Perspectives on implementing Individual Placement and Support (IPS) within primary health care settings for adults living in British Columbia, Canada.

BACKGROUND: Individual placement and support (IPS) is an evidence-based practice (EBP) designed to help people with severe mental illness re-enter the labour market. Implementing an IPS program within a new context (e.g., primary health care setting) to support populations that are complex and multi-barriered presents a set of unique challenges and considerations. This paper provides community-based perspectives that identify implementation strengths and challenges and highlights potential strategies aimed at addressing emergent barriers. METHODS: A case study was conducted across three community health centres in British Columbia (BC), Canada, where a novel IPS program was embedded within primary care services. Data collection consisted of open-ended surveys and focus groups with service providers directly involved in program implementation and their associated clinical and managerial support teams (n = 15). Using the updated Consolidated Framework for Implementation Research (CFIR) as a guide, we performed deductive thematic analysis to identify key areas impacting IPS implementation. RESULTS: Integration with existing health care systems and primary health care teams and support from leadership across all levels were identified as both key facilitators and barriers to implementation. Facilitators and barriers were identified across all domains, with those within innovation and process most easily addressed. Four cross-cutting themes emerged for promoting more integrated and sustainable program implementation: investing in pre-implementation activities, supporting a dynamic and flexible program, building from community experiences, and developing a system for shared knowledge. CONCLUSIONS: Implementing an IPS program embedded within primary health care settings is complex and requires extensive planning and consultation with community-based service providers and decision-makers to achieve full integration. Future practice and policy decisions aimed at supporting employment and well-being should be made in collaboration with communities.

A study of the essence of play experience to children living in Zanzibar, Tanzania.

This study aimed to gain an understanding of the essence of play experience to children in Zanzibar, Tanzania. A phenomenological approach using the photovoice method was adopted. The study was carried out over 4 weeks, with 12 boys and 4 girls. Four key themes emerged from the analysis of 116 photographs: creative play, physical play/games, football and equipment play. The findings suggest that play experience in Zanzibar has aspects of creativity and resourcefulness, and influences from tradition, culture and poverty. Furthermore, that opportunity for play may differ for children in Tanzania, compared with children in Western countries. Unequal boy and girl participants, and the lack of representation of children with a disability were some limitations of this study. The occupational therapy profession may want to further investigate the opportunities for play for children living in developing countries. Additionally, it may be valuable to look at different aspects of play, such as its meaning to children from different cultures and its potential restorative value for children who have experienced traumatic events.