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Assessing the readiness and feasibility to implement a model of care for spine disorders and related disability in Cross Lake, an indigenous community in northern Manitoba, Canada: A research protocol
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Background
Since the 1990s, spine disorders have remained the leading cause of global disability, disproportionately affecting economically marginalized individuals, rural populations, women, and older people. Back pain related disability is projected to increase the most in remote regions where lifestyle and work are increasingly sedentary, yet resources and access to comprehensive healthcare is generally limited. To help tackle this worldwide health problem, World Spine Care Canada, and the Global Spine Care Initiative (GSCI) launched a four-phase project aiming to address the profound gap between evidence-based spine care and routine care delivered to people with spine symptoms or concerns in communities that are medically underserved. Phase 1 conclusions and recommendations led to the development of a model of care that included a triaging system and spine care pathways that could be implemented and scaled in underserved communities around the world.
Methods
The current research protocol describes a site-specific customization and pre-implementation study (Phase 2), as well as a feasibility study (Phase 3) to be conducted in Cross Lake, an Indigenous community in northern Manitoba, Canada. Design: Observational pre-post design using a participatory mixed-methods approach. Relationship building with the community established through regular site visits will enable pre- and post-implementation data collection about the model of spine care and provisionally selected implementation strategies using a community health survey, chart reviews, qualitative interviews, and adoption surveys with key partners at the meso (community leaders) and micro (clinicians, patients, community residents) levels. Recruitment started in March 2023 and will end in March 2026. Surveys will be analyzed descriptively and interviews thematically. Findings will inform co-tailoring of implementation support strategies with project partners prior to evaluating the feasibility of the new spine care program.
Discussion
Knowledge generated from this study will provide essential guidance for scaling up, sustainability and impact (Phase 4) in other northern Canada regions and sites around the globe. It is hoped that implementing the GSCI model of care in Cross Lake will help to reduce the burden of spine problems and related healthcare costs for the local community, and serve as a scalable model for programs in other settings
Can a Recovery College be implemented online? Multi-perspective case study documenting the process of adapting courses online
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Purpose
This study aims to document the process of adapting Recovery College (RC) courses into an online format and assess whether online adaptation meets learners’ goals. The study describes the challenges encountered, the strategies deployed and the factors influencing implementation from the perspectives of four interested parties: coordination team, partners advisory committee, trainers and learners.
Design/methodology/approach
The study adopts a descriptive single-case study design. Several sources of data were collected: focus groups, implementation daybook, meeting minutes, interviews and satisfaction survey. Simple descriptive content analysis was used for all qualitative data, and simple descriptive statistical analyses were used for the online satisfaction survey with learners.
Findings
The results highlight challenges and strategies for adapting content and facilitation, as well as challenges and strategies for respecting RC key principles. Internal, organizational and technological factors have influenced the implementation. Most learners were satisfied with the courses attended and felt that it met their goals. Three overarching aspects of online implementation are discussed based on findings: training and supporting trainers, facilitation and pedagogical methods and ongoing monitoring and feedback to interested parties.
Research limitations/implications
Findings encourage further research to determine the extent to which online RC courses align with recommended strategies for reducing digital inequalities and implementing digital health interventions.
Originality/value
Few studies have focused on implementing RC online. This case study offers insights for organizations pursuing similar initiatives
Production, disponibilité et consommation de ressources satisfatoires à caractère sexuel pour hommes au Japon
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Prévention de l’anxiété en mathématiques en contexte orthopédagogique par le développement d’un rapport positif envers les mathématiques chez les élèves du primaire
Full text linkSupporting sustainability: A philosophical analysis of certain assumptions underlying occupational therapy
Full text linkAbstract
Background:
The relevance of supporting sustainability within occupational therapy is increasingly demonstrated and argued for. However, difficulties persist in supporting sustainability in practice, which presents occupational therapists with an occupational paradox. Why is sustainability still so difficult to include into occupational therapy practice?
Purpose:
The objective was to analyse certain assumptions underlying the profession that may constitute potential obstacles to the inclusion of sustainability in practice.
Method:
To identify and critically examine these assumptions, a philosophical analysis of five key concepts of the profession was carried out based on a triangulation of two philosophical methods.
Findings:
The results reveal that the five concepts analysed—person, occupation, environment, health, and justice—may act as barriers to support sustainability within the practice.
Conclusion:
A paradigm shift is therefore relevant, even necessary in the current climate emergency to mitigate its impacts. This is especially relevant as the climate crisis poses the greatest threat to health and endangers the ability of humans to engage in occupations essential for well-being and survival.
Résumé
Contexte.
La pertinence d’inclure la durabilité à la pratique de l’ergothérapie est de plus en plus démontrée et argumentée. Cependant, des difficultés persistent pour l’inclure dans la pratique, ce qui place les ergothérapeutes face à un paradoxe occupationnel. Pourquoi est-il encore si difficile d’inclure la durabilité à la pratique de l’ergothérapie?
But.
L’objectif était d’analyser certaines présuppositions au fondement de la profession qui constituent des obstacles potentiels à l’inclusion de la durabilité à la pratique. Pour identifier et examiner de manière critique ces présuppositions, une analyse philosophique de cinq concepts clés de la profession a été réalisée sur la base d’une triangulation de deux méthodes philosophiques. Les résultats révèlent que les cinq concepts analysés (personne, occupation, environnement, santé et justice) peuvent constituer des obstacles à l’inclusion de la durabilité à la pratique. Un changement paradigmatique semble dès lors pertinent, voire nécessaire, dans le contexte de l’urgence climatique actuelle, pour atténuer les impacts de cette crise. Cela est d’autant plus pertinent dans le contexte où la crise climatique est non seulement la plus grande menace à la santé, mais également une menace importante à l’engagement dans des occupations pouvant contribuer au bien-être, voire à la survie humaine
Effet de la cécité congénitale sur la perception des odeurs et la plasticité du système olfactif chez la souris : une étude comportementale et immunohistochimique
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