Mode Of Service Delivery Research Articles

Active Learning Assisted Admission and Bandwidth Management in HWN for Facilitating Differential QoS under Multicriteria Factors

Control of call admission and management of bandwidth are the two important functionalities to achieve higher call handling capacity in heterogeneous wireless networks (HWN). This work addresses the problem of supporting differential qualities of services (QoS) with adherence to multicriteria factors in addition to reducing call-dropping probability in HWN. Toward this end, learning-assisted admission and bandwidth management are proposed. The decision to control the call acceptance ratio and bandwidth allocation level is learned continuously based on current network dynamics and the differential QoS requirements of the current calls. This learning reduces the call drop probability and slippage in QoS for calls. The parameters employed for evaluation in the suggested approach for call admission control include call priority, service type, service delivery mode, bandwidth availability for scalable and nonscalable calls, QoS distortion rate, and call ratio.

Qualitative Study of Certified Peer Specialists' Experiences Delivering Peer Support Services During the COVID-19 Pandemic.

The purpose of this qualitative study was to examine the experiences of certified peer specialists (CPSs) in delivering telehealth services during the COVID-19 pandemic. Fourteen semistructured interviews with CPSs were conducted from August to November 2020. Data were analyzed by using thematic analysis. Helpful support from employers during the transition to telehealth included clear communication and access to training on telehealth technologies. Main barriers and facilitators were related to interpersonal relationships and logistical factors. CPSs reported that telehealth allowed them to continue to support the peers they serve but that the quality of interactions was not as good as with in-person services. Logistical challenges included inadequate equipment and Internet access. To support CPSs in delivering telehealth, employers can engage them in open and transparent communication about guidelines for service delivery, provide training and equipment, and allow them the flexibility to tailor service delivery modalities to the peers they serve.

Increasing Adherence to Prophylactic Swallowing Exercises During Head and Neck Radiotherapy: The Multicenter, Randomized Controlled PRESTO-Trial

BackgroundProphylactic swallowing exercises (PSE) during radiotherapy can significantly reduce dysphagia after radiotherapy in head and neck cancer (HNC). However, its positive effects are hampered by low adherence rates during the burdensome therapy period. Hence, the main goal of this multicenter randomized controlled trial (RCT) was to investigate the effect of 3 different service-delivery modes on actual patients’ adherence.MethodsA total of 148 oropharyngeal cancer patients treated with primary (chemo)radiotherapy were randomly assigned to a 4 weeks PSE program, either diary-supported (paper group; n = 49), app-supported (app group; n = 49) or therapist-supported (therapist group; n = 50). Participants practiced 5 days/week, daily alternating tongue strengthening exercises with chin tuck against resistance exercises. Adherence was measured as the percentage of completed exercise repetitions per week (%reps). Statistical analysis was performed by means of SPSSv27, using Linear Mixed-effects Models with post hoc pairwise testing and Bonferroni-Holm correction.ResultsAdherence and evolution of adherence over time was significantly different between the three groups (p < .001). Adherence rates decreased in all three groups during the 4 training weeks (p < .001). During all 4 weeks, the therapist group achieved the highest adherence rates, whilst the app group showed the lowest adherence rates.ConclusionsPSE adherence decreased during the first 4 radiotherapy weeks regardless of group, but with a significant difference between groups. The therapist group achieved the highest adherence rates with a rather limited decline, therefore, increasing the face-to-face contact with a speech-language therapist can overcome the well-known problem of low adherence to PSE in this population.Trial RegistrationTrial registration: ISRCTN, ISRCTN98243550. Registered December 21, 2018 – retrospectively registered, https://www.isrctn.com/ISRCTN98243550?q=gwen%20van%20nuffelen&filters=&sort=&offset=1&totalResults=2&page=1&pageSize=10&searchType=basic-search.

Preferences of Young Black Gay, Bisexual, and Other Men Who Have Sex with Men Regarding Integration of HIV and Mental Health Care Services.

