Promoting Family-Centered Care: A Provider Training Effectiveness Study.

IMPORTANCE: Although family-centered care (FCC) is a best practice in pediatrics, health care providers report challenges in translating FCC from theory to practice. OBJECTIVE: To measure the effectiveness of the Better Together (BT) training to enhance providers' changes in FCC practice and self-efficacy. DESIGN: Pretest-posttest quasi-experimental design. SETTING: Continuing education centers in Israel. PARTICIPANTS: Eighty-two participants-occupational therapists, speech-language pathologists, physical therapists, and art therapists-working in outpatient or school-based pediatric practices. INTERVENTION: We developed BT on the basis of adult learning theory to prepare providers to implement best practices in FCC. The training was delivered as six consecutive in-person workshops (30-hr total over 10 wk). OUTCOMES AND MEASURES: We used the Measure of Processes of Care (MPOC) Service Provider and Confidence versions to measure providers' perceptions of how they used specific aspects of FCC in their practice and their related self-efficacy. RESULTS: Observed changes included improved reports of FCC implementation and increased self-efficacy in all MPOC domains, with medium effect sizes. These outcomes were positively interrelated. Before the training, providers in outpatient settings who had more years of experience reported higher FCC use than less experienced participants in other settings; these differences disappeared by the end of the training. CONCLUSIONS AND RELEVANCE: BT training can enhance health care providers' perceptions of FCC implementation and self-efficacy and minimize differences in FCC implementation by providers across expertise levels and practice settings. This study can inform the development of future FCC training interventions for providers, managers, educators, and researchers. What This Article Adds: Intensive training can improve both the way practitioners work with families and their self-efficacy in doing so. This study highlights the importance of self-efficacy in promoting knowledge translation.

Understanding and Enhancing Occupational Therapists' Use of Standard Family-Centered Measures.

IMPORTANCE: The use of standard family-centered measures (FCMs) is imperative to guide family-centered care (FCC) interventions and monitor their outcomes. OBJECTIVE: To measure the frequency of FCM use and evaluate the effectiveness of experiential learning and reflection to increase their use. DESIGN: Descriptive and two-group pre-post comparative training study. SETTING: Continuing education center. PARTICIPANTS: Phase 1 included 145 health care providers. Phase 2 included 44 school-based occupational therapists who participated in Phase 1. INTERVENTION: Phase 2 participants enrolled in 30-hr FCC training that included a 2-hr workshop on FCM. One group (n = 22) conducted an FCM with a family and wrote a reflective report. OUTCOMES AND MEASURES: All participants completed the Measure of Processes of Care-Service Provider (MPOC-SP) questionnaire and reported how frequently they used FCMs. RESULTS: FCM use rates were low (50%, not at all; 26%, to a very small extent). The extent of FCC was correlated with FCM use (r = .24-.30, p < .01). A Wilcoxon signed-rank test demonstrated that participants who administered an FCM with a family and reflected on this experience showed significant increases (Z = 176.0, p = .001) in FCM use compared with participants who were only instructed about available FCM. A Mann-Whitney U test confirmed the difference (U = 3.54, p = .012). CONCLUSIONS AND RELEVANCE: FCM use is sparse, but experiential and reflective activities are simple keys to promoting FCC and integrating FCM into practice. What This Article Adds: Training designers, educators, and managers should consider integrating experiential learning to enhance providers' expertise and quality of care.

Evaluating change: Using the Measure of Processes of Care-Service Provider as an outcome measure for performance and confidence in family-centred care.

