1
|
Rosenbaum PL, Imms C, Miller L, Hughes D, Cross A. Perspectives in childhood-onset disabilities: integrating 21st-Century concepts to expand our horizons. Disabil Rehabil 2024:1-11. [PMID: 39185771 DOI: 10.1080/09638288.2024.2394647] [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: 04/09/2024] [Revised: 08/12/2024] [Accepted: 08/16/2024] [Indexed: 08/27/2024]
Abstract
PURPOSE A powerful aphorism states: "If I hadn't believed it, I wouldn't have seen it!" This challenging notion reminds us how strongly we are influenced by prevailing ideas, and how we interpret things according to current fashions and teachings. MATERIALS AND METHODS In this paper we present and discuss contemporary perspectives concerning childhood-onset disability and the evolving nature of how people are thinking and acting. We illustrate these ideas by reminding readers of how we have all traditionally been trained and acculturated to think about many dimensions of neurodevelopmental disability ("What?"); reflect on the impact of these ways of thinking in terms of what we have conventionally "seen" and done ("So What?"); and contrast those traditions with contemporary concepts that we believe or know impact the field ("Now What?"). RESULTS Many of the concepts discussed here will be familiar to readers. In taking this analytically critical perspective we aim to illustrate that by weaving these individual threads together we are able to create a coherent fabric that can serve children with childhood-onset NDD, their families, service providers, the community, and policy-makers. We do not purport to offer a comprehensive view of the whole field. CONCLUSIONS We encourage readers to consider the integration of these new ways of thinking and acting in our still-evolving field of "childhood-onset disability".
Collapse
Affiliation(s)
| | - Christine Imms
- Apex Australia Chair of Neurodevelopment and Disability, Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Laura Miller
- Occupational Therapy School of Allied Health, Australian Catholic University, Virginia, Australia
| | - Debra Hughes
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Andrea Cross
- Department of Pediatrics, Institute of Applied Health, Sciences, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
2
|
Brekke I, Alecu A. The health of mothers caring for a child with a disability: a longitudinal study. BMC Womens Health 2023; 23:639. [PMID: 38037017 PMCID: PMC10688054 DOI: 10.1186/s12905-023-02798-y] [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: 05/31/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Raising a child with disabilities requires a significant parental investment that is greater than that required by typically developing children. Previous studies have shown that parents caring for a child with a disability experience a range of health problems, particularly the mothers. However, few of these studies have controlled for maternal health prior to birth. METHODS This study used a sample from the Norwegian administrative register that comprised all children born between 2009 and 2015. We followed the mothers and their children for 11 years, between 2009 and 2019. The outcome variable was the mothers' physical and mental health, which was assessed using specific ICD-10 diagnoses recorded in the Norwegian Patient Register (NPR). The data included information on the mothers' health before and after the birth of their first child, enabling us to control for maternal health prior to birth in our analysis, in addition to socio-demographic characteristics. The analyses of maternal health were performed using multiple logistic regression, and the results are presented on both a relative scale (odds ratio [OR]) and an absolute scale (average marginal effect [AME]), both with 95% confidence intervals. RESULTS Mothers caring for a child with a disability have higher odds of having a diagnosis of a musculoskeletal disorder, depression, anxiety, sleeping disorder or migraines than mothers of children without a disability. The differences between the two groups of mothers decrease after adjusting for the characteristics of the children, mothers and families, but remain significant for musculoskeletal disorder, depression, anxiety and sleeping disorder, although the absolute differences are modest. CONCLUSION The findings suggest that mothers caring for a child with a disability are more likely to have health problems than mothers of children without a disability after controlling for maternal health prior to birth. Providing more support for mothers of children with a disability might help to improve their health.
