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Innovative Approaches to Real-World Health and Rehabilitation Services
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Innovative Approaches to Real-World Health and Rehabilitation Services

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 41387

Special Issue Editors

Dr. Sue Lukersmith

E-Mail Website
Guest Editor
Disability and Health Implementation Research, Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia
Interests: disability; rehabilitation; case management; health services research; implementation research; impact analysis
Dr. Kiah L. Evans

E-Mail Website
Guest Editor
Discipline of Health Professions Education and Health Humanities Research Group, School of Allied Health, University of Western Australia, Perth, WA 6009, Australia
Interests: autism; caregivers; clinical guidelines; enhancing participation; measuring functioning; health professions education; wellbeing of health profession students; clinicians and educators; health and disability workforce sustainability
Special Issues, Collections and Topics in MDPI journals
Dr. Nicole Freene

E-Mail Website
Guest Editor
Discipline of Physiotherapy, Faculty of Health, University of Canberra, Canberra ACT 2601, Australia
Interests: physical activity; sedentary behavior; cardiac rehabilitation; prevention

Special Issue Information

Dear Colleagues, 

In contemporary contexts some established health and rehabilitation services are no longer ‘fit for purpose’. Increasingly, the complexity and constraints in real-world contexts impact a person’s functioning, disability, and health. Changes to policy, funding and resources, limits on health practitioner training and education, and service supply and demand relationships, create wicked problems for the health and rehabilitation workforce. 

We see that health and rehabilitation practitioners and service providers need to adapt, re-think, and create innovative approaches to achieve outcomes, enabling the person to achieve their goals. Interprofessional collaborations are emerging as a priority, creating enhanced integrated and coordinated person-centred care across health, disability, social, education, and workplace sectors. 

This Special Issue welcomes scientific papers on innovative and new approaches to real-world health and rehabilitation services including topics on:

  • Holistic and biopsychosocial approaches to functioning, disability, and health;
  • Person-centred services focused on individual support needs and goals within their context;
  • Primary and secondary strategies for disease and disability prevention, including assessment and therapy;
  • Innovative methods and adaptions to practice including managing change and remaining agile in dynamic contexts;
  • Strategies to optimise service provision;
  • Health and rehabilitation workforce and service sustainability;
  • Transdisciplinary roles within teams or strategies to enhance interprofessional collaboration;
  • Translation and implementation of evidence informed practice;
  • Analysis of impact.

Dr. Sue Lukersmith
Dr. Kiah L. Evans
Dr. Nicole Freene
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • biopsychosocial
  • contextual factors
  • functioning and disability
  • health and rehabilitation services
  • implementation and translation
  • prevention
  • impacts
  • sustainability

Published Papers (15 papers)