BACKGROUND: Family-centred care (FCC) is considered the best practice in paediatric care but it is not always implemented sufficiently. Effective training programmes that enhance health care providers' knowledge and self-efficacy have the potential to improve FCC implementation in their daily practice. The goal of the study was to evaluate the sensitivity of the measure of processes of care (MPOC)-service provider (MPOC-SP) version and MPOC confidence (MPOC-Con) in detecting changes following an FCC training. METHODS: The MPOC-Con was developed for this study as a sequel to MPOC-SP to measure self-efficacy related to specific FCC practices. Twenty-four health care providers (occupational and physical therapists, speech pathologist, and special education teacher) participated in a 6-month FCC provider training. The training included 30 contact hours on FCC principles and techniques through experiential learning, reflective exercises, peer mentoring, and case-study analyses. The MPOC-SP and MPOC-Con were administered preparticipation and postparticipation. RESULTS: Repeated multivariate analysis of variance and reliable change index (RCI) analyses indicated a significant group increase in performance and confidence following the training in two of the four MPOC-SP factors and in all MPOC-Con factors, F(1, 7) = 5.17, P = .003, η2  = .68; RCI > 1.96. Individual change patterns in FCC performance indicated patterns of increased, decreased, or stable performance, with the highest increased performances reported for treating people respectfully (79%) and communicating specific information (71%), mostly stable performance in providing general information (75%) and similar levels of increase and stability (41% and 39%, respectively) for interpersonal sensitivity. The Pearson's correlation between MPOC-SP and MPOC-Con were significant, moderate-strong, and positive (r = .42-.69, P < .05). CONCLUSIONS: The MPOC-SP and the MPOC-Con are sensitive measures suitable for evaluating individual and group changes following training. When designing professional development programmes, managers and educators should consider the interrelation between self-efficacy and implementing acquired knowledge and skills in FCC.

Scoping review of mentoring research in the occupational therapy literature, 2002-2018.

INTRODUCTION: Mentoring affords personalised learning for professional growth. Research across disciplines has shown mentoring to positively affect behaviour, attitude, motivation, job performance, organisational commitment, and career productivity and success. This study was conducted to provide an overview of research focussed on mentoring practices and related outcomes specific to the occupational therapy profession. METHODS: This study follows Arksey and O'Malley's five main scoping review stages. PubMed, Embase, CINAHL, PsycINFO, Web of Science, ERIC, Social Services Abstract, ScienceDirect and ProQuest databases were searched for mentoring practices in the occupational therapy profession. Inclusion criteria were: empirical studies of mentoring provided to occupational therapy students, practitioners, faculty and researchers, published in English between January 2002 and December 2018. Studies of mentoring provided to occupational therapy clients were excluded. Data were extracted for quantitative information about study characteristics and qualitative information about mentoring processes and outcomes. RESULTS: Of 1313 retrieved resources, 20 empirical studies were selected for analysis. In these studies, occupational therapy entry-level students, post-professional students, educators, researchers and clinicians were mentored in education, research and clinical areas of practice. Mentoring definitions, rationale, approaches and measurement methods were varied. Mentoring processes and relationships were facilitated by mechanisms of creating a plan, using mentoring strategies and providing support. Common defining terms, mechanisms and outcomes of mentoring were extracted and categorised into: support, learning, process and relationship. Mentoring outcomes were related to knowledge acquisition and translation, professional behaviours, increased productivity and professional networking. CONCLUSION: This scoping review presented commonalities of mentoring definitions, mechanisms and outcomes in empirically studied mentoring experiences and programmes in the occupational therapy profession. Methodological gaps in this research emphasise the need for occupational therapy practitioners and researchers to continue researching mentoring experiences by integrating theoretical frameworks, uniform definitions, rigorous design and standardised measures to evaluate the effectiveness of mentoring.

Enhancing leadership and relationships by implementing a peer mentoring program.