Collapse
Affiliation(s)
- Idunn Brekke
- Department of Childhood and Families, Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, N-0213, Norway.
| | - Andreea Alecu
- Consumption Research Norway, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
3
|
Garrood A, Bjornstad G, Borek A, Gillett A, Lloyd J, Brand S, Tarrant M, Ball S, Hawton A, McDonald A, Fredlund M, Boyle F, Berry V, Logan S, Morris C. Healthy Parent Carers: Acceptability and practicability of online delivery and learning through implementation by delivery partner organisations. Health Expect 2023; 26:2050-2063. [PMID: 37401625 PMCID: PMC10485339 DOI: 10.1111/hex.13812] [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: 11/16/2022] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Parent carers of disabled children are at increased risk of physical and mental health problems. The Healthy Parent Carers (HPC) programme is a manualised peer-led group-based programme that aims to promote parent carer health and wellbeing. Previously, the programme had been delivered in person, with recruitment and delivery managed in a research context. This study explored implementation by two delivery partner organisations in the United Kingdom. Facilitator Training and Delivery Manuals were modified for online delivery using Zoom due to COVID-19. METHODS The study methodology utilised the Replicating Effective Programs framework. A series of stakeholder workshops informed the development of the Implementation Logic Model and an Implementation Package. After delivering the programme, delivery partner organisations and facilitators participated in a workshop to discuss experiences of implementing the programme. A wider group of stakeholders, including commissioners, Parent Carer Forums and charity organisations representatives and researchers subsequently met to consider the sustainability and potential barriers to delivering the programme outside the research context. RESULTS This study explored implementation by two delivery partner organisations in the United Kingdom that were able to recruit facilitators, who we trained, and they recruited participants and delivered the programme to parent carers in different localities using Zoom. The co-created Implementation Logic Model and Implementation Package were subsequently refined to enable the further roll-out of the programme with other delivery partner organisations. CONCLUSIONS This study provides insight and understanding of how the HPC programme can be implemented sustainably outside of the research context. Further research will evaluate the effectiveness of the programme and refine the implementation processes. PATIENT AND PUBLIC CONTRIBUTION Parent carers, delivery partner organisation staff and service commissioners were consulted on the design, delivery and reporting of the research.
Collapse
Affiliation(s)
- Alice Garrood
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Gretchen Bjornstad
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Aleksandra Borek
- Nuffield Department of Primary Care Health Sciences, Medical Sciences DivisionUniversity of Oxford, Radcliffe Observatory QuarterOxfordUK
| | - Annette Gillett
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Jenny Lloyd
- Relational Health Group and NIHR Applied Research Collaboration (PenARC) South West Peninsula, Department of Health and Community Sciences, Institute of Health Research, University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Sarah Brand
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Mark Tarrant
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Susan Ball
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Annie Hawton
- Health Economics Group and NIHR Applied Research Collaboration (PenARC) South West PeninsulaUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Annabel McDonald
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Mary Fredlund
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Fleur Boyle
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Vashti Berry
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Stuart Logan
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Christopher Morris
- Peninsula Childhood Disability Research Unit (PenCRU) and NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| |
Collapse
|
4
|
Salvino C, Spencer C, Filipe AM, Lach LM. Mapping of Financial Support Programs for Children With Neurodisabilities Across Canada: Barriers and Discrepancies Within a Patchwork System. JOURNAL OF DISABILITY POLICY STUDIES 2022. [DOI: 10.1177/10442073211066776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A cross-jurisdictional pan-Canadian environmental scan was conducted to identify provincial, territorial, and federal financial supports available to families with children living with neurodisabilities. In partnership with the organization Childhood Disability LINK, flowchart-styled pathway documents were developed for each financial support identified, mapping out the processes required to access each support. A critical analysis was completed as it relates to structural barriers, accessibility of program information and geographic discrepancies. The results revealed that, despite almost universal availability of programs to support families of children living with neurodisabilities, significant barriers and inequity remain. This included considerable variation in access to financial support based on geographic and jurisdictional discrepancies, absence of adequate and accurate information about programs, and minimal support provided to families in the application process. We argue that the barriers and discrepancies identified were an inherent result of the Canadian federalist fragmentation of the delivery of social care and financial support programs for children living with neurodisabilities. A more unified response by Canadian provincial, territorial, and federal governments is clearly needed to take positive steps to address the consequences of federalist fragmentation and respond to the structural barriers and geographic discrepancies identified by this study.
