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Camden C, Zwicker JG, Morin M, Schuster T, Couture M, Poder TG, Maltais DB, Battista MC, Baillargeon JP, Goyette M, Pratte G, Hurtubise K, Phoenix M, Nguyen T, Berbari J, Tousignant M. Web-based early intervention for children with motor difficulties aged 3–8 years old using multimodal rehabilitation (WECARE): protocol of a patient-centred pragmatic randomised trial of paediatric telerehabilitation to support families. BMJ Open 2021. [PMCID: PMC8039274 DOI: 10.1136/bmjopen-2020-046561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Mild motor difficulties in children are underdiagnosed despite being highly prevalent, leaving such children often underserved and at higher risk for secondary consequences such as cardiovascular disease and anxiety. Evidence suggests that early patient-oriented interventions, coaching parents and providing children with early stimulation should be provided, even in the absence of a diagnosis. Such interventions may be effectively delivered via telerehabilitation. Methods and analysis A family-centred, pragmatic randomised controlled trial will be carried out to evaluate the real-world effectiveness of a Web-based Early intervention for Children using multimodAl REhabilitation (WECARE). Families of children with motor difficulties, 3–8 years of age, living in Quebec, Canada, and receiving no public rehabilitation services (n=118) will be asked to determine up to 12 performance goals, evaluated using the Canadian Occupational Performance Measure (COPM, the primary outcome). Families will be randomised to receive either usual care or the WECARE intervention. The WECARE intervention will be delivered for 1 year via a web-based platform. Families will have access to videoconferences with an assigned rehabilitation therapist using a collaborative coaching approach, a private chat function, a forum open to all intervention arm participants and online resources pertaining to child development. Participants will be asked to re-evaluate the child’s COPM performance goals every 3 months up to 1 year post allocation. The COPM results will be analysed using a mixed Poisson regression model. Secondary outcomes include measures of the child’s functional ability, parental knowledge and skills and health-related quality of life, as well as qualitative outcomes pertaining to parental satisfaction and service delivery trajectories. Investigators and quantitative data analysts will be blinded to group allocation. Ethics and dissemination The CIUSSS de l’Estrie—CHUS ethics committee approved this trial (2020-3429). Study results will be communicated via peer-reviewed journal publications, conference presentations and stakeholder-specific knowledge transfer activities. Trial registration number NCT04254302.
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Affiliation(s)
- Chantal Camden
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Jill G Zwicker
- Occupational Science & Occupational Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Melanie Morin
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Melanie Couture
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Thomas G Poder
- School of Public Health, Université de Montréal, Montreal, Québec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montreal, Québec, Canada
| | - Desiree B Maltais
- Département de réadaptation, Universite Laval, Québec City, Québec, Canada
| | - Marie-Claude Battista
- Department of Medicine, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada
| | - Jean-Patrice Baillargeon
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada
| | - Mathieu Goyette
- Département de sexologie, Université du Québec à Montréal, Montreal, Québec, Canada
| | - Gabrielle Pratte
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
| | - Karen Hurtubise
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tram Nguyen
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Jade Berbari
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Michel Tousignant
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
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