Understanding Acceptability, Barriers, and Facilitators to Clinical Implementation of the on Track Developmental Monitoring System for Children with Cerebral Palsy: A Qualitative Study

Abstract

Aims

On Track Developmental Monitoring System (DMS) is a novel series of tools to assist in shared-decision making, guide rehabilitation intervention based on functional ability levels, and promote episodic care service models. Further understanding of the acceptability, feasibility, and appropriateness of On Track DMS in clinical settings is critical. The purpose of this study was to understand clinician perspectives of the acceptability of On Track DMS and to identify potential implementation barriers and facilitators within pediatric physical therapist practice.

Methods

Three, day-long training workshops were conducted with 32 pediatric physical therapists across the US. Focus groups with 21 workshop participants were conducted following training. Results were audio recorded, transcribed verbatim, and coded into themes.

Results

Three themes emerged from the data: (1) Valuing the On Track Approach to Intervention; (2) Setting-Specific Needs and Challenges to Implementation; and (3) Training Material/Tool Strengths and Limitations.

Conclusions

On Track DMS appears to have initial value and acceptability for pediatric physical therapists across practice settings. Perceived benefits include facilitation of data-driven practice and therapist/family collaboration to improve health outcomes for children with CP. Using this data to understand and assess barriers and facilitators to knowledge use are first steps in successfully implementing On Track DMS.

Keywords:

• Acceptability
• cerebral palsy
• developmental monitoring
• evidence-informed intervention
• qualitative

Acknowledgments

All authors contributed to the collection and analysis of the study data and the drafting of this manuscript. This is original research work that is not under consideration for publication elsewhere.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the Patient Centered Outcomes Research Institute (CE-12-11-5321) and the Canadian Institutes of Health Research MOP-257732. Additional funding for the first author’s time was supported by the NIH National Center on Advancing Translational Sciences, KL2, TR002317.

Notes on contributors

Heather A. Feldner

Dr. Heather A. Feldner is an Assistant Professor in the Department of Rehabilitation Medicine at the University of Washington, a physical therapist, and Board-Certified Pediatric Clinical Specialist. She is also on the core faculty of the Disability Studies Program and an Associate Director of the Center for Research and Education on Accessible Technology and Experiences at UW. Her research is situated at the intersections of mobility, disability, and technology, as well as including disability and anti-ableism as a key component of Diversity, Equity, and Inclusion initiatives.

Alyssa LaForme Fiss

Dr. Alyssa LaForme Fiss is a Professor in Physical Therapy at Texas Woman's University, a physical therapist, and Board-Certified Pediatric Clinical Specialist. She is an International Collaborator of CanChild, participating in research collaborations to advance pediatric disability research. Her current research interests include examining interventions to support adaptive behavior in children with disabilities as well as examining strategies to promote participation for children in disabilities.

Lynn M. Jeffries

Dr. Lynn M. Jeffries is an Associate Professor and Vice Chair of the Department of Rehabilitation Sciences at the University of Oklahoma Health Sciences center and a pediatric physical therapist. She currently is Vice-President of the APTA Academy of Pediatric Physical Therapy and President of APTA Oklahoma. Her current research focuses on assessment and intervention for children with cerebral palsy and examines the relationship of student outcomes with provision of school-based physical therapy.

Sarah Westcott McCoy

Dr. Sarah (Sally) Westcott McCoy is a Professor Emeritus and former Division Head of the Physical Therapy Division in the Department of Rehabilitation Medicine at the University of Washington and a pediatric physical therapist. She is a fellow of the American Physical Therapy Association. Her research interests include development of measurements for postural and motor control dysfunction in children and developing longitudinal data for impairments, health and participation and determining best service models for children with cerebral palsy.