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Tele-care intervention performed by parents involving specific task- environment- participation (STEP protocol) for
Camila Resende Gâmbaro Lima1, Adriana Neves Dos Santos2, Mariana Martins Dos Santos3
1Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, São Carlos, SP, 13565-905, Brazil. camillinha_gambaro@hotmail.com.
Insights
Tele-care offers a solution for infants needing developmental therapy during social distancing. This home-based program trains parents in movement, participation, and environmental adaptation for at-risk infants.
Area of Science:
- Pediatrics
- Rehabilitation
- Telehealth
Background:
- COVID-19 pandemic social distancing limited therapy access for at-risk infants.
- Tele-care emerged as an alternative, delivering assessments and interventions online within the home.
- This study introduces a tele-care protocol for infants at risk of developmental delay.
Purpose of the Study:
- To describe a tele-care protocol for infants at risk for developmental delay.
- To evaluate the effectiveness of a home-based intervention focusing on movement, participation, and environmental adaptation.
- To support the implementation of remote, cost-effective, family-centered care models.
Main Methods:
- A randomized controlled trial involving infants aged 3-9 months corrected age.
- Experimental group received a task, environment, and participation in context-specific home program via tele-care.
- Assessments included motor capacity, participation, and environmental factors, conducted online before and after a 10-week intervention.
Main Results:
- The study will describe the effectiveness of the home intervention.
- Results will highlight the impact of specific activities, participation, and environmental changes.
- Data analysis will determine the significance of the intervention's outcomes.
Conclusions:
- This tele-care model can provide effective, accessible therapy for at-risk infants.
- The protocol's focus on family-specific needs and lower costs supports public health policy.
- Remote care models can enhance equitable access to evidence-based healthcare.
Background:
With the implementation of social distancing due to the Covid-19 pandemic, many at-risk infants are without therapy. An alternative mode of therapy in this situation is tele-care, a therapy in which assessments and interventions are carried out online, in the home environment. We describe a tele-care protocol involving parent delivered task and context specific movement training, participation and environmental adaptation for infants at risk for developmental delay.
Methods:
Randomized controlled trial. Infants at risk, with 3 to 9 months corrected age, will be included, and randomized into two groups: control group (conventional guidelines) and experimental group (task, environment and participation in context-specific home program). Infants will be assessed for motor capacity (Infant Motor Profile and Alberta Infant Motor Scale); participation (Young Children's Participation and Environment Measure) and environment factors (Parent-Child Early Relational Assessment; Affordances in the Home Environment for Motor Development). The intervention period will be 10 weeks, and evaluations will be carried out before and after that period. All the assessment and intervention procedures will be carried out online, with instructions to parents for home therapy. The statistical analysis will be guided according to the distribution of the data, and a significance level of 5% will be adopted. All ethical approvals were obtained by the Ethics Committee of the University of São Carlos (Case number 31256620.5.0000.5504). The protocol will follow the SPIRIT statement. Findings will be disseminated in peer-reviewed publications and presented at national and international conferences.
Discussion:
The results of this study will describe the effectiveness of a home intervention, focusing on specific activities, participation and environmental changes. These results will support the implementation of a remote protocol, with lower financial costs and focused on the particularities of the family. This type of care model can possibly help public policies to ensure equal access to evidence-based quality healthcare.
Trial Registration:
Brazilian Clinical Trials Registry: RBR8xrzjs , registered September 1, 2020.
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