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Research

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20 pages, 1544 KiB  
Article
A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools—What Works, for Whom, and under What Circumstances?
by Sue Lukersmith, Luis Salvador-Carulla, Younjin Chung, Wei Du, Anoush Sarkissian and Michael Millington
Int. J. Environ. Res. Public Health 2023, 20(5), 4362; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20054362 - 28 Feb 2023
Cited by 1 | Viewed by 1725
Abstract
Case management developed from a generalist model to a person-centred model aligned with the evidence-informed evolution of best practice people-centred integrated care. Case management is a multidimensional and collaborative integrated care strategy where the case manager performs a set of interventions/actions to support [...] Read more.
Case management developed from a generalist model to a person-centred model aligned with the evidence-informed evolution of best practice people-centred integrated care. Case management is a multidimensional and collaborative integrated care strategy where the case manager performs a set of interventions/actions to support the person with a complex health condition to progress in their recovery pathway and participate in life roles. It is currently unknown what case management model works in real life for whom and under what circumstances. The purpose of this study was to answer these questions. The study methods used realistic evaluation framework, examined the patterns and associations between case manager actions (mechanisms), the person’s characteristics and environment (context), and recovery (outcomes) over 10 years post severe injury. There was mixed methods secondary analysis of data extracted via in-depth retrospective file reviews (n = 107). We used international frameworks and a novel approach with multi-layered analysis including machine learning and expert guidance for pattern identification. The study results confirm that when provided, a person-centred case management model contributes to and enhances the person’s recovery and progress towards participation in life roles and maintaining well-being after severe injury.Furthermore, the intensity of case management for people with traumatic brain injury, and the person-centred actions of advising, emotional and motivational support, and proactive coordination contribute to the person achieving their goals. The results provide learnings for case management services on the case management models, for quality appraisal, service planning, and informs further research on case management. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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15 pages, 598 KiB  
Article
Exploration of the Experiences of Persons in the Traumatic Spinal Cord Injury Population in Relation to Chronic Pain Management
by Tammy-Lee Williams, Conran Joseph, Lena Nilsson-Wikmar and Joliana Phillips
Int. J. Environ. Res. Public Health 2023, 20(1), 77; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20010077 - 21 Dec 2022
Cited by 1 | Viewed by 1950
Abstract
Chronic pain amongst individuals with traumatic and nontraumatic spinal cord injury (SCI) has high prevalence rates, with severe impact on the activities of daily living, mood, sleep and quality of life. This study aimed to explore the experiences and challenges of chronic pain [...] Read more.
Chronic pain amongst individuals with traumatic and nontraumatic spinal cord injury (SCI) has high prevalence rates, with severe impact on the activities of daily living, mood, sleep and quality of life. This study aimed to explore the experiences and challenges of chronic pain management amongst the traumatic spinal cord injury (TSCI) population in the Western Cape region of South Africa. A qualitative descriptive approach was chosen for the study, in which 13 individuals living with TSCI were purposively recruited and interviewed telephonically. An inductive thematic analytic approach was used. The results indicate ineffectiveness of standard pain management, with a lack of education regarding pain physiology and pain management strategies as well as unbalanced decision-making between clinician and patient. Thus, patients develop coping strategies to survive with pain. Current pain regimes are suboptimal at best, underpinned by the lack of clarity or a mutually agreed plan to mitigate and eradicate pain. There is a need for chronic pain management beyond pharmacological prescription. Future practices should focus on adopting a holistic, biopsychosocial approach, which includes alternative pain therapy management. In addition, advances in pain management cannot be achieved without adopting a therapeutic alliance between the clinician and patient. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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24 pages, 1147 KiB  
