Student/Research Assistant University of Southern California Los Angeles, California, United States
Background: Approximately 1 in 5 children experience disabilities, and about 6% require long-term rehabilitation services. While progress has been made in developing and evaluating pediatric rehabilitation interventions, there's a dearth of comprehensive research on their implementation in clinical practice. To advance pediatric rehabilitation and streamline the translation process, consistent terminology and detailed descriptions of specific implementation strategies are essential. Objective: The aim of this scoping realist review was to evaluate the range of implementation strategies that have been utilized in the field of pediatric rehabilitation and also initiate the process of recognizing the strategies employed for promoting the adoption of research findings in pediatric rehabilitation. Design/Methods: The scoping review followed the JBI (Joanna Briggs Institute) criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. A research librarian helped search five databases. Included studies should have reported implementation strategies and outcomes as defined by Powell (2015) and Proctor (2012). In addition, studies should have focused on rehabilitation by occupational, physical, and speech-language therapists for children aged 0–12 years. A realist review approach identified and refined theories/themes from articles, synthesized the findings, and sought confirmation from rehabilitation science subject area experts and opinion leaders. Results: We reviewed the titles and abstracts of 11,300 papers and 559 full texts and then extracted data from 59 completed investigations. Many studies did not discuss implementation strategies or detailed interventions that were not related to rehabilitation. A significant number of studies were excluded because they concentrated on the pre-implementation phase (e.g., defining facilitators and barriers, not testing strategies). Some implementation strategies that were tested included assessment for readiness, identifying facilitators and barriers, developing education materials and including consumers. The most common description of implementation strategies included Actor, Action, and Action targets.
Conclusion(s): While there have been efforts to design and evaluate implementation strategies in pediatric rehabilitation, more rigorous research is needed to determine their effectiveness in promoting evidence-based interventions. Standardized terminology and explicit explanations of the mechanisms driving these strategies are essential for ensuring consistency in reporting by researchers.