Optimization of mental health service use is critical to HIV care engagement among young Black gay, bisexual, and other men who have sex with men (YB-GBMSM). Clinic-level interventions to integrate HIV and mental health services have been proposed; however, patient perspectives on such care models are often lacking. We conducted a mixed-methods study consisting of surveys (N = 100) and qualitative in-depth interviews (n = 15) with YB-GBMSM recruited from two Ryan White-funded HIV clinics in Atlanta, Georgia. Most participants (70%) agreed that integration of HIV and mental health services was beneficial to them. Thirty-six percent (36%) desired a higher level of integration than what they perceived was currently available in their clinic setting, 51% believed their clinic was already optimally integrated, and 13% preferred less integration. In the qualitative interviews, participants discussed their support for potential integration strategies such as training HIV providers to prescribe antidepressants, closer in-clinic proximity of HIV and mental health providers, and use of patient navigators to help patients access mental health care and remind them of appointments. Perceived benefits of care integration included easier access to mental health services, enhanced overall well-being, and improved HIV care engagement. In summary, YB-GBMSM were supportive of integrating HIV and mental health services, with varying individual preferences regarding the degree and operationalization of this integration. Improving integration of mental health and HIV services, and tailoring modes of service delivery to individual preferences, has the potential to improve both general well-being and HIV care engagement in this high priority population.

The Importance of Centers for Independent Living Supporting Youth With Disabilities: A Critical Contribution to Maximize Transition Service Delivery

An integral element of maximizing positive postschool outcomes for youth with disabilities is interagency collaboration. Centers for Independent Living (CILs) can be critical service providers for youth and young adults with disabilities. This study explored CIL professionals’ contributions in supporting transition-age youth. Furthermore, the study examined these professionals’ perspectives of why CIL involvement is vital in transition service delivery. Eight dyads consisting of a CIL administrator and a CIL staff member providing direct services to transition-age youth with disabilities were interviewed from eight U.S. CILs. Thematic analysis of each interview transcript yielded themes related to the scope of services that CILs are providing in tandem with special education professionals, and why CIL professionals believe their involvement in secondary transition is critical. Findings included that interview participants delineated three overarching areas where CILs support transition-age youth while collaborating with schools. Furthermore, the findings showed that the crucial nature of CIL involvement in the transition service delivery process is rooted in several value-based principles. These five value-based principles were as follows: (a) Empowerment-, autonomy-, and independence-based, (b) youth-led and individualized, (c) strengths-based and goal-driven, (d) peer-based and disability-pride-driven, and (e) ensuring services were available and accessible. These findings, implications for practice, and future research directions are also discussed.

COVID-19-induced atypical pneumonia in an unseparated adult conjoined twin in a remote setup of developing country: management by telemedicine. Illustrative case.

Telemedicine is the use of wireless communications and Web-based technologies to provide healthcare and services. The coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to healthcare providers, who have been forced to change their usual mode of service delivery and have been given an opportunity to adopt the concept of telemedicine. A 40-year-old underprivileged and unseparated conjoined twin (pygopagus) had dorsal spine tuberculosis and was on a regular follow-up through telemedicine due to the ongoing COVID-19 pandemic and embarrassment they had to face in public appearances. After a few months, they contracted COVID-19 infection after which they were shifted to our tertiary care center. Several unique challenges were encountered during the 4-day course of management. Ultimately, they died and left us with questions of whether we are really prepared to tackle these challenges. The general public should be made aware of such groups of patients and to encourage them to follow COVID-appropriate behavior. Vaccinations should be given on a priority basis to these subsets. A more robust approach of telemedicine consultation is required for management of patients in remote areas at the time of a pandemic. Ventilator management of these patients is still intriguing.

Follow-up management service and health outcomes of hypertensive patients in China: A cross-sectional analysis from the national health service survey in Jiangsu province.

BackgroundHypertension is a major cause of early mortality worldwide. Health follow-up management services can encourage patients with hypertension to improve their health behavior and outcomes. However, a lack of studies on the relationship between specific factors of follow-up management and both subjective and objective health outcome among hypertensive patients exists. The current study investigated the relationship between service content, frequency, mode, and institutions of follow-up management and health outcomes among Chinese hypertensives.MethodsData were obtained from the sixth National Health Service Survey (NHSS) of Jiangsu Province, which was conducted in 2018. Descriptive statistics were used to analyze the sample characteristics and the utilization of follow-up management services. Both multiple linear regression and logistic regression were used to estimate the association of follow-up management service and other factors with hypertensives' subjective and objective health outcomes.ResultSome respondents (19.30%) reported hypertension, and 75.36% of these patients obtained follow-up management services. Hypertensive patients' subjective health outcome self-reported health status and objective health outcome blood pressure (BP) control were found to be significantly associated with follow-up management services. The outcomes were both significantly improved by a high frequency of management services, a high level of follow-up providers, the mode of visiting healthcare facilities and/or calling, and receiving instructions on medication use. However, inquiring about patients' symptoms was negatively associated with self-reported health status and BP control. In addition, BP measurement was significantly and positively associated with hypertensive patients' self-reported health status; the patients receiving lifestyle guidance were more likely to have their BP levels under control.ConclusionsHypertension management strategies should further focus on the frequency of healthcare follow-up management via categorization of the follow-up services and appropriate adjustment of service delivery modes to optimize health follow-up management for hypertensives further improve their outcomes. Meanwhile, complementary policies are also needed to address other socioeconomic factors that can promote good health conditions for hypertension patients.