Article
Perceived Support Needs of School-Aged Young People on the Autism Spectrum and Their Caregivers
by Kiah Evans, Andrew J. O. Whitehouse, Emily D’Arcy, Maya Hayden-Evans, Kerry Wallace, Rebecca Kuzminski, Rebecca Thorpe, Sonya Girdler, Benjamin Milbourn, Sven Bölte and Angela Chamberlain
Int. J. Environ. Res. Public Health 2022, 19(23), 15605; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192315605 - 24 Nov 2022
Cited by 2 | Viewed by 2369
Abstract
With increasing demands for health, disability and education services, innovative approaches can help distribute limited resources according to need. Despite an increased focus on support needs within the clinical pathway and policy landscape, the body of research knowledge on this topic is at [...] Read more.
With increasing demands for health, disability and education services, innovative approaches can help distribute limited resources according to need. Despite an increased focus on support needs within the clinical pathway and policy landscape, the body of research knowledge on this topic is at a relatively early stage. However, there appears to be a sense of unmet support needs and dissatisfaction with the provision of required support following an autism diagnosis amongst caregivers of young people on the spectrum. The primary aim of this study was to explore the perceived support needs of Australian school-aged young people on the spectrum and their caregiver(s). This was achieved using a phenomenographic Support Needs Interview conducted by occupational therapists during home-visits with caregivers of 68 young people on the spectrum (5–17 years). Qualitative data analysis resulted in two hierarchical outcome spaces, one each for young people and their caregivers, indicating interacting levels of support need areas that could be addressed through a combination of suggested supports. These support needs and suggested supports align with almost all chapters within the Body Functions, Activities and Participation and Environmental Factors domains of the International Classification of Functioning, Disability and Health. The overall goals of meeting these complex and interacting support needs were for the young people to optimize their functioning to reach their potential and for caregivers to ensure the sustainability of their caregiving capacity. A series of recommendations for support services, researchers and policy makers have been made to position support needs as central during the assessment, support and evaluation phases. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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18 pages, 1045 KiB  
Article
Towards Co-Design in Delivering Assistive Technology Interventions: Reconsidering Roles for Consumers, Allied Health Practitioners, and the Support Workforce
by Natasha Layton, Jackie O’Connor, Amy Fitzpatrick and Sharon Carey
Int. J. Environ. Res. Public Health 2022, 19(21), 14408; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192114408 - 03 Nov 2022
Cited by 2 | Viewed by 2670
Abstract
A complexity of factors, from health and technology innovations to policy redesign to achieve consumer-directed care, are impacting traditional roles for Australian allied health practitioners (AHPs). This pilot study considers roles for AHPs in relation to assistive technology (AT) interventions. Articulating ‘who does [...] Read more.
A complexity of factors, from health and technology innovations to policy redesign to achieve consumer-directed care, are impacting traditional roles for Australian allied health practitioners (AHPs). This pilot study considers roles for AHPs in relation to assistive technology (AT) interventions. Articulating ‘who does what’ may serve a number of purposes including de-professionalization of the discourse; better utilization of support networks and workforces; and alignment with contemporary policy. Yet, a suitable framework to assist with collaborative AT implementation between relevant stakeholders was not identified within the existing literature. This research aimed to develop and pilot an AT collaboration tool which enables AHPs, consumers, their support networks and the support workforce, to navigate policy redesign toward ethical consumer-directed implementation of AT interventions. An AT collaboration tool was developed based upon practice-based knowledge, relevant regulatory and practice evidence and identifies relevant stakeholders, AT service steps and roles, and quality indicators to support competent practice. The tool was piloted in four separate and diverse practice analyses of AT interventions (custom prosthetics, home enteral nutrition, communication devices, and vehicle modifications) considering four allied health professions (prosthetics and orthotics, dietetics, speech pathology, occupational therapy). Pilot testing of the tool supports the feasibility of re-framing AT provision using competency-based and risk-informed approaches and enabling more inclusive roles for consumers and the support workforce. Further testing of the tool is indicated, followed by strategic actions for uptake by individuals, professions and policymakers. The AT collaboration tool has potential to enable AHPs to fulfil ethical obligations for consumer-centered practice, and to facilitate consumer choice, both in Australia and internationally. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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17 pages, 3005 KiB  
