Training Intervention and Program of Support (TIPS): Fostering Family-centred Telehealth in Pediatric Rehabilitation

NCT05312827 | Recruiting

• 1 other identifier: 2022-4546
• Study Type: interventional
• Target: 2,360
• Locations: 1 country
• Sites: 3

Brief Summary

Timely access to family-centred services for children with disability and their families is important to support their development and well-being. Currently, many children face long wait times and barriers to services. Lack of access can lead to negative impacts for children and stress for their families. With the COVID-19 pandemic, these issues have been made more challenging with the loss of rehabilitation support for children, increasing stress on families. During this time, therapists moved to telehealth service delivery to support children and families. We know that telehealth can improve access to services, children's outcomes, and family satisfaction, and that telehealth a key element of Family Centred Services (FCS) in pediatric rehabilitation. FCC include practices that promote flexibility, respect and dignity for families' views, knowledge and strengths, effective information sharing, partnership and collaboration in decision making, and coordinated and comprehensive care. FCC focuses on developing collaborative family-provider relationships, where parents are active participants in collaborative goal-setting, therapy planning, implementation, and evaluation, and where activities are integrated within daily routines and contexts (e.g., home and community). Compared to traditional service delivery methods, telehealth offers opportunities to enhance FCC practices. FCC provides alternate, convenient, and flexible ways to partner with families, respecting their characteristics and barriers, allows knowledge and information sharing about the child within their contexts, supports family decision making and parents' well-being, and has been recognized as an important addition to comprehensive care coordination and service delivery. Telehealth is an important and effective alternative for families living in both urban and remote or underserved areas and can be more convenient than in-person visits (e.g., less travel time, schedule flexibility). However, the use of telehealth prior to the pandemic was low in pediatric rehabilitation. In addition, many therapists report delivering telehealth without prior experience, and lack confidence, knowledge, and training in effective intervention strategies. Although therapists' knowledge, skills and attitudes toward telehealth can improve with time and experience, training and support are required for behavioural changes to occur. Following the pandemic, there has been continued support for the use of FCT and for its ongoing use to support families of children with disability. Pediatric rehabilitation therapists, service managers, professional associations, policy makers, and families are all making the case for not "returning to normal", and are asking for help to keep telehealth as part of FCS care. The goal of the current study is to evaluate the use and effectiveness of a Training Intervention and Program of Support (TIPS) to increase the uptake of FCT in pediatric rehabilitation centres across Canada. The main research question is: Can TIPS be adapted to increase the use of FCT interventions by therapists working in different contexts? The primary objectives are to:

1. 1.Evaluate the use of FCT regarding:
2. 2.Therapists' desire to use vs actual use of FCT practices
3. 3.Use of FCT practices as they were intended to be used
4. 4.Describe the variations required to adapt the TIPS to meet each site's needs
5. 5.Identify factors that influence FCT use and adherence
6. 6.Evaluate the effectiveness with regards to:
7. 7.Service wait-times
8. 8.Family-centredness of services
9. 9.Changes in service delivery
10. 10.Evaluate the costs (and possible cost savings) related to increased use of FCT

Conditions

Telerehabilitation

Keywords

telehealth; family-centred; pediatric rehabilitation

Outcome Measures

Primary Outcomes (18)

• TIPS Therapist Survey-1

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  3 months prior to TIPS implementation

• TIPS Therapist Survey-2

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  2 months prior to TIPS implementation

• TIPS Therapist Survey-3

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  1 month prior to TIPS implementation

• TIPS Therapist Survey-4

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  on day 1 of TIPS implementation

• TIPS Therapist Survey-5

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  1 month post TIPS commencement

• TIPS Therapist Survey-6

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  4 months post TIPS commencement

• TIPS Therapist Survey-7

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  8 months post TIPS commencement

• TIPS Therapist Survey-8

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  12 months post TIPS commencement

• TIPS Therapist Survey-9

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  3 months following the end of TIPS implementation

• TIPS Therapist Survey-10

  The TIPS Therapist Survey contains sociodemographic information about the study participant (e.g., discipline, site, province, age), as well as the Therapists' Implementation Questionnaire (TIQ). The TIQ includes the ACCEPT-VFCC (Assessment of Competencies and Contributors to Enhance Practice Transition to Virtual Family Centred Care), a newly created tool inspired by the ADOPT-VR, yet specifically designed for telerehabilitation, the Family Centered Telerehabilitation (FCT) fidelity self-perceived checklist and the PRIME-SP (Pediatric Rehabilitation Intervention Measure of Engagement - Service Provider version).