BACKGROUND: Peer-mentoring is often described as effective means to promote professional and leadership skills, yet evidence on practical models of such programs for occupational therapy students are sparse. The purpose of this study was to evaluate the outcomes of a peer-mentoring program designed for graduate occupational therapy students. METHODS: Forty-seven second-year student volunteers were randomly assigned to individually mentor first-year students in a year-long program. Students met biweekly virtually or in person to provide mentorship on everyday student issues, according to mentees' needs. Faculty-led group activities prior and during the peer-mentoring program took place to facilitate the mentorship relationships. Program effectiveness was measured using the Multi-factor Leadership Questionnaire (Avolio & Bass, MLQ: Multifactor Leadership Questionnaire, 2004) and an open-ended feedback survey. RESULTS: Results of multi-variate MANOVA for repeated measures indicating significant enhancement in several leadership skills (F(12,46) = 4.0, P = 0.001, η2  = 0.579). Qualitative data from feedback surveys indicated that an opportunity to help; forming relationships; and structure as enabler were perceived as important participation outcomes. Students expressed high satisfaction and perceived value from their peer-mentoring experience. CONCLUSION: As we seek ways to promote our profession and the leadership of its members, it is recommended to consider student peer-mentoring to empower them to practice and advance essential career skills from the initial stages of professional development. Evidence found in this study demonstrates that peer-mentoring programs can promote leadership development and establishment of networks in an occupational therapy emerging professional community, at a low cost. The peer-mentoring blueprint and lessons learned are presented with hopes to inspire others to implement peer-mentoring programs in their settings.

Practical Strategies for Integrating Interprofessional Education and Collaboration into the Curriculum.

Interprofessional collaboration is vital for the provision of quality patient care. Thoughtfully designed educational programs can help students of health professions develop interprofessional competencies and capacities, including values and ethics, roles and responsibilities, interprofessional communication, and teamwork (Interprofessional Education Collaborative Expert Panel, 2011). The authors were involved in developing Interprofessional Education (IPE) activities and simulations to be infused into the curriculums of the various health professions programs in their College. A review of the IPE experiences revealed students greatly benefited from involvement in a diverse set of IPE activities and simulations.

Addressing Barriers to Chronic Obstructive Pulmonary Disease (COPD) Care: Three Innovative Evidence-Based Approaches: A Review.

Chronic obstructive pulmonary disease (COPD) is a preventable yet widespread and profoundly debilitating respiratory condition, exerting substantial personal and global health ramifications alongside significant economic implications. The first objective of this literature review was to identify reviews the barriers to optimal COPD care, categorizing them into personal patient factors, professional awareness and knowledge, patient-professional relationships, and healthcare service models, including access to care that significantly impacts the quality of COPD management. The second objective was to introduce three approaches for enhancing COPD care outcomes: Self-Management Educational Programs, Health Qigong, and Telehealth service provision, each demonstrating positive effects on COPD patients' health status. These evidence-based interventions offer promising avenues for enhancing COPD care and patient outcomes. Integrating these approaches into comprehensive COPD management strategies holds potential for improving the well-being and quality of life of individuals living with this chronic condition.

Interprofessional online course for telehealth delivery of pediatric developmental services.

PURPOSE: This study aimed to examine the effectiveness of an interprofessional telehealth course developed based on a collaborative needs assessment of professionals working in community-based child-development units. MATERIALS AND METHODS: Ninety-six pediatric therapists, including psychologists, social workers, speech-language pathologists, physiotherapists, and occupational therapists, participated in a 10-week, 30-hour online training on best practices in telehealth delivered according to adult learning theory guidelines. Participants reported their telehealth competencies before and after the training using a questionnaire developed for the study. RESULTS: Repeated paired t-tests showed significant increases with high effect sizes in participants' knowledge, attitudes, emotions, and willingness to use telehealth in their practices. However, at follow-up, the implementation rates remained low. CONCLUSIONS: Online learning tailored to learners' needs can change knowledge, attitudes, and willingness to incorporate telehealth into routine care. Collaboration among regulators, foundations, professional associations, and clients attuned to health care's changing needs is essential to providing solutions and boosting the quality of rehabilitation services. However, providing knowledge alone is not enough: Sustainable implementation planning is essential for knowledge translation.IMPLICATIONS FOR REHABILITATIONTelehealth can enhance access to rehabilitation services, but providers require training to promote knowledge, attitudes, and willingness to incorporate telehealth into routine care.Effective training should be based on collaboration among all stakeholders, from needs assessment and content development to implementation and devising a plan to translate sustainable knowledge into rehabilitation.Training courses should combine content on best practices with a delivery approach based on adult learning principles.To translate knowledge into practice, the course must be a part of a sustainable implementation plan at the workplace.