Collapse
|
5
|
Lloyd J, Bjornstad G, Borek A, Cuffe-Fuller B, Fredlund M, McDonald A, Tarrant M, Berry V, Wilkinson K, Mitchell S, Gillett A, Logan S, Morris C. Healthy Parent Carers programme: mixed methods process evaluation and refinement of a health promotion intervention. BMJ Open 2021; 11:e045570. [PMID: 34433591 PMCID: PMC8388296 DOI: 10.1136/bmjopen-2020-045570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Parent carers of children with special educational needs or disability are at risk of poorer mental and physical health. In response to these needs, we codeveloped the 'Healthy Parent Carers' (HPC) programme. This study examined the views and experiences of participants in the HPC feasibility trial to inform programme refinement. INTERVENTION, SETTING AND PARTICIPANTS HPC is a peer-led group-based intervention (supported by online materials) for primary carers of disabled children, encouraging behaviours linked with health and well-being. It was delivered by two lead and six assistant peer facilitators in six community sites (one lead and one assistant per group) in South West England over six or 12 sessions. Control participants had online materials only. The trial involved 47 intervention and 45 control parent carers (97% female and 97% white) and eight facilitators (one male). DESIGN A preplanned mixed methods process evaluation using questionnaires and checklists (during and after the intervention), qualitative interviews with participants after intervention (n=18) and a focus group with facilitators after trial. RESULTS HPC was highly acceptable to participants and facilitators and experiences were very positive. Participants reported that the programme increased awareness of what parent carers could and could not change and their self-efficacy to engage in health-promoting behaviours. The intended mechanisms of action (social identification and peer support) matched participants' expectations and experiences. Control participants found the online-only programme flexible but isolating, as there were no opportunities to share ideas and problem solve with peers, the key function of the programme. Areas for improvement were identified for programme content, facilitator training and delivery. CONCLUSION HPC was acceptable, well received and offers considerable potential to improve the health of parent carers. Under the pandemic, the challenge going forward is how best to maintain reach and fidelity to function while delivering a more virtual programme. TRIAL REGISTRATION NUMBER ISRCTN151144652.
Collapse
Affiliation(s)
- Jenny Lloyd
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
- Relational Health Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Gretchen Bjornstad
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Aleksandra Borek
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - Beth Cuffe-Fuller
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Mary Fredlund
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Annabel McDonald
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Mark Tarrant
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Vashti Berry
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Kath Wilkinson
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Siobhan Mitchell
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Annette Gillett
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Stuart Logan
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Christopher Morris
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, UK
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| |
Collapse
|
6
|
Bjornstad G, Cuffe-Fuller B, Ukoumunne OC, Fredlund M, McDonald A, Wilkinson K, Lloyd J, Hawton A, Berry V, Tarrant M, Borek A, Fitzpatrick K, Gillett A, Rhodes S, Logan S, Morris C. Healthy Parent Carers: feasibility randomised controlled trial of a peer-led group-based health promotion intervention for parent carers of disabled children. Pilot Feasibility Stud 2021; 7:144. [PMID: 34301334 PMCID: PMC8298691 DOI: 10.1186/s40814-021-00881-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/02/2021] [Indexed: 12/25/2022] Open
Abstract
Background Parent carers of children with special educational needs or disability are at higher risk of poor mental and physical health. The need for a tailored, peer-led group programme was raised by parent carers, who co-developed the Healthy Parent Carers programme with researchers. This study aimed to test the feasibility of programme delivery in community settings, and the feasibility and acceptability of a randomised controlled trial design. Methods Participants were individually randomised with concealed allocation to a structured group programme and access to online resources (intervention), or access to the online resources only (control). Measures of wellbeing and secondary and economic outcomes were collected before randomisation, immediately post-intervention, and 6 months post-intervention. Descriptive statistics on recruitment and attrition, demographics, attendance, and fidelity of intervention delivery were analysed with feedback on the acceptability of the trial design. Results One hundred and ninety-three parent carers expressed an interest in taking part. Ninety-two participants recruited from across six sites were randomised (47 intervention, 45 control). Lead and assistant facilitators were trained and delivered the group sessions. Sixteen (34%) participants in the intervention arm did not attend any sessions, and attendance varied across sites and sessions. One participant withdrew post-randomisation, and 83 (90%) participants completed outcome measures at the six-month follow-up. Conclusions The study demonstrated that it was feasible to deliver the programme in community settings. The number of parent carers who expressed interest signifies the need for such a programme and the feasibility of recruiting to a definitive trial. Loss to follow-up was low. Further research is needed to explore ways to reduce barriers to participation in person and assess the feasibility and acceptability of programme content and delivery for more ethnically diverse groups, and potentially using interpreters. Given the Covid-19 pandemic and delivery format feedback, there is also a need to investigate remote or blended delivery strategies. Although the results indicate that a definitive trial is feasible, programme impact would be strengthened through exploration of these uncertainties. Trial registration ISRCTN, ISRCTN15144652, registered on 25 October 2018, ClinicalTrials.gov, NCT03705221, registered on 15 October 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00881-5.