Factors influencing the success of telepractice during the COVID-19 pandemic and preferences for post-pandemic services: An interview study with clinicians and parents.

BackgroundThere has been a significant uptake in the use of telepractice during the coronavirus SARS‐CoV‐2 (COVID‐19) pandemic. This study explored the experiences of speech and language therapists (SLTs), assistants (SLTAs) and parents with telepractice during the COVID‐19 pandemic.Aims(1) To identify factors that influenced success of telepractice; and (2) to describe clinicians’ and parents’ preferences for the future mode of service delivery for preschoolers with communication disorders.Methods & ProceduresThe study was conducted in partnership with one publicly funded programme in Ontario, Canada, that offered services to preschoolers with speech, language and communication needs at no cost. SLTs (N = 13), assistants (N = 3) and parents (N = 13) shared their experiences and perspectives during semi‐structured videoconference interviews.Outcomes & ResultsFactors that influenced the success of telepractice were reported in three categories: the setting (i.e., where and how telepractice was being delivered); the nature of telepractice (i.e., the services that were provided via telepractice); and the individuals (i.e., who was involved in telepractice). These factors were reported to interact with each other. As the needs for each child and family are unique, parents and clinicians reported a preference for a hybrid and flexible service delivery model in the future.Conclusions & ImplicationsThe themes identified in this study can be used by clinicians and managers to consider factors that influence the success of telepractice for children and families.WHAT THIS PAPER ADDSWhat is already known on the subject? Studies conducted before the COVID‐19 pandemic showed that telepractice was an effective and acceptable service approach. However, some clinicians and parents reported wanting to resume in‐person visits. The provision of telepractice services to families with children with communication disorders increased significantly during COVID‐19. What this paper adds to existing knowledge? Parents and clinicians shared factors that influenced the success of telepractice during semi‐structured interviews. Factors were identified in three categories: the setting (i.e., where and how telepractice was being delivered); the nature of telepractice (i.e., the services that were provided via telepractice); and the individuals (i.e., who were involved in telepractice). As each child's and family's needs are unique, parents and clinicians reported a preference for a hybrid and flexible service delivery model in the future. What are the potential or actual clinical implications of this work? SLTs and SLT managers can use the factors identified to discuss with parents and decide whether telepractice may be well suited to the needs of each child and family.

The void: COVID-19 restrictions and junior doctor education opportunities

Background In the setting of the COVID-19 pandemic, the modes of hospital service delivery, education, training, and the context surrounding them has undergone enormous change and disruptions. Objective This study aimed to understand the ‘lived-experience’ of junior doctors in relation to their education, training, and professional development during the pandemic. Methods A qualitative study based on thematic and cohort narrative analysis. 20 junior doctors who trained at an Australian tertiary paediatric hospital during the time of COVID-19 restrictions were interviewed. Based on a phenomenological approach, the interviews examined junior doctors’ experiences in relation to medical education, adaptive education styles and the value attributed by participants to different forms of education provided to them. Results Four overarching themes were identified regarding trainee perceptions of the impact of COVID-19 restrictions on learning opportunities, both positive and negative. These were: ‘The void’ – learning expectations junior doctors felt were missed, education affordances, peers and networks, and professional identity. Conclusion The pace with which educators have adapted to new teaching modes should be harnessed to incite equally novel curriculum evolution, smart investment in clinical moments, reconnect learning communities and create robust virtual learning environments.

