Getting inTOUCH: outcomes of a knowledge translation intervention for tactile assessment knowledge, barriers, and practice in paediatric therapists working with children with cerebral palsy

Abstract

Background: Tactile impairments are common in children with cerebral palsy (CP), however assessment is not routinely carried out by therapists. We investigated a multi-faceted Knowledge Translation intervention to improve Knowledge, remove Barriers and enhance Practice of tactile assessments by paediatric therapists.

Method: Twelve therapists from a state-wide service for children with CP (seven physiotherapists, five occupational therapists; 12 female) received: written information, demonstration videos, a face-to-face workshop, equipment provision, and on-call mentoring. Therapists completed pre–post-intervention questionnaires reporting their perceived tactile assessment Knowledge, current Practices and implementation Barriers.

Results: Following intervention, therapists improved Knowledge of correct (1) tactile impairment prevalence in children with CP (pre 3/12; post 9/12), (2) tactile assessment items (e.g. Registration – pre 1/12; post 9/12; Localisation – pre 2/12; post 10/12), and (3) equipment choice (e.g. Monofilaments – pre 1/12; post 10/12). Tactile assessment Practice improved slightly. All major clinician-level implementation Barriers were resolved and less obvious organisational-level Barriers were identified for follow-up.

Conclusion: A 12-month multi-faceted Knowledge Translation intervention can improve tactile assessment Knowledge, resolve major clinician-level implementation Barriers, and identify less obvious organisational-level Barriers to be addressed to achieve maximum Practice improvement. Ongoing multi-faceted knowledge translation processes are essential for high-performing organisations.

Implications for rehabilitation

• A multi-faceted knowledge translation intervention significantly improved paediatric therapists’ knowledge of the items and equipment necessary for tactile assessment.

• A 12-month intervention can address clinician-level barriers of knowledge, confidence, and access to equipment and assist in the identification of less obvious organisational-level barriers.

• Consideration of motivational readiness for change, intervention timelines, monitoring of emergent barriers, and fitting tactile assessment into a broader assessment framework are critical for improving uptake of tactile assessment in practice.

Keywords:

• Touch
• sensation
• measurement
• physiotherapist
• occupational therapist

Acknowledgements

The authors wish to acknowledge the participating occupational therapists and physiotherapists for their time and willingness to participate in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

MA is supported by a Translation of Research into Practice (TRIP) Fellowship from the National Health and Medical Research Council of Australia [NHMRC 1073226].