scholarly journals Sustainable support solutions for Community-Based Rehabilitation Workers in refugee camps: Piloting telehealth acceptability and implementation

2020 ◽  
Author(s):  
Bria Mitchell-Gillespie ◽  
Hiba Hashim ◽  
Megan Griffin ◽  
Rawan AlHeresh
Keyword(s):  
Focus Groups ◽  
Speech Therapy ◽  
Cultural Beliefs ◽  
Scale Up ◽  
Community Based ◽  
Quality Health Care ◽  
Middle Income ◽  
Training Support ◽  
Sustainable Implementation ◽  
Community Based Rehabilitation

Abstract Background The lack of training and education of Community-Based Rehabilitation (CBR) workers poses one of the most significant barriers to receiving effective occupational, physical and speech therapy for individuals with disabilities in Low-to-Middle Income Countries (LMIC), especially in countries with significant refugee populations. The aim of this study was to successfully implement a telehealth support system for CBR workers, evaluate the feasibility and acceptability of this intervention’s implementation among CBR workers in the CBR setting, and further identify strategies to address the deficit of skilled rehabilitation workers in LMIC through technological intervention. Methods This pilot study included CBR workers and CBR managers to inform feasibility, acceptability, and sustainable implementation. The RE-AIM and Dynamic Sustainability Framework were incorporated to guide procedural design, survey development, data collection, data evaluation, and increase success of telehealth implementation. CBR workers participate in trainings, telehealth sessions, surveys and focus groups to inform feasibility and acceptability. CBR Managers participated in focus groups to inform feasibility and sustainable implementation. NVIVO 12 Software was utilized to develop themes from CBR worker and CBR manager responses. Results Findings from this study demonstrate the need for additional training support for CBR workers in CBR settings throughout the entire treatment process. The telehealth system demonstrated successful short-term implementation across several domains of feasibility. Telehealth utilization was also proven acceptable, appropriate and necessary. Cultural beliefs, CBR worker training, and CBR Center infrastructure pose the most significant barriers to implementation of telehealth technologies in CBR Centers. CBR workers and managers confirmed the demand for future telehealth-based support systems, strengthening effort towards sustainability and scale-up. Conclusions Telehealth can be utilized to support CBR workers that serve vulnerable and marginalized populations, and in turn improve the global health status among refugee populations by reducing inequitable access to quality health care. The results support the need for further research to rigorously evaluate effectiveness of telehealth interventions to support CBR workers.

scholarly journals Sustainable support solutions for community-based rehabilitation workers in refugee camps: piloting telehealth acceptability and implementation

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Bria Mitchell-Gillespie ◽  
Hiba Hashim ◽  
Megan Griffin ◽  
Rawan AlHeresh
Keyword(s):  
Focus Groups ◽  
Speech Therapy ◽  
Cultural Beliefs ◽  
Scale Up ◽  
Community Based ◽  
Quality Health Care ◽  
Middle Income ◽  
Training Support ◽  
Sustainable Implementation ◽  
Community Based Rehabilitation

Abstract Background The lack of training and education of Community-Based Rehabilitation (CBR) workers poses one of the most significant barriers to receiving effective occupational, physical and speech therapy for individuals with disabilities in Low-to-Middle Income Countries (LMIC), especially in countries with significant refugee populations. The aim of this study was to successfully implement a telehealth support system for CBR workers, evaluate the feasibility and acceptability of this intervention’s implementation among CBR workers in the CBR setting, and further identify strategies to address the deficit of skilled rehabilitation workers in LMIC through technological intervention. Methods This pilot study included CBR workers and CBR managers to inform feasibility, acceptability, and sustainable implementation. The RE-AIM and Dynamic Sustainability Framework were incorporated to guide procedural design, survey development, data collection, data evaluation, and increase success of telehealth implementation. CBR workers participate in trainings, telehealth sessions, surveys and focus groups to inform feasibility and acceptability. CBR Managers participated in focus groups to inform feasibility and sustainable implementation. NVIVO 12 Software was utilized to develop themes from CBR worker and CBR manager responses. Results Findings from this study demonstrate the need for additional training support for CBR workers in CBR settings throughout the entire treatment process. The telehealth system demonstrated successful short-term implementation across several domains of feasibility. Telehealth utilization was also proven acceptable, appropriate and necessary. Cultural beliefs, CBR worker training, and CBR Center infrastructure pose the most significant barriers to implementation of telehealth technologies in CBR Centers. CBR workers and managers confirmed the demand for future telehealth-based support systems, strengthening effort towards sustainability and scale-up. Conclusions Telehealth can be utilized to support CBR workers that serve vulnerable and marginalized populations, and in turn improve the global health status among refugee populations by reducing inequitable access to quality health care. The results support the need for further research to rigorously evaluate effectiveness of telehealth interventions to support CBR workers.