Collapse
Affiliation(s)
- Gretchen Bjornstad
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK.,NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Beth Cuffe-Fuller
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Obioha C Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Mary Fredlund
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK.,NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Annabel McDonald
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Kath Wilkinson
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Jenny Lloyd
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK.,Relational Health Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU UK
| | - Annie Hawton
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK.,Health Economics Group and NIHR Applied Research Collaboration (PenARC) South West Peninsula, University of Exeter Medical School, University of Exeter, Exeter, EX1 2LU UK
| | - Vashti Berry
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Mark Tarrant
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Aleksandra Borek
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - Katharine Fitzpatrick
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Annette Gillett
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Shelley Rhodes
- Exeter Clinical Trials Unit, University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Stuart Logan
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK.,NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Christopher Morris
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK.,NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| |
Collapse
|
7
|
Dehghan L, Dalvand H, Hadian Rasanani MR, Kelly G. Exploring the process of health in mothers of children with cerebral palsy: Changing “clinical reasoning”. Br J Occup Ther 2021. [DOI: 10.1177/03080226211020659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The issue of the health status of mothers of children with disability is one that is beginning to be addressed more fully. This study aimed to explore the process of health in mothers during caregiving of children with cerebral palsy (CP). Method A qualitative research method with a grounded theory approach was used, including purposive and theoretical sampling. A constant comparative analysis method was adopted, and data were gathered from 15 mothers with CP children through interviews. Results The results were grouped into six main categories: Self-neglecting of their health, facing challenges in caring their children, physical and psychosocial damages, perceiving threat of health problems from concern to action, trying to regain their health, and caring in a complex context. “Facing challenges in caring” was extracted as a core concept. Conclusion Results showed an urgent need to establish family-centered services in clinical settings and change the “way of thinking” of the health provider system.
Collapse
Affiliation(s)
| | - Hamid Dalvand
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Hadian Rasanani
- Department of Postgraduate, School of Rehabilitation, Brain and Spinal Injury Research Center, Institute of Neurosciences and Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Greg Kelly
- Reader in Occupational Therapy, University of Ulster, Newtownabbey, UK
| |
Collapse
|
8
|
Majnemer A, McGrath PJ, Baumbusch J, Camden C, Fallon B, Lunsky Y, Miller SP, Sansone G, Stainton T, Sumarah J, Thomson D, Zwicker J. Time to be counted: COVID-19 and intellectual and developmental disabilities—an RSC Policy Briefing. Facets (Ott) 2021. [DOI: 10.1139/facets-2021-0038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has impacted the lives and well-being of all people globally, with consequences being observed across all domains from physical and mental health, to education and employment outcomes, to access to community supports and services. However, the disproportionate impact of the COVID-19 pandemic and its associated public health restrictions on individuals with intellectual and developmental disabilities (IDD) has largely been overlooked. Not only do people with IDD have a greater risk of severe complications and death from the virus as shown in large-scale studies, but they also face significant short- and long-term consequences of COVID-related public health measures on their mental health and well-being. At a time when this vulnerable population is already feeling undervalued, ignored, and forgotten, it is imperative that the risks facing adults and children with IDD—as well as their families and caregivers—are recognized, valued, and addressed through a disability-inclusive approach to Canada’s pandemic policy response planning. This requires both a mainstreaming of disability inclusion into all COVID-19 response and recovery policies as well as disability-specific policies to address the unique barriers and challenges encountered by people with IDD during the pandemic. The recommendations in this policy briefing aim to achieve a more inclusive, accessible, and sustainable Canada for people with IDD both during and after the pandemic—an approach that will result in benefits for all of society.
