Peterson-Katz Karys, Piccone Caitlin, Tuzi Nicole, Kulkarni Chaya, Reynolds James N
Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada.
Front Health Serv. 2023 Jun 23;3:1160217. doi: 10.3389/frhs.2023.1160217. eCollection 2023.
Developmental delay affects approximately 1 in 4 children under 6 years old. Developmental delay can be detected using validated developmental screening tools, such as the Ages and Stages Questionnaires. Following developmental screening, early intervention can occur to address and support any developmental areas of concern. Frontline practitioners and supervisors must be trained and coached to organizationally implement developmental screening tools and early intervention practice. No prior work has qualitatively investigated the barriers and facilitators to implementing developmental screening and early intervention in Canadian organizations from the perspectives of practitioners and supervisors who have completed a specialized training and coaching model.
Following semi-structured interviews with frontline practitioners and supervisors, thematic analysis identified four themes: cohesive networks support implementation efforts, implementation success is dependent on shared perspectives, established organizational policies increase implementation opportunities, and COVID-19 guidelines create organizational challenges. Each theme encompasses sub-themes that describe implementation facilitators: strong implementation context, multi-level multi-sectoral collaborative partnerships, adequate and collective awareness, knowledge, and confidence, consistent and critical conversations, clear protocols and procedures, and accessibility to information, tools, and best practice guidelines.
The outlined barriers and facilitators fill a gap in implementation literature by informing a framework for organization-level implementation of developmental screening and early intervention following training and coaching.
发育迟缓影响约四分之一的6岁以下儿童。发育迟缓可通过经过验证的发育筛查工具进行检测，如《年龄与阶段问卷》。在进行发育筛查后，可以采取早期干预措施来解决和支持任何令人担忧的发育领域。一线从业者和管理人员必须接受培训和指导，以便在组织层面实施发育筛查工具和早期干预实践。此前没有研究从完成了专门培训和指导模式的从业者和管理人员的角度，对加拿大各组织在实施发育筛查和早期干预方面的障碍和促进因素进行定性调查。
在对一线从业者和管理人员进行半结构化访谈后，主题分析确定了四个主题：紧密的网络支持实施工作、实施成功取决于共同的观点、既定的组织政策增加实施机会，以及新冠疫情防控指南带来组织挑战。每个主题都包含描述实施促进因素的子主题：强大的实施背景、多层次多部门的合作伙伴关系、充分的集体意识、知识和信心、持续且关键的对话、明确的协议和程序，以及获取信息、工具和最佳实践指南的途径。
所概述的障碍和促进因素填补了实施文献中的空白，为培训和指导后在组织层面实施发育筛查和早期干预提供了一个框架。