Article
What Does It Take to Get Somebody Back to Work after Severe Acquired Brain Injury? Service Actions within the Vocational Intervention Program (VIP 2.0)
by Philippa McRae, Conrad Kobel, Sue Lukersmith and Grahame Simpson
Int. J. Environ. Res. Public Health 2022, 19(15), 9548; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19159548 - 03 Aug 2022
Cited by 3 | Viewed by 1650
Abstract
Little is known about service actions delivered in the complex intervention of vocational rehabilitation (VR) for people with severe acquired brain injury (ABI). Scale-up of the Vocational Intervention Program (VIP) across the 12 Community teams of the NSW Brain Injury Rehabilitation Program provided [...] Read more.
Little is known about service actions delivered in the complex intervention of vocational rehabilitation (VR) for people with severe acquired brain injury (ABI). Scale-up of the Vocational Intervention Program (VIP) across the 12 Community teams of the NSW Brain Injury Rehabilitation Program provided an opportunity to analyse the intensity and profile of actions delivered in providing VR programs. Seventy-two participants with severe TBI were supported in returning to either pre-injury employment (FastTrack, FT, n = 27) or new employment (NewTrack, NT, n = 50), delivered by two types of VR providers (Disability Employment Service DES; private providers). VR providers documented their service actions in hours and minutes, using the Case Management Taxonomy, adapted to VR. The NT pathway required significantly higher levels of intervention in comparison to FT (25 h, five minutes vs. 35 h, 30 min, p = 0.048, W = 446). Case coordination was the most frequent service action overall (41.7% of total time for FT, 42.3% for NT). DES providers recorded significantly greater amounts of time undertaking engagement, assessment and planning, and emotional/motivational support actions compared to private providers. Overall duration of the programs were a median of 46 weeks (NT) and 36 weeks (FT), respectively. This study helps illuminate the profile of VR interventions for people with severe TBI. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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14 pages, 677 KiB  
Article
Australian University Nursing and Allied Health Students’ and Staff Physical Activity Promotion Preparedness and Knowledge: A Pre-Post Study Using an Educational Intervention
by Nicole Freene, Katie Porra, Jaquelin A. Bousie, Mark Naunton, Nick Ball, Andrew Flood, Kasia Bail, Sally De-Vitry Smith, Milli Blenkin, Lynn Cheong, Madeleine Shanahan, Stephen Isbel, Myra Leung and Ann B. Gates
Int. J. Environ. Res. Public Health 2022, 19(15), 9255; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19159255 - 28 Jul 2022
Cited by 2 | Viewed by 2218
Abstract
The promotion of physical activity (PA) by health professionals is a key strategy to increase PA levels in the population. In this study, we investigated PA promotion, preparedness, and knowledge among university nursing and allied health students and staff, as well as PA [...] Read more.
The promotion of physical activity (PA) by health professionals is a key strategy to increase PA levels in the population. In this study, we investigated PA promotion, preparedness, and knowledge among university nursing and allied health students and staff, as well as PA resource usage within curricula, before and after an educational intervention. Students and staff from 13 health disciplines at one Australian university were invited to complete an online survey, and a curriculum audits were conducted before and after PA teaching resources were promoted by academic PA champions (n = 14). A total of 299 students and 43 staff responded to the survey pre-intervention, and 363 and 32 responded to the post-intervention, respectively. PA promotion role perception (≥93%) and confidence to provide general PA advice (≥70%) were high throughout the study. Knowledge of PA guidelines was poor (3–10%). Students of physiotherapy, sport and exercise science, as well as more active students, were more likely to be aware of the PA guidelines (p < 0.05). Over 12 months, PA promotion preparedness and knowledge did not change significantly, nor was there a change in the amount of PA content delivered, despite a significant increase in the use of the teaching resources across a number of disciplines (p = 0.007). Future research should be carried out to investigate the implementation of the resources over time and to develop additional strategies for PA promotion and education scaffolded across curricula. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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19 pages, 377 KiB  
