Abstract
BackgroundBacked by over 20 years of research development, the Wheelchair Skills Program (WSP) has proven to be a safe and effective program to improving wheelchair skills for adult wheelchair users. However, evidence is lacking for the pediatric population, which may help to explain the limited use of the WSP in pediatric settings. While additional evidence specific to the pediatric population is needed, concurrent implementation of the WSP into pediatric clinical practice is equally prudent to allow those users to benefit from the years of accumulated WSP evidence. To facilitate implementation of evidence-based programs into practice, adaptation is also often required to improve the fit between the program and the local context. Therefore, the objective of this study was to understand what adaptations, if any, are required for the WSP to be implementable in a pediatric setting.MethodsA deductive qualitative descriptive study design was used, guided by the Knowledge to Action Framework and Consolidated Framework for Implementation Research (CFIR). Occupational Therapists (OTs) from a pediatric rehabilitation center and two specialized schools in Montreal, Canada were invited to participate in a 90-min focus group. The Framework Method was followed for the data analysis.ResultsOne focus group in each site (n = 3) was conducted with a total of 19 participants. From the OTs’ perspectives, our analysis revealed benefits of WSP use and various issues (e.g. some skills seem unrealistic) affecting its uptake in relation to the constructs of the CFIR Intervention Characteristics domain. The results provided guidance for the recommendations of adaptations (e.g. addition of a caregiver assistance score) to enhance implementation of the WSP in pediatric rehabilitation settings and helped to identify the need for the production of new knowledge and knowledge translation (KT) tools.ConclusionsImplementation of the WSP with the adaptations and KT tools proposed could allow pediatric manual wheelchair users to improve their wheelchair skills.
Highlights
Backed by over 20 years of research development, the Wheelchair Skills Program (WSP) has proven to be a safe and effective program to improving wheelchair skills for adult wheelchair users
Independent mobility among pediatric manual wheelchair users is important for their achievement of developmental milestones [1, 2], yet many children using a manual wheelchair rely on their parents and others for personal mobility [3, 4]
Our qualitative analysis revealed benefits of using the WSP and various issues affecting its uptake in pediatric settings in relation to five constructs of the Consolidated Framework for Implementation Research (CFIR) Intervention Characteristic domain
Summary
Backed by over 20 years of research development, the Wheelchair Skills Program (WSP) has proven to be a safe and effective program to improving wheelchair skills for adult wheelchair users. To facilitate implementation of evidence-based programs into practice, adaptation is often required to improve the fit between the program and the local context. One way to improve mobility is through wheelchair skills training using an evidence-based program, such as the Wheelchair Skills Program (WSP) [5]. Backed by over 20 years of research development, there is extensive evidence that the WSP is a safe, effective intervention with the adult population [6]. Evidence is lacking for the pediatric population, which may help to explain the limited use of the WSP in pediatric settings [7, 8]
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