背景:残疾儿童面临漫长的康复服务等待时间。在COVID-19大流行之前,在儿科康复中,远程医疗的采用率很低。由于COVID-19大流行的限制,儿科治疗师被要求迅速转向远程医疗,通常只有最少的训练。为了促进远程医疗采用所需的行为改变,需要提供适当的循证培训和支持。然而,缺乏支持有效实施此类培训的证据。针对儿科治疗师的培训干预和支持计划(TIPS)的成功实施,以增强以家庭为中心的远程康复(FCT)的采用,需要对实施和有效性进行评估。
目的:本研究旨在评估不同儿科康复设置中TIPS的实施情况,并评估TIPS的有效性。因为它与治疗师的收养有关,服务等待时间,家庭对服务质量的感知,和成本。
方法:这4年,泛加拿大研究涉及经理,儿科职业治疗师,物理治疗师,语言病理学家,以及来自8个省级司法管辖区20个地点的家庭。它将使用多种方法,prospective,混合类型3实施有效性设计。中断的时间序列将评估TIPS实施情况。TIPS将包括为期1个月的培训干预,包括自定进度的学习模块和网络研讨会,接下来是为期11个月的支持计划,包括每月的现场会议和虚拟实践社区的访问。纵向混合模型将用于分析治疗师在10个时间点收集的FCT的采用和保真度的指标。确定采用和忠诚的障碍和促进者,定性数据将在实施过程中收集,并使用演绎归纳专题方法进行分析。为了评估有效性,准实验前测-后测设计将使用问卷来评估TIPS在服务中的有效性,治疗师,和家庭水平。广义线性混合效应模型将用于数据分析。经理,治疗师,和家庭访谈将在实施后进行,并使用反思性主题分析进行分析。最后,将收集成本数据来计算公共系统和社会成本。
结果:已获得2个司法管辖区(2022年2月和2022年7月)的道德批准;其他司法管辖区正在等待批准。总的来说,已经招募了20个网站,数据收集预计将于2022年9月开始,预计将于2024年9月完成。数据分析将与数据收集同时进行,结果在整个研究期间传播。
结论:这项研究将获得有关针对TIPS的儿科治疗师的有效性的知识,以提高FCT在儿科康复机构的采用,确定采用的促进者和障碍,并记录了采用远程医疗对治疗师的影响,服务,和家庭。获得的学习知识将完善培训干预,加强干预措施的吸收,并支持将远程医疗整合为残疾儿童家庭的一致儿科康复服务选择。
背景:ClinicalTrials.govNCT05312827;https://clinicaltrials.gov/ct2/show/NCT05312827。
未经评估:PRR1-10.2196/40218。
BACKGROUND: Children with disability face long wait times for rehabilitation services. Before the COVID-19 pandemic, telehealth adoption was low across pediatric rehabilitation. Owing to the COVID-19 pandemic restrictions, pediatric therapists were asked to rapidly shift to telehealth, often with minimal training. To facilitate the behavior changes necessary for telehealth adoption, provision of appropriate evidence-based training and support is required. However, evidence to support the effective implementation of such training is lacking. The successful real-world implementation of a training intervention and program of support (TIPS) targeting pediatric therapists to enhance the adoption of family-centered telerehabilitation (FCT) requires the evaluation of both implementation and effectiveness.
OBJECTIVE: This
study aimed to evaluate TIPS implementation in different pediatric rehabilitation settings and assess TIPS effectiveness, as it relates to therapists\' adoption, service wait times, families\' perception of service quality, and costs.
METHODS: This 4-year, pan-Canadian
study involves managers, pediatric occupational therapists, physiotherapists, speech-language pathologists, and families from 20 sites in 8 provincial jurisdictions. It will use a multimethod, prospective, hybrid type 3 implementation-effectiveness design. An interrupted time series will assess TIPS implementation. TIPS will comprise a 1-month training intervention with self-paced learning modules and a webinar, followed by an 11-month support program, including monthly site meetings and access to a virtual community of practice. Longitudinal mixed modeling will be used to analyze indicators of therapists\' adoption of and fidelity to FCT collected at 10 time points. To identify barriers and facilitators to adoption and fidelity, qualitative data will be collected during implementation and analyzed using a deductive-inductive thematic approach. To evaluate effectiveness, a quasi-experimental pretest-posttest design will use questionnaires to evaluate TIPS effectiveness at service, therapist, and family levels. Generalized linear mixed effects models will be used in data analysis. Manager, therapist, and family interviews will be conducted after implementation and analyzed using reflective thematic analysis. Finally, cost data will be gathered to calculate public system and societal costs.
RESULTS: Ethics approval has been obtained from 2 jurisdictions (February 2022 and July 2022); approval is pending in the others. In total, 20 sites have been recruited, and data collection is anticipated to start in September 2022 and is projected to be completed by September 2024. Data analysis will occur concurrently with data collection, with results disseminated throughout the
study period.
CONCLUSIONS: This
study will generate knowledge about the effectiveness of TIPS targeting pediatric therapists to enhance FCT adoption in pediatric rehabilitation settings, identify facilitators for and barriers to adoption, and document the impact of telehealth adoption on therapists, services, and families. The
study knowledge gained will refine the training intervention, enhance intervention uptake, and support the integration of telehealth as a consistent pediatric rehabilitation service option for families of children with disabilities.
BACKGROUND: ClinicalTrials.gov NCT05312827; https://clinicaltrials.gov/ct2/show/NCT05312827.
UNASSIGNED: PRR1-10.2196/40218.