  6 months following the end of TIPS implementation

• TIPS Manager Survey (Pre-Implementation)-1

  This survey includes sociodemographic information about the manager (e.g., academic degree, discipline, years of experience), the site profile (SPQ) which includes characteristics about the services provided, the organizations e-readiness, and service wait-time indicators.

  3 months prior to the commencement of TIPS implementation

• TIPS Manager Survey (Pre-Implementation)-2

  This survey includes sociodemographic information about the manager (e.g., academic degree, discipline, years of experience), the site profile (SPQ) which includes characteristics about the services provided, the organizations e-readiness, and service wait-time indicators.

  on day 1 of TIPS implementation

• TIPS Manager Survey (Post-Implementation)

  This survey includes sociodemographic information about the manager (e.g., academic degree, discipline, years of experience), the site profile (SPQ) which includes characteristics about the services provided, the organizational e-readiness, service wait-time indicators, as well as the addition of organizational costs.

  within 6 months following the end of TIPS implementation

• TIPS Therapist Champion Survey

  This one-time survey is limited to the participant's sociodemographic information (e.g., discipline, years of experience), as well as their telerehabilitation experience, expertise, and training.

  once, 2 months prior to TIPS implementation

• TIPS Parent Survey-1

  This questionnaire contains The Family Questionnaire (Fam-Q) which collects sociodemographic information about the parent participants and their family (e.g., age, household income, family structure, remoteness) and the family costs and savings associated with accessing rehabilitation services, as well as the MPOC-20 (Measure of Process of Care - 20 questions).

  once, prior to day 1 of TIPS implementation

• TIPS Parent Survey-2

  This questionnaire contains The Family Questionnaire (Fam-Q) which collects sociodemographic information about the parent participants and their family (e.g., age, household income, family structure, remoteness) and the family costs and savings associated with accessing rehabilitation services, as well as the MPOC-20 (Measure of Process of Care - 20 questions).

  once, within 6 months of the end of TIPS implementation

• TIPS Parent Partner Survey

  This one-time survey is limited to the participant's sociodemographic characteristics (e.g., age, household income), their comfort level with technology, and their experiences with the site and the various service options (including telerehabilitation)

  once, 2 months prior to TIPS implementation

• Semi-Structured Interviews

  To explore all changes in service delivery (both negative and positive), stakeholders will be invited to participate in a video-recorded semi-structured interview post-implementation. The samples will include all managers, a sample of therapists (all local site champions and a subsample of therapists showing high or low adoption in different sites); and parents with diverse sociocultural characteristics and levels of perception of quality of care and experience with FCT. Parent, manager, therapist and therapist champion interviews will all be conducted only once with each participant.

  within 6 months following the end of TIPS implementation

Secondary Outcomes (3)

• TIPS Logic Model

  within 2 months prior to commencement of TIPS implementation

• Monthly therapist mentoring meetings

  recorded at the frequency at which they occur (i.e., monthly) throughout the 11-months of the study in which they are scheduled

• Virtual community of practice discussion threads and posts

  collected regularly (i.e. monthly) over the 11 months of the support program

Study Arms (1)

Telehealth

EXPERIMENTAL

The proposed pre-post study will evaluate the implementation and effectiveness of a Training Intervention and Program of Support (TIPS) to enhance the adoption of family-centred telehealth in pediatric rehabilitation centres across Canada. TIPS is a multifaceted intervention, comprised of the following: 1) a 10-hour intensive training program offered to participating therapists at each site over a one-month period, including 4 hours of self-paced learning modules and a 6-hour mandatory interactive webinar; and 2) an 11-month program of support which is composed of monthly mentoring meetings at each site led by the local therapist champion, and a national virtual community of practice facilitated by 3 national knowledge brokers - an occupational therapist, a physiotherapist and a speech-language pathologist - experienced in family-centred telehealth in pediatric rehabilitation, offered simultaneously to all participating therapists across Canada.