Toward successful future use of telehealth in occupational therapy practice: What the COVID-19 rapid shift revealed.

BACKGROUND: Prior to the onset of the COVID-19 pandemic, occupational therapy (OT) services delivered through telehealth demonstrated comparative effectiveness to in-person services. At the onset of the pandemic, occupational therapy practitioners (OTPs) needed to continue delivering care to clients without being in-person. Many OT practitioners pivoted rapidly to telehealth, in many instances, with very little training. OBJECTIVE: The objective of this study was to describe the use of telehealth in occupational therapy during the early stages of the pandemic, and to explore how participants traversed the barriers. The perceived benefits and barriers to success with rapid telehealth adoption as experienced by OTPs, along with the specific strategies used to promote favorable outcomes may inform ongoing successful telehealth use in occupational therapy. METHOD: This study used a mixed-methods sequential explanatory design. Data was collected from September to December 2020 with an electronic survey. RESULTS: A total of 193 OTPs completed the survey, representing the delivery of OT services in 13 countries. Three main barriers to the use of telehealth were availability of materials, mastery of technology, and collaboration with caregivers/e-helpers. These barriers were negatively and significantly correlated with the participants' confidence level in the use of telehealth. Participants overcame barriers by independently obtaining telehealth training, including training within one's organization, support from social media, self-directed learning, and paid online telehealth webinars. CONCLUSION: Employers and educators can remove barriers to telehealth use by OTPs by providing a variety of learning opportunities and supports to enhance practitioners' confidence, thus increasing the likelihood of continued use of telehealth as a powerful and gap-bridging delivery model in occupational therapy.

Improving work conditions through strike: Examination of nurses' attitudes through perceptions of two physician strikes in Israel.

BACKGROUND: Strikes are means to influence policies related to working conditions, yet raise ethical dilemmas for healthcare workers. Nurse strikes have become more prominent around the world. OBJECTIVE: To assess the change in Israeli nurses' attitudes towards strikes in light of two physician strikes that have preceded a nursing strike. METHODS: An anonymous survey was administered once in 2000 (N = 106) and again in 2011 (n = 175) following 110 days of a physician strike, to assess nurses' attitudes towards the strike and resulting ethical issues. RESULTS: A statistically significant change (p < 0.05) between administrations revealed that in 2011 more nurses identified striking as a legitimate mechanism, would strike under the same circumstances, and felt that collaboration with physicians persisted despite the strike. Additionally, an increasing number of nurses said that the suffering of patients due to the strike is somewhat or entirely justified, although they were faced with a difficult dilemma of loyalty to physician colleagues vs. PATIENTS: Nurses reported finding ways to mitigate the suffering of patients resulting from the strike. CONCLUSIONS: While patient-centered care remains nurses' first and foremost priority, findings indicate an increasing support of collective bargaining and strike to promote working conditions related to professional and public health agendas.

Handwriting Proficiency Screening Questionnaire for Children (HPSQ-C): Development, Reliability, and Validity.

OBJECTIVE: To adapt the Handwriting Proficiency Screening Questionnaire (HPSQ), previously designated for adults, into a children's self-report version (the HPSQ for Children, or HPSQ-C) and to examine its reliability and validity. METHOD: Participants included 230 children ages 7-14 yr from regular schools in Israel. The questionnaire's content validity, internal consistency, and concurrent and construct validity were assessed. RESULTS: The tool demonstrated good internal consistency (α=.77). We found a significant moderate correlation between final HPSQ-C scores and the HPSQ, r=.51, p<.001, establishing the HPSQ-C's concurrent validity. Construct validity was also confirmed. Results demonstrated that the HPSQ-C significantly distinguished between children with and without handwriting deficiencies on the basis of measures of handwriting product (Hebrew Handwriting Evaluation) and handwriting process (Computerized Penmanship Evaluation Tool). CONCLUSION: The HPSQ-C is suitable for identification of handwriting deficiency among school-aged children and is appropriate for varied academic and clinical uses.