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Realist process evaluation of occupational performance coaching: protocol.

Fiona Graham1, Jonathan Williman2, Laura Desha3

  • 1Department of Medicine, University of Otago, Wellington, New Zealand fi.graham@otago.ac.nz.

BMJ Open
|June 6, 2024
PubMed
Summary
This summary is machine-generated.

This study evaluates occupational performance coaching (OPC) for children with neurodisability, examining its effectiveness for diverse families. Findings will refine OPC delivery to improve outcomes for children and caregivers.

Keywords:
Child & adolescent psychiatryCommunity child healthDevelopmental neurology & neurodisabilityPatient SatisfactionPatient-Centered CareRehabilitation medicine

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Area of Science:

  • Rehabilitation Science
  • Implementation Science
  • Child Development

Background:

  • The Meaning, Agency and Nurturing Autonomy (MANA) study is a cluster randomized controlled trial evaluating occupational performance coaching (OPC) against usual care for children with neurodisability.
  • This protocol outlines a parallel realist process evaluation to refine the OPC program theory and logic model.

Purpose of the Study:

  • To examine the mechanisms, contexts, and outcomes of occupational performance coaching (OPC) implementation for caregivers of children with neurodisability.
  • To understand what works, for whom, and under what circumstances OPC is effective, with a focus on Māori and Pasifika families.

Main Methods:

  • A mixed-methods approach using data from the MANA study's OPC group.
  • Quantitative analysis of treatment fidelity, caregiver emotional response, preintervention emotional state, and client outcomes.
  • Reflexive thematic analysis of interviews with therapists and culturally focused interviews with Māori and Pasifika clients.

Main Results:

  • The evaluation aims to synthesize Intervention-Actor Context-Mechanism-Outcome configurations.
  • Analysis will identify factors influencing therapist fidelity and mechanisms triggering caregiver/therapist responses to OPC.
  • Trial outcomes from the MANA study will be reported separately.

Conclusions:

  • This realist evaluation will provide in-depth understanding of OPC implementation in real-world settings.
  • Findings will inform the refinement of OPC delivery to optimize social participation, health, and well-being for children with neurodisability and their caregivers.
  • Dissemination to participants, clinicians, and policymakers will support evidence-based decision-making for effective OPC services.