Article
Critical Characteristics of Housing and Housing Supports for Individuals with Concurrent Traumatic Brain Injury and Mental Health and/or Substance Use Challenges: A Qualitative Study
by Maria Jennifer Estrella, Bonnie Kirsh, Pia Kontos, Alisa Grigorovich, Angela Colantonio, Vincy Chan and Emily Joan Nalder
Int. J. Environ. Res. Public Health 2021, 18(22), 12211; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212211 - 20 Nov 2021
Cited by 5 | Viewed by 2774
Abstract
Traumatic brain injury (TBI) and mental health and/or substance use challenges (MHSU) are commonly co-occurring and prevalent in individuals experiencing homelessness; however, evidence suggests that systems of care are siloed and organized around clinical diagnoses. Research is needed to understand how housing and [...] Read more.
Traumatic brain injury (TBI) and mental health and/or substance use challenges (MHSU) are commonly co-occurring and prevalent in individuals experiencing homelessness; however, evidence suggests that systems of care are siloed and organized around clinical diagnoses. Research is needed to understand how housing and housing supports are provided to this complex and understudied group in the context of siloed service systems. This study aimed to describe critical characteristics of housing and housing supports for individuals with concurrent TBI and MHSU from the perspectives of service users with TBI and MHSU and housing service providers. Using basic qualitative description, in-depth interviews were conducted with 16 service users and 15 service providers. Data were analyzed using thematic analysis techniques. Themes capture core processes in finding and maintaining housing and the critical housing supports that enabled them: (1) overcoming structural barriers through service coordination, education and awareness raising, and partnerships and collaborations; and (2) enabling engagement in meaningful activity and social connection through creating opportunities, training and skills development, and design of home and neighborhood environments. Implications for practice, including the urgent need for formalized TBI and MHSU education, support for service providers, and potential interventions to further enable core housing processes are discussed. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
14 pages, 282 KiB  
Article
WHO Systematic Assessment of Rehabilitation Situation (STARS): Results of the Field Testing in Jordan, Myanmar, Sri Lanka, Solomon Islands, Laos, Haiti, and Guyana
by Pauline Kleinitz, Carla Sabariego and Alarcos Cieza
Int. J. Environ. Res. Public Health 2021, 18(21), 11549; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111549 - 03 Nov 2021
Cited by 4 | Viewed by 2259
Abstract
The WHO Systematic Assessment of Rehabilitation Situation (STARS) tool was developed by WHO to facilitate effective prioritization and strategic planning for rehabilitation in countries. The objective of this paper is to present the results of the fourth phase of its development, its field [...] Read more.
The WHO Systematic Assessment of Rehabilitation Situation (STARS) tool was developed by WHO to facilitate effective prioritization and strategic planning for rehabilitation in countries. The objective of this paper is to present the results of the fourth phase of its development, its field testing in seven countries focusing on its completeness, usefulness, accessibility and feasibility. Field testing occurred in Jordan, Myanmar, Sri Lanka, Solomon Islands, Laos, Haiti, and Guyana. Evaluation occurred through structured interviews and rating exercises with 17 government representatives, international consultants, WHO country or regional office staff and rehabilitation experts who were actively engaged and familiar with the STARS assessment and who were knowledgeable of the rehabilitation situation in the countries. STARS was appraised as relevant, complete and accurate in describing the country situation. Areas of inaccuracy were mostly linked to challenges in describing areas of services similarly when significant diversity existed. Feasibility and accessibility were mostly confirmed and more complex components of the tool as well as the guidance to the assessment process were slightly revised in light of the field-testing results. The field testing of WHO STARS confirmed its completeness, usefulness, accessibility and feasibility, and concerns raised by the interviews informed the last refinement of the tool. STARS is part of the WHO Rehabilitation in Health Systems-Guide for Action, available online, by September 2021, STARS had guided 21 country situation assessments. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