Understanding Service Delivery Decisions: More Than a Digital Divide

Abstract Date Presented 04/01/2022 Postpandemic, OT practitioners must make clinical judgments about the continuation of telehealth for specific clients. However, there is a lack of research on the factors that influence both practitioners’ and clients’ decision-making processes in using telehealth and promote success. The purpose of this research was to uncover ways in which OT practitioners drew from clinical reasoning, expertise, and resilience to guide service delivery modality decision making. Primary Author and Speaker: Timothy Dionne Additional Authors and Speakers: Lauren Little, Megan E. Gately

The transformation of a student-led health clinic in rural Australia from a face-to-face service to a telehealth model: Evaluation of student and client experiences during a COVID 19 driven transition

Introduction: The COVID-19 pandemic has necessitated the rapid transition of many face-to-face health services to alternate modes of service delivery. The objective of this study was to explore the benefits, challenges and perceived quality of a telehealth service delivery model from the perspective of clients and students. Further, students’ perceptions relating to the quality of the educational experience were also explored. Methods: The study was set in a student-led interprofessional health and wellness clinic in rural Queensland, Australia. A qualitative case study design was used, including semi-structured student interviews and client open-response survey data. Participants were nursing and allied health students who completed a student-led interprofessional clinic placement and adults with low to rising risk of chronic disease who attended the clinic for telehealth delivered services. Results: Themes identified following analysis included: new or adapted skills needed for success; challenges, limitations and the need for resources, training and support; quality interprofessional education experiences can be achieved in telehealth; coming away with a new set of skills; the important role of the client for success; and benefits and disadvantages of telehealth for clients. Conclusions: The findings support that telehealth-based service-learning models are a feasible way to deliver health and wellness services from the perspective of students and clients and provide students with important skills for rural health service delivery.

A Qualitative Study Exploring Parental Perceptions of Telehealth in Early Intervention.

Using telehealth as a mode of service delivery has the potential to address some long-standing challenges in early intervention (EI) services such as waiting lists to access services. Yet, little is known about parent perceptions of telehealth in EI based on their lived experiences partnering with EI practitioners. The purpose of this study was to explore parent perceptions on using telehealth, especially on family-professional partnerships and coaching. Interviews were conducted with 15 parents of children receiving EI services via telehealth from June to August of 2021. Almost half of the participants reflected under-represented racial and ethnic backgrounds. Constant comparative analysis and emergent coding were used for data analysis. The findings showed that the advantages outnumbered the disadvantages regarding telehealth. Participants reported that telehealth provided a safe and flexible option and eliminated the wait to access EI services. However, participants identified some disadvantages to telehealth including telehealth precluded substantive interactions with therapists and limited access to technology. The findings also indicated that telehealth enhanced family-professional partnerships. Nearly all participants valued coaching during telehealth. Participants suggested initial supports to facilitate EI via telehealth, including stable internet access, telehealth training, and an initial in-person visit. Implications for research and practice are discussed. Supplementary InformationThe online version contains supplementary material available at 10.1007/s10882-022-09853-w.

Vocational teachers’ perceptions of transition components and relevance of curriculum to employment for students with disabilities

Employment is one important post-school outcome for youth and adults and its benefits include enjoying a productive life, enhanced self-worth, and economic independence. Although Botswana has made notable strides to enhance post-school outcomes for students with disabilities (SWDs), many of these youth continue to face underemployment and unemployment. Hence, this study used a quantitative research approach to examine vocational teachers’ perceptions of necessary transition components and the relevance of the curriculum in helping SWDs to transition to employment successfully. Participants were selected through census and purposive sampling from two regions in Botswana and their gender and teaching experience differences were further examined. A total of 158 participants completed a paper survey. A Factorial ANOVA was run to determine significant differences in participants’ perceptions of essential transition components and the relevance of vocational coursework in supporting SWDs to transition successfully to employment. A Tukey post hoc test was run to establish differences between groups. Participants held somewhat positive beliefs about transition components and vocational coursework. However, participants’ views were inconsistent based on gender and teaching experience. This diversity of views clearly shows the extent to which vocational teachers differ regarding transition planning, which may hinder the effective delivery of transition services.

Municipal Solid Waste Management in the Czech Republic and in Slovakia

Abstract Contracting waste management services is one of the most commonly used approaches to the delivery of this service and this topic is clearly in the focus of frequent academic research. The goal of this article is to examine trends in the area of solid waste collection and disposal on the municipal level for the Czech Republic and Slovakia in terms of developments over the past 20 years with a focus on the share of inter-municipal cooperation in the delivery of this service. In contrast to Western European countries, which are undergoing re-municipalization, the data obtained for Slovakia and the Czech Republic over 20 years show that the municipal solid waste management service is dominated by contracting, which has increased over the examined period. This fact is apparently a reflection of the high rate of fragmentation in municipal structures and the low willingness among municipalities to cooperate. The data obtained also indicate that using external suppliers seems to bring marginal savings that could certainly be substantially larger; potential increases in efficiency via contracting are unequivocally limited by the low quality of contract management. Regarding our core question, we found that the proportion of inter-municipal cooperation between service delivery modes did not significantly increase during the investigated period. The experts interviewed almost uniformly agreed on three critical limits related to the issue of inter-municipal cooperation in MSW management delivery – transaction costs of different types, non-existent regular comparisons of best solutions, and limited motivation to select optimal service delivery modes.