Collapse
Affiliation(s)
- Annette Majnemer
- School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 1Y5, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC H4A 3S5, Canada
| | - Patrick J. McGrath
- Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
- IWK Health Centre, Halifax, NS B3K 6R8, Canada
| | - Jennifer Baumbusch
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Canadian Institute of Health Research Chair in Sex & Gender Science, Ottawa, ON K1A 0W9, Canada
| | - Chantal Camden
- École de Réadaptation, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- CRCHUS et à l’IUPLSSS, Sherbrooke, QC J1H 5N4, Canada
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Steven P. Miller
- Neurology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Genevieve Sansone
- Fraser Mustard Policy Bench, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Tim Stainton
- School of Social Work, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
- Canadian Institute for Inclusion and Citizenship, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
| | - John Sumarah
- Counselling Psychology, Acadia University, Wolfville, NS B4P 2R6, Canada
| | | | - Jennifer Zwicker
- School of Public Policy, University of Calgary, Calgary, AB T2P 1H9, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| |
Collapse
|
9
|
Bjornstad G, Wilkinson K, Cuffe-Fuller B, Fitzpatrick K, Borek A, Ukoumunne OC, Hawton A, Tarrant M, Berry V, Lloyd J, McDonald A, Fredlund M, Rhodes S, Logan S, Morris C. Healthy Parent Carers peer-led group-based health promotion intervention for parent carers of disabled children: protocol for a feasibility study using a parallel group randomised controlled trial design. Pilot Feasibility Stud 2019; 5:137. [PMID: 31788323 PMCID: PMC6875041 DOI: 10.1186/s40814-019-0517-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/15/2019] [Indexed: 01/08/2023] Open
Abstract
Background Parent carers of disabled children are at increased risk of mental and physical health problems. They often experience challenges to maintaining good health which have implications for their well-being and their ability to care for their children. In response to these needs, researchers and parent carers developed the Healthy Parent Carers (HPC) programme. It is a peer-led, group-based intervention that promotes behaviours associated with health and well-being. The aims of this trial are to assess the acceptability of the HPC programme and the feasibility of its delivery in the community and to assess the feasibility and acceptability of the design of the definitive trial to evaluate the programme's effectiveness and cost-effectiveness. Methods We will establish six research sites and train facilitators to deliver the manualised intervention. Parent carers of children with special educational needs and disabilities will be individually randomised, stratified by group delivery site, to either take part in a group programme and online resources (intervention) or to receive access to the online resources only (control). Measures of mental health; well-being; health-related quality of life; health behaviours; patient activation; protective factors such as resilience, social connections, and practical support; and use of health care, social care, and wider societal resources will be collected before randomisation (baseline), immediately post-intervention, and 6 months later. Recruitment of participants, adherence to the programme, and the dose received will be assessed. Group sessions will be audio-recorded to evaluate the fidelity of delivery and participant engagement. Participants' and facilitators' feedback on the programme content and delivery, their experience, and the acceptability of the outcome measures and trial design will be collected through feedback forms, interviews, and focus groups. Discussion This trial will assess whether the programme delivery and evaluative trial design are feasible, to inform whether to progress to a definitive randomised controlled trial to test the effectiveness and cost-effectiveness of the Healthy Parent Carers programme. Trial registration ISRCTN, ISRCTN151144652, registered on 25 October 2018; ClinicalTrials.gov, NCT03705221, registered on 15 October 2018.
Collapse
Affiliation(s)
- Gretchen Bjornstad
- 1Peninsula Childhood Disability Research Unit (PenCRU) and National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Kath Wilkinson
- 1Peninsula Childhood Disability Research Unit (PenCRU) and National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Beth Cuffe-Fuller
- 1Peninsula Childhood Disability Research Unit (PenCRU) and National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Katharine Fitzpatrick
- 1Peninsula Childhood Disability Research Unit (PenCRU) and National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Aleksandra Borek
- 2Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford, OX2 6GG UK
| | - Obioha C Ukoumunne
- 3National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Annie Hawton
- 4Health Economics Group, University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Mark Tarrant
- 3National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Vashti Berry
- 3National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Jenny Lloyd
- 3National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Annabel McDonald
- 5PenCRU Family Faculty, University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Mary Fredlund
- 5PenCRU Family Faculty, University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Shelley Rhodes
- 6Exeter Clinical Trials Unit, University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Stuart Logan
- 1Peninsula Childhood Disability Research Unit (PenCRU) and National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Christopher Morris
- 1Peninsula Childhood Disability Research Unit (PenCRU) and National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU UK
| |
Collapse
|