20 pages, 362 KiB  
Article
Australia’s Disability Employment Services Program: Participant Perspectives on Factors Influencing Access to Work
by Alexandra Devine, Marissa Shields, Stefanie Dimov, Helen Dickinson, Cathy Vaughan, Rebecca Bentley, Anthony D. LaMontagne and Anne Kavanagh
Int. J. Environ. Res. Public Health 2021, 18(21), 11485; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111485 - 31 Oct 2021
Cited by 8 | Viewed by 3850
Abstract
Disability employment programs play a key role in supporting people with disability to overcome barriers to finding and maintaining work. Despite significant investment, ongoing reforms to Australia’s Disability Employment Services (DES) are yet to lead to improved outcomes. This paper presents findings from [...] Read more.
Disability employment programs play a key role in supporting people with disability to overcome barriers to finding and maintaining work. Despite significant investment, ongoing reforms to Australia’s Disability Employment Services (DES) are yet to lead to improved outcomes. This paper presents findings from the Improving Disability Employment Study (IDES): a two-wave survey of 197 DES participants that aims to understand their perspectives on factors that influence access to paid work. Analysis of employment status by type of barrier indicates many respondents experience multiple barriers across vocational (lack of qualifications), non-vocational (inaccessible transport) and structural (limited availability of jobs, insufficient resourcing) domains. The odds of gaining work decreased as the number of barriers across all domains increased with each unit of barrier reported (OR 1.22, 95% CI 1.07, 1.38). Unemployed respondents wanted more support from employment programs to navigate the welfare system and suggest suitable work, whereas employed respondents wanted support to maintain work, indicating the need to better tailor service provision according to the needs of job-seekers. Combined with our findings from the participant perspective, improving understanding of these relationships through in-depth analysis and reporting of DES program data would provide better evidence to support current DES reform and improve models of service delivery. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
16 pages, 501 KiB  
Article
Participants’ Perspective of Engaging in a Gym-Based Health Service Delivered Secondary Stroke Prevention Program after TIA or Mild Stroke
by Maria Sammut, Kirsti Haracz, Coralie English, David Shakespeare, Gary Crowfoot, Michael Nilsson and Heidi Janssen
Int. J. Environ. Res. Public Health 2021, 18(21), 11448; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111448 - 30 Oct 2021
Cited by 2 | Viewed by 2643
Abstract
People who have had a transient ischemic attack (TIA) or mild stroke have a high risk of recurrent stroke. Secondary prevention programs providing support for meeting physical activity recommendations may reduce this risk. Most evidence for the feasibility and effectiveness of secondary stroke [...] Read more.
People who have had a transient ischemic attack (TIA) or mild stroke have a high risk of recurrent stroke. Secondary prevention programs providing support for meeting physical activity recommendations may reduce this risk. Most evidence for the feasibility and effectiveness of secondary stroke prevention arises from programs developed and tested in research institute settings with limited evidence for the acceptability of programs in ‘real world’ community settings. This qualitative descriptive study explored perceptions of participation in a secondary stroke prevention program (delivered by a community-based multidisciplinary health service team within a community gym) by adults with TIA or mild stroke. Data gathered via phone-based semi-structured interviews midway through the program, and at the end of the program, were analyzed using constructivist grounded theory methods. A total of 51 interviews from 30 participants produced two concepts. The first concept, “What it offered me”, describes critical elements that shape participants’ experience of the program. The second concept, “What I got out of it” describes perceived benefits of program participation. Participants perceived that experiences with peers in a health professional-led group program, held within a community-based gym, supported their goal of changing behaviour. Including these elements during the development of health service strategies to reduce recurrent stroke risk may strengthen program acceptability and subsequent effectiveness. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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Review

