The Department of Social Work and Social Administration, The University of Hong Kong, Room 511, 5/F, The Jockey Club Tower, Centennial Campus, Pokfulam Road, Hong Kong, Special Administrative Region, China.
The Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Special Administrative Region, China.
Sci Rep. 2022 Oct 8;12(1):16932. doi: 10.1038/s41598-022-21343-9.
The World Health Organization Caregiver Skills Training Program (WHO-CST) was developed to strengthen caregivers' skills in supporting children with developmental delays and the caregivers' well-being. The WHO-CST Hong Kong (HK) was adapted, and pre-pilot tested to support families with children suspected of having developmental delays and autism spectrum disorder and to empower the caregivers to foster their children's learning, social communication, and adaptive behavior. A sequential mixed-methods research methodology was undertaken to examine the adaptation process and initial implementation experiences. The acceptability, feasibility, and perceived benefits of the WHO-CST were assessed using stakeholders' and caregivers' qualitative and caregivers' quantitative pre- and post-intervention feedback. The data included materials generated from (1) three consultation meetings with stakeholders; (2) detailed reviews of the translated and adapted WHO-CST materials by master trainees (n = 10) trained by the WHO-CST representatives; (3) needs assessment focus group interviews with caregivers (n = 15) of children with autism spectrum disorder; and (4) pre- and post-CST program qualitative focus group interviews and quantitative evaluation. Consultation with stakeholders suggested that the program was acceptable for the local community, but the home visit and fidelity components were initially considered to be challenges towards the feasibility and sustainability of the program. Caregivers in the needs assessment focus groups gave widely diverse views about the program's uniqueness, length, delivery mode, and the inclusion of videotaping in-home visits. Post-intervention comments by caregivers about the program were mainly positive, while the MTs were critical of the content and length of the training and fidelity process. As one of the first high-income locations to adopt the WHO-CST, the evaluation findings of the WHO-CST-HK indicate that it is feasible and acceptable to implement the program in a metropolitan area where families have busy work schedules and are very conscious of privacy issues. The study results suggest that the WHO-CST program in HK and other high-income countries require scaling up and further evaluation of its implementation in real community settings. This involves systemic and contextual changes to allow task-sharing between professionals and non-specialists at the macro level. Furthermore, technology should be used to support the supervision of non-specialists. In addition, easier access to the WHO-CST materials at the micro level is required to ensure equity, equality, diversity, and inclusion of diversified families of children with developmental delays.
世界卫生组织照料者技能培训计划（WHO-CST）旨在增强照料者在支持发育迟缓儿童方面的技能，并提高照料者的幸福感。该计划已在香港（HK）进行了适应性调整和预试点测试，以支持有发育迟缓儿童和自闭症谱系障碍儿童的家庭，并使照料者能够培养孩子的学习、社交沟通和适应行为能力。本研究采用序贯混合方法学，旨在检验适应性调整过程和初始实施经验。采用利益攸关方和照料者的定性反馈以及照料者干预前后的定量反馈，评估了 WHO-CST 的可接受性、可行性和感知益处。数据包括以下方面生成的材料：（1）与利益攸关方举行的三次咨询会议；（2）WHO-CST 代表培训的熟练学员（n=10）对翻译和调整后的 WHO-CST 材料的详细审查；（3）对自闭症谱系障碍儿童的照料者（n=15）进行的需求评估焦点小组访谈；（4）干预前后的 WHO-CST 计划定性焦点小组访谈和定量评估。与利益攸关方的协商表明，该计划为当地社区所接受，但家访和保真度部分最初被认为是该计划可行性和可持续性的挑战。需求评估焦点小组中的照料者对该计划的独特性、长度、交付模式以及在家访中纳入录像带提出了广泛不同的看法。干预后，照料者对该计划的评价主要是积极的，而熟练学员则对培训内容和长度以及保真度过程提出了批评。作为首批采用 WHO-CST 的高收入地区之一，对 WHO-CST-HK 的评估结果表明，在一个工作繁忙且对隐私问题非常关注的大都市地区实施该计划是可行和可接受的。研究结果表明，香港和其他高收入国家/地区的 WHO-CST 计划需要扩大规模，并进一步评估其在真实社区环境中的实施情况。这需要在宏观层面上进行系统和背景的改变，以允许专业人员和非专业人员之间的任务分担。此外，还应利用技术支持对非专业人员的监督。此外，还需要在微观层面上更容易获得 WHO-CST 材料，以确保发育迟缓儿童多样化家庭的公平、平等、多样性和包容性。
