Telehealth for Telerehabilitation

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
TelerehabilitationTraining Intervention and Program of Support (TIPS) for fostering the adoption of family-centred telehealth interventions in pediatric rehabilitation - Behavioral
Eligibility
18+
All Sexes
What conditions do you have?
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Study 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: Evaluate the use of FCT regarding: Therapists' desire to use vs actual use of FCT practices Use of FCT practices as they were intended to be used Secondary objectives are to: Describe the variations required to adapt the TIPS to meet each site's needs Identify factors that influence FCT use and adherence Evaluate the effectiveness with regards to: Service wait-times Family-centredness of services Changes in service delivery Evaluate the costs (and possible cost savings) related to increased use of FCT The primary hypotheses are that therapists' desire to adopt FCT and deliver FCT practices as intended will (i) improve slightly in the short term (i.e., one-month post-TIPS), yet (ii) will improve significantly post-TIPS, (iii) while actual use will vary over time, across sites and therapists, and will depend on therapist-, client-, organizational- and system-factors. For the secondary hypotheses, the investigators expect that, for sites with the largest changes in desire to use and use of FCT practices as intended, (iv) wait times will significantly decrease and (v) families' perceptions of service quality will significantly improve post-TIPS.

Treatment Effectiveness

Study Objectives

18 Primary · 3 Secondary · Reporting Duration: 12 months post TIPS commencement

Month 1
TIPS Therapist Survey-5
Month 1
TIPS Therapist Survey-3
Month 12
TIPS Therapist Survey-8
Month 2
TIPS Therapist Survey-2
Month 3
TIPS Therapist Survey-9
Month 3
TIPS Therapist Survey-1
Month 3
TIPS Manager Survey (Pre-Implementation)-1
Month 4
TIPS Therapist Survey-6
Month 6
TIPS Therapist Survey-10
Month 8
TIPS Therapist Survey-7
Month 11
Virtual community of practice discussion threads and posts
Day 1
TIPS Manager Survey (Pre-Implementation)-2
TIPS Therapist Survey-4
Month 2
TIPS Parent Partner Survey
TIPS Therapist Champion Survey
Day 1
TIPS Parent Survey-1
Month 6
TIPS Parent Survey-2
recorded at the frequency at which they occur (i.e., monthly) throughout the 11-months of the study in which they are scheduled
Monthly therapist mentoring meetings
Month 2
TIPS Logic Model
Month 6
Semi-Structured Interviews
TIPS Manager Survey (Post-Implementation)

Trial Safety

Trial Design

1 Treatment Group

Telehealth
1 of 1

Experimental Treatment

2360 Total Participants · 1 Treatment Group

Primary Treatment: Telehealth · No Placebo Group · N/A

Telehealth
Behavioral
Experimental Group · 1 Intervention: Training Intervention and Program of Support (TIPS) for fostering the adoption of family-centred telehealth interventions in pediatric rehabilitation · Intervention Types: Behavioral

Trial Logistics

Trial Timeline

Screening: ~3 weeks
Treatment: Varies
Reporting: 12 months post tips commencement

Who is running the clinical trial?

Canadian Institutes of Health Research (CIHR)OTHER_GOV
1,233 Previous Clinical Trials
24,674,292 Total Patients Enrolled
1 Trials studying Telerehabilitation
330 Patients Enrolled for Telerehabilitation
Université de SherbrookeLead Sponsor
264 Previous Clinical Trials
66,279 Total Patients Enrolled
1 Trials studying Telerehabilitation
330 Patients Enrolled for Telerehabilitation
Chantal Camden, PhDPrincipal InvestigatorÉcole de réadaptation, CRCHUS, Université de Sherbrooke
1 Previous Clinical Trials
118 Total Patients Enrolled

Eligibility Criteria

Age 18+ · All Participants · 1 Total Inclusion Criteria

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