Covid-19’s Effects on Contraceptive Services Across the Humanitarian–Development Nexus

Sexual and reproductive health (SRH) services, including contraception, save lives in humanitarian emergencies. To document practitioners’ perceptions of the effects of the Covid-19 pandemic on contraceptive programming in humanitarian settings and across the humanitarian–development nexus, the Women’s Refugee Commission conducted 29 key informant interviews with respondents from non-governmental organisations, the United Nations, and government ministries. Disruptions to contraceptive services included closures or repurposing of health facilities, limited availability of health providers, supply chain interruptions, restricted service delivery modalities, and lower demand for services. Adaptations to sustain services included telemedicine, task-shifting and sharing, community-based service delivery, and other innovations. Underlying factors affecting the types and extent of disruptions and adaptations included emergency preparedness for SRH, decision makers’ prioritisation of SRH services, funding, and coordination. Findings reinforce the need to build awareness that SRH services, including contraception, are lifesaving and essential in humanitarian settings, and to improve preparedness, including bridging gaps between humanitarian and development actors.

P032 Are telephone consultations as effective as face-to-face consultations in the follow-up of patients in the Rheumatology Clinic? A service evaluation

Background/AimsThe COVID-19 pandemic forced rheumatology clinics to utilise telephone consultations as a means to limit footfall at hospitals and to protect our vulnerable patients. This was a new mode of service delivery for most rheumatology departments as previously all appointments used to be face-to-face. Although remote consultations were previously being considered as a mode of service delivery, the COVID-19 pandemic has expedited the uptake remote consultations within a very short span of time. There are no systematic studies to compare the effectiveness of remote consultations versus face-to-face consultations although remote consultations are now being widely adopted. Our aim was to assess the effectiveness of telephone consultations compared to face-to-face consultations in the routine review of rheumatology patients.Methods101 face-to-face consultations and 98 telephone consultations were randomly selected from the months of June and August in 2019 and 2020 respectively. The clinic letters were then accessed and the clinic outcomes were noted. The parameters chosen to aid comparison included start of new medication, medication dose changes, referral for investigations, referral to another specialty, referral to MDT, referral for a steroid injection, timescale of subsequent follow up and discharge from services.ResultsThe main results broadly showed similarities in case-mix and several outcomes, including time scale of follow up and intra-articular and intramuscular steroid injections. Fewer patients were started on a new medication following a telephone consultation (14.9% vs 10.2%), more patients had their current medication dose changed (14.9% vs 17.3%) and slightly more patients were referred for investigations (25.7% vs 30.6%). Furthermore, telephone consultations resulted in a lower rate of referrals to MDT (13.9% vs 5.1%) and marginally fewer discharges.ConclusionThe evaluation showed there were clear similarities between the two groups which showed telephone consultations were comparable to face-to-face consultations. Out of the 98 telephone consultations, only 10 were converted to a face-to-face appointment which was lower than many had predicted. However, the drop in referral rates to other specialties may represent that consultants do not feel confident to refer to another team without a comprehensive face-to-face assessment. Telephone consultations, with the back up of face-to-face slots made available for appropriate patients, appear to be an effective means of service delivery and is likely to continue in a scaled down form.Disclosure A. Paul: Other; Sponsorship for educational meetings from UCB, AbbVie, Pfizer, Novartis and Celgene. C. Walker: None. C. McHugh: None.