Jump to: Research, Other

52 pages, 957 KiB  
Review
Exploring and Mapping Screening Tools for Cognitive Impairment and Traumatic Brain Injury in the Homelessness Context: A Scoping Review
by Erin M. Fearn-Smith, Justin Newton Scanlan and Nicola Hancock
Int. J. Environ. Res. Public Health 2023, 20(4), 3440; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20043440 - 15 Feb 2023
Cited by 1 | Viewed by 2085
Abstract
Cognitive impairment is common amongst people experiencing homelessness, yet cognitive screening and the collection of history of brain injury rarely features in homelessness service delivery practice. The purpose of this research was to scope and map strategies for screening for the potential presence [...] Read more.
Cognitive impairment is common amongst people experiencing homelessness, yet cognitive screening and the collection of history of brain injury rarely features in homelessness service delivery practice. The purpose of this research was to scope and map strategies for screening for the potential presence of cognitive impairment or brain injury amongst people experiencing homelessness and identify instruments that could be administered by homelessness service staff to facilitate referral for formal diagnosis and appropriate support. A search was conducted across five databases, followed by a hand search from relevant systematic reviews. A total of 108 publications were included for analysis. Described in the literature were 151 instruments for measuring cognitive function and 8 instruments screening for history of brain injury. Tools that were described in more than two publications, screening for the potential presence of cognitive impairment or history of brain injury, were included for analysis. Of those regularly described, only three instruments measuring cognitive function and three measuring history of brain injury (all of which focused on traumatic brain injury (TBI)) may be administered by non-specialist assessors. The Trail Making Test (TMT) and the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) are both potentially viable tools for supporting the identification of a likely cognitive impairment or TBI history in the homelessness service context. Further population-specific research and implementation science research is required to maximise the potential for practice application success. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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21 pages, 1690 KiB  
Review
Demystifying Case Management in Aotearoa New Zealand: A Scoping and Mapping Review
by Caroline Stretton, Wei-Yen Chan and Dianne Wepa
Int. J. Environ. Res. Public Health 2023, 20(1), 784; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20010784 - 31 Dec 2022
Viewed by 2591
Abstract
Background: Community-based case managers in health have been compared to glue which holds the dynamic needs of clients to a disjointed range of health and social services. However, case manager roles are difficult to understand due to poorly defined roles, confusing terminology, and [...] Read more.
Background: Community-based case managers in health have been compared to glue which holds the dynamic needs of clients to a disjointed range of health and social services. However, case manager roles are difficult to understand due to poorly defined roles, confusing terminology, and low visibility in New Zealand. Aim: This review aims to map the landscape of case management work to advance workforce planning by clarifying the jobs, roles, and relationships of case managers in Aotearoa New Zealand (NZ). Methods: Our scoping and mapping review includes peer-reviewed articles, grey literature sources, and interview data from 15 case managers. Data was charted iteratively until convergent patterns emerged and distinctive roles identified. Results: A rich and diverse body of literature describing and evaluating case management work in NZ (n = 148) is uncovered with at least 38 different job titles recorded. 18 distinctive roles are further analyzed with sufficient data to explore the research question. Social ecology maps highlight diverse interprofessional and intersectoral relationships. Conclusions: Significant innovation and adaptations are evident in this field, particularly in the last five years. Case managers also known as health navigators, play a pivotal but often undervalued role in NZ health care, through their interprofessional and intersectoral relationships. Their work is often unrecognised which impedes workforce development and the promotion of person-centered and integrated health care. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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19 pages, 858 KiB  
Review
Turning to ‘Trusted Others’: A Narrative Review of Providing Social Support to First Responders
by Anna Tjin, Angeline Traynor, Brian Doyle, Claire Mulhall, Walter Eppich and Michelle O’Toole
Int. J. Environ. Res. Public Health 2022, 19(24), 16492; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192416492 - 08 Dec 2022
Cited by 1 | Viewed by 2459
Abstract
First responders, such as paramedics and firefighters, encounter duty-related traumatic exposures, which can lead to post-traumatic stress (PTS). Although social support protects against PTS, we know little about how first responders’ families, spouses/partners, friends, and care-partners (i.e., ‘trusted others’) provide social support. This [...] Read more.
