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Implementation and impact: integrating a parenting intervention into routine care for children with early
Rivka R Green1, Marin M Taylor1, Chantal C Cheung1
1Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.
Insights
Interact-North, a telehealth program, successfully supports children with behavioral challenges in hospitals. While effective and scalable, consistent funding is needed for long-term sustainability.
Area of Science:
- Implementation Science
- Pediatric Healthcare
- Telehealth Interventions
Background:
- Children with neurological/neurodevelopmental conditions frequently experience behavioral regulation challenges.
- Limited hospital-based support exists for these behavioral challenges.
- Interact-North is a telehealth intervention offering behavioral coaching and psychoeducation to parents.
Purpose of the Study:
- To assess organizational readiness for implementing Interact-North in a pediatric tertiary hospital.
- To co-design clinical service pathways for the intervention.
- To evaluate implementation outcomes and sustainability of the telehealth program.
Main Methods:
- A mixed-methods design guided by The Implementation Roadmap was employed.
- Evaluated organizational readiness, co-developed service pathways, and assessed outcomes via surveys, administrative data, field notes, and interviews.
- Implementation occurred across three hospital divisions.
Main Results:
- Clinicians reported high organizational readiness, program fit, and acceptability.
- 167 families were referred, 108 enrolled, and 75 completed the program with 90% fidelity.
- Facilitators included adaptability and alignment with clinical needs; funding stability was a concern.
Conclusions:
- Interact-North is a scalable model addressing psychosocial support gaps for families of children with neurological/neurodevelopmental conditions.
- Successful implementation within pediatric specialty divisions demonstrates feasibility and effectiveness.
- Sustained funding is crucial for the long-term viability of this telehealth intervention.
Background:
Children with neurological/neurodevelopmental conditions experience behavioral regulation challenges, yet few receive support in hospitals. Interact-North is a tele-health intervention providing individualized behavioral coaching and neurological and health-related psychoeducation to parents of children with neurological/neurodevelopmental conditions. This study assessed its implementation in a pediatric tertiary hospital. Objectives included: (1) assess organizational readiness, (2) co-design service pathways, and (3) evaluate implementation outcomes and sustainability.
Methods:
Guided by The Implementation Roadmap, we evaluated Interact-North's implementation across three hospital divisions. A mixed-methods design was used to assess organizational readiness, co-develop clinical service pathways, and evaluate outcomes through surveys, program administrative metrics, field notes, and semi-structured interviews.
Results:
Clinicians reported high organizational readiness, strong perceived fit, and high program acceptability. Clinical service pathways were co-developed iteratively over a 6-month period during which 167 families were referred, 108 enrolled, and 75 completed. Fidelity was high (90%), as was perceived effectiveness noted by improvements in behavioral concerns. Key implementation facilitators included program adaptability, alignment with clinical needs, and enhanced continuity of care. Sustainability ratings were high across domains, except for funding stability.
Conclusions:
The implementation of Interact-North represents a scalable model to address the gap in psychosocial support for families, but funding remains a barrier.
Impact:
Early behavior and emotional regulation challenges impact up to 40% of young children followed in early neurological and neurodevelopmental hospital clinics, yet there are limited embedded interventions. This study demonstrates that an evidence-based family-centered tele-health behavioral and psychosocial intervention can be successfully implemented within pediatric specialty hospital divisions. Results support strong clinician engagement, program fidelity, and meaningful acceptability and effectiveness outcomes for families. Findings provide a scalable model for implementing early behavioral interventions for children with early neurological/neurodevelopmental conditions seen in the hospital.
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