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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
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
Background: the need for remote delivery of diagnostic, treatment and correctional care has increased significantly due to the COVID-19 pandemic. At the same time, at present, remote forms of care in psychiatry cause ambiguous attitudes among representatives of the medical community, and many organizational, legal and clinical-methodological issues of the use of telemedicine technologies in the provision of medical care, especially in the “patient–doctor” format, remain insufficiently developed. The purpose of this review is to analyze the scientific publications on the organization and legal regulation of telemedicine consultation in the “doctor–doctor” and “patient–doctor” formats when providing assistance to children and adolescents with mental disorders in the Russian Federation. Material and method of review: according to keywords “child psychiatry”, “health care”, “telemedicine technologies”, “regulatory acts” Russian scientific studies published between January 2016 and September 2023 presented in the databases eLibrary and PubMed were selected and analyzed. An analysis of the organizational and regulatory parameters of telemedicine consultations in the “doctor — patient (legal representative)” format and in the “doctor — doctor” format was made based on the practical activities of the Center named after G.E. Sukhareva of the Moscow Department of Health. Conclusion: the review of scientific articles confirmed the validity of telecommunication technologies use to make accessible the children’s psychiatric care, as well as for destigmatization and improvement the quality of medical care. It was shown the need to optimise the regulatory framework, to eliminate conflicting regulatory requirements for primary telemedicine consultation.
Background/Objective: Over the past two decades, the utilization of virtual care in rehabilitation has witnessed a significant surge; this is owing to the widespread availability of technological tools and the global impact of the COVID-19 pandemic. As a result, discussions surrounding the relevance and benefits of telerehabilitation have gained prominence among practitioners, who continually seek to enhance patient care while maintaining high standards of quality. Associated with these discussions are concerns over being able to provide care in an ethical way, as well as addressing equity issues that might be hindered or improved via telerehabilitation. To address the ethical and equity concerns around telerehabilitation, a series of five parallel rapid reviews of the scientific literature were conducted, focusing on different rehabilitation fields: physiotherapy and occupational therapy (1); speech therapy and audiology (2); psychology and neuropsychology (3); and in two age groups: older adults (4); and pediatrics and young adults (5). The objective of this series of rapid reviews is to evaluate the evidence presented regarding telerehabilitation; identifying and recommending best practices especially in the realm of ethics and equity. Methods: Medline; CINAHL; and EMBASE were searched between 2010 and 2023 for English or French-language reviews (2010–2020) and individual studies (2020–2023) pertaining to telerehabilitation and these fields of interest. Data were extracted following a standardized form focusing on: outcomes; findings; quality assessment/biases; limitations; and discussion of ethical and equity concerns. Results: The results are presented according to the most relevant themes, which include: findings; strengths; limitations; and ethical/equity considerations. Conclusions: This research presents a methodology rarely published before, on how to conduct multiple parallel rapid reviews on the theme of telerehabilitation, based on different rehabilitation fields and age groups. This research will shape future guidelines and standards in applying ethical and equity standards in telerehabilitation
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