Realist process evaluation of occupational performance coaching: protocol.

Autor:	Graham F; Department of Medicine, University of Otago, Wellington, New Zealand fi.graham@otago.ac.nz., Williman J; Public Health and General Practice, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand., Desha L; Department of Medicine, University of Otago, Wellington, New Zealand., Snell D; University of Otago, Christchurch, New Zealand., Jones B; Department of Medicine, University of Otago, Wellington, New Zealand., Ingham T; Department of Medicine, University of Otago, Wellington, New Zealand., Latu ATF; School of Pharmacy, University of Otago, Dunedin, New Zealand., Ranta A; Department of Medicine, University of Otago, Wellington, New Zealand., Walker E; Department of Medicine, University of Otago, Wellington, New Zealand., Makasini S; Department of Medicine, University of Otago, Wellington, New Zealand., Ziviani J; The University of Queensland - Saint Lucia Campus, Saint Lucia, Queensland, Australia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jun 06; Vol. 14 (6), pp. e075727. Date of Electronic Publication: 2024 Jun 06.
DOI:	10.1136/bmjopen-2023-075727
Abstrakt:	Introduction: A cluster randomised controlled trial, the Meaning, Agency and Nurturing Autonomy (MANA) study, is underway comparing the effects of occupational performance coaching (OPC) and usual care on the social participation, health and well-being of children with neurodisability and their caregivers. This protocol presents the realist process evaluation which is occurring in parallel with the trial to allow testing and further refinement of OPC programme theory, as represented in its logic model. The aim of this realist evaluation is to examine what works, for whom, in the implementation of OPC with caregivers of children with neurodisability (in particular, Māori and Pasifika) in current service delivery contexts. Methods and Analysis: Guided by OPC programme theory and realist evaluation processes, mixed-methods data collected from the MANA study OPC group will be analysed to elucidate when OPC works (outcomes), for whom, how (mechanisms) and under what circumstances (contexts). This will culminate in the synthesis of Intervention-Actor Context-Mechanism-Outcome configurations. Descriptive analyses will be reported for quantitative measures of treatment fidelity (OPC-Fidelity Measure), caregiver emotional response to OPC (Session Rating Scale) preintervention emotional state (Depression Stress and Anxiety Scale) and client outcomes (Canadian Occupational Performance Measure). Reflexive thematic analysis will be undertaken to analyse realist interviews with therapists who implemented OPC above and below fidelity thresholds and culturally focused interviews with clients of Māori or Pasifika ethnicity, informing understanding of the contexts influencing therapists' implementation of OPC with fidelity, and the mechanisms triggered within therapists or caregivers to elicit a response to the intervention. The MANA study trial outcomes will be reported separately. Ethics and Dissemination: Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee (20/STH/93). In all participating jurisdictions local area approval was obtained, involving a process of local Māori consultation. Results will be disseminated to all participants, and more broadly to clinicians and policy-makers through conference presentations and peer-reviewed journal publications, which will inform decision-making about resourcing and supporting effective delivery of OPC to optimise outcomes for children and caregivers. Trial Registration Number: ACTRN12621000519853. Competing Interests: Competing interests: FG and the University of Otago provide commercial consultation services related to Occupational Performance Coaching. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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