Patients’ Perceptions on Telerehabilitation as a Mode of Physical Therapy Service Delivery

Aim: Since telerehabilitation is a relatively new service in the Philippines translating to a scarcity in related literature, this study determined the perceptions of patients regarding the recorded facilitators and barriers to this mode of physical therapy service delivery. Methods: A quantitative, descriptive, survey type research design was utilized, wherein a self-reported survey questionnaire formulated by the researchers was administered to the respondents. The data gathered were analyzed using frequency, percentage, weighted mean (WM), and class interval. Results: Findings showed that the perceived top facilitators include less travel time and cost (WM = 3.606) and less exposure to external risk (WM = 3.545). In comparison, the top barriers were technical difficulties (WM = 3.273) and internet connectivity (WM = 3.242). The majority of the respondents were highly satisfied (WM = 3.338) and compliant (WM = 2.798) with telerehabilitation. Conclusion and Implications: With the results of this study, it was revealed that telerehabilitation is a viable alternative to conventional rehabilitation, as seen with the respondents' generally positive perception towards this mode of service that ultimately enhances both access and continuity of care, especially during the COVID-19 pandemic.

PATIENT SATISFACTION WITH TELEPSYCHIATRY CONSULTATIONS IN THE TIME OF COVID19: DATA FROM A TERTIARY CARE HOSPITAL IN PAKISTAN

OBJECTIVES: To assess the patient satisfaction with telepsychiatry consultations, and whether time and money was saved by patients availing the service. METHODS: Anonymous internet survey using Google Form method, was conducted between April 2020 and September 2020 to collect data from patients using teleconsultation in out-patients psychiatry clinic. The google form consisted of patient satisfaction questionnaire, demographic details, and additional questions about the money and time saved by patients using the service. RESULTS: Out of 260 participants, 152, (58.5%) were males, 148 (58.3 %) were married and majority (n=157: 60.4%) of patients were &lt;40 years of age. About 62.7% (n=163) were highly educated. Majority (n=108; 41.5%) of the survey participants were from Khyber Pakhtunkhwa province. The average cost saving was Pakistani Rupees 3000 for the consultation whereas the average time saved was 1.5 days. Patients were happy during communication with doctor including seeing doctor on screen (85.7%), hearing to doctor (90.4%), talking to doctor (84.6%) and discussion of their care plan (81.6%). Majority (79.2%) of the survey participants were happy with the meeting of care needs and 86.5% were happy to avail the service in future. CONCLUSION: The study underscores the importance of telepsychiatry as mode of service delivery during the pandemics. The findings demonstrated a high level of patient satisfaction, considerable amount of time and money saving indicates the effectiveness of telepsychiatry consultation. It needs to expand the telepsychiatry service both in public and private hospitals and also test this model on a representative sample of patients in Pakistan.

Occupational therapy intervention to address handwriting deficit in elementary-aged school children: How to, how much, and how often? A scoping review

ABSTRACT Handwriting is a key occupation for school-aged children and one of the common reasons for referral to a school-based occupational therapist. There are many interventions offered by school-based occupational therapists and this scoping review aimed to examine specific intervention approaches and compare their mode of service delivery (i.e., direct and/or indirect), recommended dosage (i.e., frequency and duration), embedded theoretical frameworks, and identify if the intervention caused statistically significant changes in a child’s handwriting ability. Eight (8) studies were reviewed (seven Level III; one Level V) identified through a comprehensive database search. Of the eight studies that met the inclusion criteria, five were curriculum-based programs, all of which incorporated task-specific motor learning approaches and showed statistically significant improvement in handwriting (both direct and indirect OT involvement). Two studies reviewed devices (iPad and weighted pencil) and one study did not involve performing handwriting during treatment sessions. The studies reviewing the use of devices and the study where task-specific handwriting was not completed in treatment sessions did not demonstrate statistically significant benefit on improving a child’s handwriting ability. Curriculum-based interventions that have an embedded motor learning practice component, with either direct or indirect involvement from occupational therapy, may have a positive impact on a student’s handwriting ability; however, more rigorous studies need to be completed. The use of devices (i.e., iPad & weighted pencils) to improve handwriting is not currently supported in the literature.

Establishing Construct Validity of a Measure of Adolescent Perceptions of College and Career Readiness

The purpose of this study was to establish construct validity of a college and career readiness measure using a sample of youth with ( n = 356) and without ( n = 1,599) disabilities from five high schools across three U.S. states. We established content validity through expert item review, structural validity through initial field-testing, and convergent validity by correlating domain scores with school academic and behavioral data. A four-factor measurement model emerged representing the domains Ownership of Learning, Academic Engagement and Processes, Interpersonal Engagement, and Career Development. Domain scores were significantly correlated with achievement, college admission exam scores, and attendance. Implications for research and practice with an emphasis on transition service delivery via multi-tiered systems of support are discussed.