scholarly journals Knowledge, Attitude and Practice Survey Tool for Intellectual Disability (KAP-ID)

2014 ◽  
Vol 3 (1) ◽  
pp. 22-25
Author(s):  
R Lakhan
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Resource Poor Setting ◽  
Community Based ◽  
Middle Income ◽  
Survey Tool ◽  
Practice Survey ◽  
Attitude And Practice ◽  
Community Based Rehabilitation ◽  
Knowledge Attitude And Practice

Background: Community based rehabilitation approach is very popular in providing rehabilitation services to the people with intellectual disability in low and middle income countries. It is useful to assess level of knowledge, attitude and practices of parents and relatives of people with intellectual disabilities for strategic planning of the program. Method: series of meetings, focus groups and in-depth interviews with the professionals employed in community based rehabilitation project and workers, and community members were conducted. Common questions around the issues related with intellectual disabilities were collected and discussed. These questions were refined with consultation, references with existing literature and field testing. Result: We have developed and tested a Knowledge, Attitude and Practice survey tool for Intellectual Disability (KAP-ID) in a resource poor setting of a middle income country, India. This tool contains fifteen questions. Conclusion: This brief survey tool is helpful in assessing knowledge, attitude and practices of parents, relatives and also of the community on intellectual disabilities. Information gained through the survey on KAPID found to be useful in designing the behavioral, awareness, educational, health promotional, and interventional program for the population with intellectual disabilities in rural poor settings. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 22-25 DOI: http://dx.doi.org/10.3126/njms.v3i1.10345

scholarly journals ASHA-Led Community-Based Groups to Support Control of Hypertension in Rural India Are Feasible and Potentially Scalable

2021 ◽  
Vol 8 ◽  
Author(s):  
Michaela A. Riddell ◽  
G. K. Mini ◽  
Rohina Joshi ◽  
Amanda G. Thrift ◽  
Rama K. Guggilla ◽  
...  
Keyword(s):  
Program Implementation ◽  
Scale Up ◽  
Complex Interventions ◽  
Implementation Process ◽  
Rural India ◽  
Supportive Supervision ◽  
Culturally Appropriate ◽  
Clinical Trial Registry ◽  
Community Based ◽  
Middle Income

Background: To improve the control of hypertension in low- and middle-income countries, we trialed a community-based group program co-designed with local policy makers to fit within the framework of India's health system. Trained accredited social health activists (ASHAs), delivered the program, in three economically and developmentally diverse settings in rural India. We evaluated the program's implementation and scalability.Methods: Our mixed methods process evaluation was guided by the United Kingdom Medical Research Council guidelines for complex interventions. Meeting attendance reports, as well as blood pressure and weight measures of attendees and adherence to meeting content and use of meeting tools were used to evaluate the implementation process. Thematic analysis of separate focus group discussions with participants and ASHAs as well as meeting reports and participant evaluation were used to investigate the mechanisms of impact.Results: Fifteen ASHAs led 32 community-based groups in three rural settings in the states of Kerala and Andhra Pradesh, Southern India. Overall, the fidelity of intervention delivery was high. Six meetings were delivered over a 3-month period to each of the intervention groups. The mean number of meetings attended by participants at each site varied significantly, with participants in Rishi Valley attending fewer meetings [mean (SD) = 2.83 (1.68)] than participants in West Godavari (Tukeys test, p = 0.009) and Trivandrum (Tukeys test, p < 0.001) and participants in West Godavari [mean (SD) = 3.48 (1.72)] attending significantly fewer meetings than participants in Trivandrum [mean (SD) = 4.29 (1.76), Tukeys test, p < 0.001]. Culturally appropriate intervention resources and the training of ASHAs, and supportive supervision of them during the program were critical enablers to program implementation. Although highly motivated during the implementation of the program ASHA reported historical issues with timely remuneration and lack of supportive supervision.Conclusions: Culturally appropriate community-based group programs run by trained and supported ASHAs are a successful and potentially scalable model for improving the control of hypertension in rural India. However, consideration of issues related to unreliable/insufficient remuneration for ASHAs, supportive supervision and their formal role in the wider health workforce in India will be important to address in future program scale up.Trial Registration: Clinical Trial Registry of India [CTRI/2016/02/006678, Registered prospectively].

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