A measure of parent engagement: plan appropriateness, partnering, and positive outcome expectancy in pediatric rehabilitation sessions

Abstract

Purpose

To examine the psychometric properties of a parent-report measure of engagement in pediatric rehabilitation.

Method

113 parents (of children 4 months to 18 years, varying in diagnoses) were recruited from standard outpatient/inpatient, early intervention, and life skills programs, sampled from different sites in Canada, the US, and Australia. Parents completed the Pediatric Rehabilitation Intervention Measure of Engagement—Parent version (PRIME-P) twice, after two therapy sessions approximately two weeks apart. Analyses examined factor structure, internal consistency, and test-retest reliability, and assessed construct validity hypotheses concerning participant characteristics and contextual factors.

Results

The resulting 11-item PRIME-P has three factors capturing engagement in terms of Plan Appropriateness, Partnering, and Positive Outcome Expectancy. The factors displayed strong internal consistency and test-retest reliability (Partnering demonstrated slightly weaker test-retest reliability). Construct validity was shown by significant associations between the PRIME-P scales and parents’ presence versus absence during the sessions, as well as service providers’ years of experience.

Conclusions

The PRIME-P captures parent engagement as a multifaceted construct involving appropriateness of the therapy plan, a sense of active partnership in the intervention process, and an expectation for a positive outcome. The PRIME-P has promise for research, clinical practice, and educational purposes.

IMPLICATIONS FOR REHABILITATION

• The PRIME-P is a psychometrically sound tool that fills a gap in how researchers and practitioners can measure the engagement of parents in the therapy process.

• To enhance parent engagement, service providers can encourage collaboration in planning, foster a sense of working in partnership, and convey a sense of hope.

• The findings point to the need to pay attention to parents’ beliefs about the therapy plan and outcomes, in addition to their behavioral involvement.

• The PRIME-P is a promising tool for pediatric rehabilitation that can be used to investigate the role of a crucial, yet poorly understood variable in the therapy process.

Keywords:

• Parent involvement
• measure development
• engagement
• pediatric rehabilitation
• construct validity
• intervention

Acknowledgements

We acknowledge the contributions of Heidi Schwellnus, Anne Poulsen, Rachel D’Arrigo, Roger Ideishi, and other members of the Pediatric Rehabilitation Intervention Measure of Engagement (PRIME) research team (http://primeresearchteam.com). We thank the participating hospitals, service organizations, service providers, and parents.

Disclosure statement

The authors alone are responsible for the content and writing of this paper.

Additional information

Funding

This work was funded by an operating grant from the Canadian Institutes of Health Research (CIHR) [MOP-133397]. Gillian King holds the Canada Research Chair in Optimal Care for Children with Disabilities, funded by the Canadian Institutes of Health Research. This chair is supported by matching funds from the Kimel Family Opportunities Fund through the Holland Bloorview Kids Rehabilitation Hospital Foundation.