Assistance and Data Analysis, CQL | The Council on Quality and Leadership, Towson, MD;
| | - Laura VanPuymbrouck
- Laura VanPuymbrouck, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Rush University, Chicago, IL
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McIsaac JL, Warner G, Lawrence L, Urquhart R, Price S, Gahagan J, McNally M, Jackson LA. The application of implementation science theories for population health: A critical interpretive synthesis. AIMS Public Health 2018; 5:13-30. [PMID: 30083567 PMCID: PMC6070464 DOI: 10.3934/publichealth.2018.1.13] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 02/07/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Over the last decade, the field of implementation science (IS) has yielded an array of theoretical approaches to clarify and understand how factors influence the application and scaling-up of evidence-based practice in health care. These developments have led to questions about whether IS theories and frameworks might be of value to population health researchers and decision makers. The purpose of this research was to conduct a critical interpretive synthesis to explore, if, and how, key IS theories and frameworks might inform population health interventions aimed at reducing the burden of illness across populations. METHODS An initial list of theories and frameworks was developed based on previous published research and narrowed to focus on theories considered as formative for the field of IS. A standardized data extraction form was used to gather key features of the theories and critically appraise their relevance to population health interventions. RESULTS Ten theories were included in the review and six deemed most applicable to population health based on their consideration of broader contextual and system-level factors. The remaining four were determined to have less relevant components for population health due to their limited consideration of macro-level factors, often focusing on micro (individual) and meso (organizational) level factors. CONCLUSIONS Theories and frameworks are important to guide the implementation and sustainability of population health interventions. The articulation of meso level factors common in IS theories may be of value to interventions targeted at the population level. However, some of the reviewed theories were limited in their consideration of broader contextual factors at the macro level (community, policy or societal). This critical interpretive synthesis also found that some theories lacked provision of practical guidance to address interventions targeting structural factors such as key social determinants of health (e.g., housing, income).
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Affiliation(s)
- Jessie-Lee McIsaac
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Education, Mount Saint Vincent University, Canada
| | - Grace Warner
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Health, Dalhousie University, Canada
| | - Logan Lawrence
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Health, Dalhousie University, Canada
| | - Robin Urquhart
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Medicine, Dalhousie University, Canada
| | - Sheri Price
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Health, Dalhousie University, Canada
| | - Jacqueline Gahagan
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Health, Dalhousie University, Canada
| | - Mary McNally
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Medicine, Dalhousie University, Canada
- Faculty of Dentistry, Dalhousie University, Canada
| | - Lois A Jackson
- Healthy Populations Institute, Dalhousie University, Canada
- Faculty of Health, Dalhousie University, Canada
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O'Leary L, Taggart L, Cousins W. Healthy lifestyle behaviours for people with intellectual disabilities: An exploration of organizational barriers and enablers. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:122-135. [DOI: 10.1111/jar.12396] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Lisa O'Leary
- Scottish Learning Disabilities Observatory, Academic Unit for Mental Health & Wellbeing; Gartnavel Royal Hospital, University of Glasgow; Glasgow UK
| | - Laurence Taggart
- Institute of Nursing and Health Research; School of Nursing, Ulster University, Jordanstown Campus; Newtownabbey Northern Ireland UK
| | - Wendy Cousins
- Institute of Nursing and Health Research; School of Nursing, Ulster University, Jordanstown Campus; Newtownabbey Northern Ireland UK
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