Protocol to Develop an Interprofessional Pediatric Rehabilitation Model of Care in Northern Cree First Nation Communities with a Community-Directed, Team, and Virtual Care Approach (Preprint)

Abstract

BACKGROUND In Canada, the Indigenous population is the youngest and fastest growing, yet ongoing health disparities for Indigenous Peoples are widely recognized. There is a concerning lack of research to provide accurate data on childhood disabilities and health conditions in Indigenous populations in Canada. For children with disabilities and chronic health conditions, ongoing access to rehabilitation services such as occupational therapy, physical therapy, speech-language pathology, and/or audiology is critical in promoting positive health and developmental outcomes. Elders and the Peter Ballantyne Cree Nation (PBCN) Health Services Board have guided a critical priority for addressing access challenges to pediatric rehabilitation in three specific northern Indigenous communities. OBJECTIVE The purpose of this manuscript is to outline the protocol for a community-directed needs assessment and subsequent development of a multi-disciplinary pediatric rehabilitation service in three specific northern Indigenous communities. METHODS Phase 1): The needs assessment process was led by two physiotherapy researcher/clinicians and two graduate students, with experienced health professionals in pediatric speech-language pathology, audiology, physiotherapy, and occupational therapy, with experience in both private and public health entities. The process consisted of multiple phases, which included a community led request, preliminary literature review, survey development, interview guide development, communication and feedback with healthcare professionals, test phase with pediatric family members, and finalizing the survey and interview guides for deployment for data collection. Phase 2): Findings from phase 1 will inform co-development of a pilot hybrid care interprofessional pediatric rehabilitation clinic for each of the communities. Phase 3): A stakeholder meeting will take place to facilitate knowledge sharing and open discussion regarding implementation of Phase 2, as well as considerations for sustainability of this model of care. RESULTS The final survey was multidisciplinary, with 6 content areas covered in 18 items. Interview guides for one-on-one interviews and sharing circles included 10 questions for community members and 12 questions for healthcare providers. Participant recruitment will begin in April 2024. Final results are anticipated in early 2025. CONCLUSIONS This manuscript details the process of a community directed needs assessment, which will inform development and implementation for a model of care for pediatric rehabilitation services, followed by a stakeholder meeting to encourage sustainability of the model. Our process was driven by the request from community for needs assessment, involvement of key stakeholders early and often during assessment development, a clear purpose of the project identified early on with community direction, utilization of multidisciplinary input from both public and private sectors when planning the needs assessment, and maintaining clear goals during our survey question design process. This study aims to inform the co-development and implementation of an interdisciplinary hybrid model of pediatric rehabilitation care for remote First Nation communities, ultimately leading to improved access to patient- and family-centered care for pediatric rehabilitation. CLINICALTRIAL n/a