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Bridging research and practice: a mixed-methods implementation protocol supporting powered mobility use in early
Sloane Bm1, Zuckerman Ke1, Davis Mm2
1Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA.
Insights
This study tested a parent-led powered mobility (PM) intervention for young children with cerebral palsy (CP). The approach showed feasibility, supporting early access to mobility for children with significant motor impairments.
Area of Science:
- Pediatric Rehabilitation
- Assistive Technology
- Early Childhood Intervention
Background:
- Cerebral palsy (CP) significantly impacts motor function in young children.
- Early intervention is crucial for maximizing developmental potential in children with CP.
- Access to powered mobility (PM) can enhance independence and participation for children with severe motor impairments.
Purpose of the Study:
- To evaluate the feasibility, acceptability, and fidelity of a clinician training and parent-led powered mobility (PM) intervention for young children with CP (GMFCS Levels IV-V).
- To assess the integration of PM into early childhood settings.
- To inform scalable models for clinician training and caregiver coaching.
Main Methods:
- A single-arm, mixed-methods feasibility trial conducted in partnership with two early childhood programs.
- Phase 1: Needs assessment. Phase 2: Community Advisory Board co-design. Phase 3: Clinician training and caregiver coaching for a 12-week home-based PM intervention.
- Participants included up to 55 clinicians coaching caregivers for children aged 12-32 months using the Explorer Mini.
Main Results:
- Feasibility outcomes included recruitment, retention, acceptability, and appropriateness of the intervention.
- Implementation fidelity was assessed through adherence, dosage, quality, participant responsiveness, and program differentiation.
- Preliminary caregiver and child outcomes were also measured.
Conclusions:
- The study advances understanding of implementing PM interventions within early childhood systems.
- Findings will guide the development of scalable models for clinician training and caregiver coaching.
- This approach supports timely access to mobility for young children with significant motor impairments.
Objective:
To evaluate the feasibility, acceptability, and fidelity of a clinician training and subsequent home-based, parent-led powered mobility (PM) intervention for young children with cerebral palsy (CP; Gross Motor Function Classification System Levels IV-V) in early childhood settings.
Methods:
This single-arm, mixed-methods feasibility trial will take place in partnership with two early childhood programs in Oregon. Phase 1 consists of a needs assessment to identify current practices and determinants of PM implementation, and Phase 2 engages with a Community Advisory Board to co-design the clinician training and implementation strategies. In Phase 3, up to 55 clinicians will participate in training focused on integrating PM into routine care, applying caregiver coaching practices, and using implementation strategies. These clinicians will then coach caregivers to deliver a 12-week, home-based PM intervention using the Explorer Mini with up to 12 children aged 12-32 months. Outcomes include feasibility (recruitment, retention, acceptability, and appropriateness), implementation fidelity (adherence, dosage, quality, participant responsiveness, and program differentiation), and preliminary caregiver and child outcomes. Quantitative and qualitative data will be analysed descriptively and thematically to inform refinement of future implementation strategies.
Impact:
This study will advance understanding of how PM interventions can be implemented in early childhood systems, through needs assessment, co-design, and feasibility testing. Findings will inform scalable models for clinician training and caregiver coaching, supporting ON Time access to mobility for young children with significant motor impairments.