Behavioral: Training Intervention and Program of Support (TIPS) for fostering the adoption of family-centred telehealth interventions in pediatric rehabilitation

Interventions

Training Intervention and Program of Support (TIPS) for fostering the adoption of family-centred telehealth interventions in pediatric rehabilitation BEHAVIORAL

The proposed pre-post study will evaluate the implementation and effectiveness of a Training Intervention and Program of Support (TIPS) to enhance the adoption of family-centred telehealth in pediatric rehabilitation centres across Canada. TIPS is a multifaceted intervention, comprised of the following: 1) a 10-hour intensive training program offered to participating therapists at each site over a one-month period, including 4 hours of self-paced learning modules and a 6-hour mandatory interactive webinar; and 2) an 11-month program of support which is composed of monthly mentoring meetings at each site led by the local therapist champion, and a national virtual community of practice facilitated by 3 national knowledge brokers - an occupational therapist, a physiotherapist and a speech-language pathologist - experienced in family-centred telehealth in pediatric rehabilitation, offered simultaneously to all participating therapists across Canada.

Also known as: TIPS

Telehealth

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may not qualify if:

• Managers:
• Person responsible for rehabilitation services at the site, or their delegate
• Therapists:
• PTs, OTs, SLPs providing outpatient pediatric rehabilitation services to children aged 0-12 years in each site, recruited via the managers and interested in utilizing FCT
• Parents:
• Parents or caregivers who received services (either in-person, virtually, or both) from at least one participating therapist in the previous 3 months
• Therapist champion:
• Therapist selected based on their telehealth experience and on peer recognition within their organization.
• Parent/patient-partners:
• Recruited from family, parent or patient advisory committees at the participating sites or, in the absence of such initiatives, from regional, provincial, or national patient engagement programs.
• All:
• Can speak French or English

Sponsors & Collaborators

• Université de Sherbrooke: lead
• Canadian Institutes of Health Research (CIHR): collaborator

Study Sites (3)

Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean

Chicoutimi, Quebec, G7H 7K9, Canada

NOT YET RECRUITING

Centre intégré universitaire de santé et des services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke

Sherbrooke, Quebec, J1J 3H5, Canada

RECRUITING

Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec

Trois-Rivières, Quebec, G8Y 1T6, Canada

RECRUITING

Related Publications (1)

• Hurtubise K, Gaboury I, Berbari J, Battista MC, Schuster T, Phoenix M, Rosenbaum P, Kraus De Camargo O, Lovo S, Pritchard-Wiart L, Zwicker JG, Beaudoin AJ, Morin M, Poder T, Gagnon MP, Roch G, Levac D, Tousignant M, Colquhoun H, Miller K, Churchill J, Robeson P, Ruegg A, Nault M, Camden C. Training Intervention and Program of Support for Fostering the Adoption of Family-Centered Telehealth in Pediatric Rehabilitation: Protocol for a Multimethod, Prospective, Hybrid Type 3 Implementation-Effectiveness Study. JMIR Res Protoc. 2022 Oct 28;11(10):e40218. doi: 10.2196/40218.

  PMID: 36306158 DERIVED

MeSH Terms

Interventions

Portasystemic Shunt, Transjugular Intrahepatic

Intervention Hierarchy (Ancestors)

Portasystemic Shunt, Surgical; Anastomosis, Surgical; Surgical Procedures, Operative; Vascular Grafting; Vascular Surgical Procedures; Cardiovascular Surgical Procedures

Study Officials

• Chantal Camden, PhD

  École de réadaptation, CRCHUS, Université de Sherbrooke

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Chantal Camden, PhD

CONTACT

819-346-1110; chantal.camden@usherbrooke.ca

Jade Berbari

CONTACT

819-346-1110; Jade.berbari@usherbrooke.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr. Chantal Camden

Model Details: A 4-year pan-Canadian stakeholder-oriented, mixed-method implementation-effectiveness design will be used. TIPS will be implemented in all sites in a same region during the same month, and sequentially introduced across all regions, 2 months apart. An interrupted time series (ITS) was selected to assess primary implementation outcomes (obj. 1), as recommended for research in real-world settings. An ITS consists of observing the same dependent variables over time, with a break in the series of observations corresponding to the introduction of an intervention. If the intervention is effective, a change in the series' pre- and post-intervention averages will be observed.

Study Record Dates

• First Submitted: February 15, 2022
• First Posted: April 6, 2022
• Study Start: October 17, 2022
• Primary Completion (Estimated): October 1, 2027
• Study Completion (Estimated): October 1, 2027
• Last Updated: May 10, 2024

Record last verified: 2024-05

Data Sharing

• IPD Sharing: Will not share

Locations

CA (3)