First responders, such as paramedics and firefighters, encounter duty-related traumatic exposures, which can lead to post-traumatic stress (PTS). Although social support protects against PTS, we know little about how first responders’ families, spouses/partners, friends, and care-partners (i.e., ‘trusted others’) provide social support. This narrative review explores support behaviors, coping strategies, and resources trusted others use to support first responders. A structured literature search yielded 24 articles. We used House’s (1981) conceptual framework to inform our analysis. We identified three main themes: providing support, finding support, and support needs. Additionally, we describe trusted others’ self-reported preparedness, coping strategies, and barriers to providing social support. We found that trusted others provided different types of support: (a) emotional (fostering a safe space, giving autonomy over recovery, facilitating coping mechanisms, prioritizing first responders’ emotional needs); (b) instrumental (prioritizing first responders’ practical needs, handling household tasks, supporting recovery); (c) appraisal (active monitoring, verbal reassurance, positive reframing), and (d) informational (seeking informal learning). In their role, trusted others sought formal (organizational) and informal (peer and personal) support and resources, alongside intrapersonal and interpersonal coping strategies. Identified barriers include inadequate communication skills, maladaptive coping, and disempowering beliefs. Thus, we offer practical, treatment, and social support recommendations. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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29 pages, 909 KiB  
Review
An Evaluation of the Overall Utility of Measures of Functioning Suitable for School-Aged Children on the Autism Spectrum: A Scoping Review
by Maya Hayden-Evans, Benjamin Milbourn, Emily D’Arcy, Angela Chamberlain, Bahareh Afsharnejad, Kiah Evans, Andrew J. O. Whitehouse, Sven Bölte and Sonya Girdler
Int. J. Environ. Res. Public Health 2022, 19(21), 14114; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192114114 - 28 Oct 2022
Cited by 4 | Viewed by 3604
Abstract
A diagnosis of an autism spectrum condition (autism) provides limited information regarding an individual’s level of functioning, information key in determining support and funding needs. Using the framework introduced by Arksey and O’Malley, this scoping review aimed to identify measures of functioning suitable [...] Read more.
A diagnosis of an autism spectrum condition (autism) provides limited information regarding an individual’s level of functioning, information key in determining support and funding needs. Using the framework introduced by Arksey and O’Malley, this scoping review aimed to identify measures of functioning suitable for school-aged children on the autism spectrum and evaluate their overall utility, including content validity against the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets for Autism. The overall utility of the 13 included tools was determined using the Outcome Measures Rating Form (OMRF), with the Adaptive Behavior Assessment System (ABAS-3) receiving the highest overall utility rating. Content validity of the tools in relation to the ICF and ICF Core Sets for Autism varied, with few assessment tools including any items linking to Environmental Factors of the ICF. The ABAS-3 had the greatest total number of codes linking to the Comprehensive ICF Core Set for Autism while the Vineland Adaptive Behavior Scales (Vineland-3) had the greatest number of unique codes linking to both the Comprehensive ICF Core Set for Autism and the Brief ICF Core Set for Autism (6–16 years). Measuring functioning of school-aged children on the spectrum can be challenging, however, it is important to accurately capture their abilities to ensure equitable and individualised access to funding and supports. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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Systematic Review
Vocational Interventions to Improve Employment Participation of People with Psychosocial Disability, Autism and/or Intellectual Disability: A Systematic Review
by Isabelle Weld-Blundell, Marissa Shields, Alexandra Devine, Helen Dickinson, Anne Kavanagh and Claudia Marck
Int. J. Environ. Res. Public Health 2021, 18(22), 12083; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212083 - 17 Nov 2021
Cited by 9 | Viewed by 4323
Abstract
Objective: To systematically review interventions aimed at improving employment participation of people with psychosocial disability, autism, and intellectual disability. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Science, Scopus, CINAHL, ERIC, and ERC for studies published from 2010 to July 2020. Randomized controlled [...] Read more.
Objective: To systematically review interventions aimed at improving employment participation of people with psychosocial disability, autism, and intellectual disability. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Science, Scopus, CINAHL, ERIC, and ERC for studies published from 2010 to July 2020. Randomized controlled trials (RCTs) of interventions aimed at increasing participation in open/competitive or non-competitive employment were eligible for inclusion. We included studies with adults with psychosocial disability autism and/or intellectual disability. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias II Tool. Data were qualitatively synthesized. Our review was registered with PROSPERO (CRD42020219192). Results: We included 26 RCTs: 23 targeted people with psychosocial disabilities (n = 2465), 3 included people with autism (n = 214), and none included people with intellectual disability. Risk of bias was high in 8 studies, moderate for 18, and low for none. There was evidence for a beneficial effect of Individual Placement and Support compared to control conditions in 10/11 studies. Among young adults with autism, there was some evidence for the benefit of Project SEARCH and ASD supports on open employment. Discussion: Gaps in the availability of high-quality evidence remain, undermining comparability and investment decisions in vocational interventions. Future studies should focus on improving quality and consistent measurement, especially for interventions targeting people with autism and/or intellectual disability. Full article
(This article belongs to the Special Issue Innovative Approaches to Real-World Health and Rehabilitation Services)
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