Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study
IntroductionThe purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect o...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1345755/full |
| _version_ | 1797306986087317504 |
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| author | Vera C. Kaelin Vera C. Kaelin Vera C. Kaelin Vera C. Kaelin Shivani Saluja Dianna L. Bosak Dana Anaby Dana Anaby Martha Werler Mary A. Khetani Mary A. Khetani Mary A. Khetani |
| author_facet | Vera C. Kaelin Vera C. Kaelin Vera C. Kaelin Vera C. Kaelin Shivani Saluja Dianna L. Bosak Dana Anaby Dana Anaby Martha Werler Mary A. Khetani Mary A. Khetani Mary A. Khetani |
| author_sort | Vera C. Kaelin |
| collection | DOAJ |
| description | IntroductionThe purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect of participation-focused caregiver strategies on the relationship(s) between participation-related constructs and community participation attendance and involvement. For the qualitative phase, we solicited caregiver perspectives to explain the quantitative findings.MethodsAn explanatory sequential mixed-methods design (QUAN > qual) was used. For the quantitative phase, we conducted secondary analyses of data collected during a second follow-up phase of a longitudinal cohort study, including 260 families of children and youth (mean age: 13.5 years) with disabilities and those at risk [i.e., 120 families of children and youth with craniofacial microsomia (CFM); 140 families of children and youth with other types of childhood-onset disabilities]. Data were collected through the Participation and Environment Measure—Children and Youth, the Pediatric Quality of Life Inventory, and the Child Behavior Checklist and analyzed using structural equation modeling. For the qualitative phase, we conducted semi-structured interviews with eight caregivers of children and youth with disabilities and those at risk (i.e., three caregivers of children and youth with CFM; five caregivers of children and youth with other childhood-onset disabilities). Interviews were transcribed verbatim and inductively content-analyzed.ResultsOur model reached acceptable to close model fit [CFI = 0.952; RMSEA = 0.068 (90% CI = 0.054–0.082); SRMR = 0.055; TLI = 0.936], revealing no significant effect of the number of participation-focused caregiver strategies on the relationships between participation-related constructs (e.g., activity competence, environment/context) and community participation in terms of attendance and involvement. The qualitative findings revealed three main categories for how caregivers explained these quantitative results: (1) caregiver workload and supports needed for implementing strategies; (2) caregivers careful strategy quality appraisal; and (3) community setting characteristics hindering successful strategy implementation.DiscussionThe findings suggest that the insignificant effect of the number of caregiver strategies may be explained by the intensified need for caregiver effort and support to develop and implement quality strategies that are responsive to community setting characteristics. |
| first_indexed | 2024-03-08T00:49:48Z |
| format | Article |
| id | doaj.art-3b3d9291877f48a4a74e91118ce0235e |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-08T00:49:48Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-3b3d9291877f48a4a74e91118ce0235e2024-02-15T05:10:40ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-02-011210.3389/fped.2024.13457551345755Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods studyVera C. Kaelin0Vera C. Kaelin1Vera C. Kaelin2Vera C. Kaelin3Shivani Saluja4Dianna L. Bosak5Dana Anaby6Dana Anaby7Martha Werler8Mary A. Khetani9Mary A. Khetani10Mary A. Khetani11Occupational Therapy, University of Illinois Chicago, Chicago, IL, United StatesComputer Science, University of Illinois Chicago, Chicago, IL, United StatesChildren’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United StatesComputing Science, Umeå University, Umeå, SwedenChildren’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United StatesChildren’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United StatesSchool of Physical and Occupational Therapy, McGill University, Montreal, CA, United StatesCanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United StatesEpidemiology, Boston University, Boston, MA, United StatesOccupational Therapy, University of Illinois Chicago, Chicago, IL, United StatesChildren’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United StatesCanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United StatesIntroductionThe purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect of participation-focused caregiver strategies on the relationship(s) between participation-related constructs and community participation attendance and involvement. For the qualitative phase, we solicited caregiver perspectives to explain the quantitative findings.MethodsAn explanatory sequential mixed-methods design (QUAN > qual) was used. For the quantitative phase, we conducted secondary analyses of data collected during a second follow-up phase of a longitudinal cohort study, including 260 families of children and youth (mean age: 13.5 years) with disabilities and those at risk [i.e., 120 families of children and youth with craniofacial microsomia (CFM); 140 families of children and youth with other types of childhood-onset disabilities]. Data were collected through the Participation and Environment Measure—Children and Youth, the Pediatric Quality of Life Inventory, and the Child Behavior Checklist and analyzed using structural equation modeling. For the qualitative phase, we conducted semi-structured interviews with eight caregivers of children and youth with disabilities and those at risk (i.e., three caregivers of children and youth with CFM; five caregivers of children and youth with other childhood-onset disabilities). Interviews were transcribed verbatim and inductively content-analyzed.ResultsOur model reached acceptable to close model fit [CFI = 0.952; RMSEA = 0.068 (90% CI = 0.054–0.082); SRMR = 0.055; TLI = 0.936], revealing no significant effect of the number of participation-focused caregiver strategies on the relationships between participation-related constructs (e.g., activity competence, environment/context) and community participation in terms of attendance and involvement. The qualitative findings revealed three main categories for how caregivers explained these quantitative results: (1) caregiver workload and supports needed for implementing strategies; (2) caregivers careful strategy quality appraisal; and (3) community setting characteristics hindering successful strategy implementation.DiscussionThe findings suggest that the insignificant effect of the number of caregiver strategies may be explained by the intensified need for caregiver effort and support to develop and implement quality strategies that are responsive to community setting characteristics.https://www.frontiersin.org/articles/10.3389/fped.2024.1345755/fullattendanceinvolvementpediatric rehabilitationcraniofacial microsomiachildhood-onset disability |
| spellingShingle | Vera C. Kaelin Vera C. Kaelin Vera C. Kaelin Vera C. Kaelin Shivani Saluja Dianna L. Bosak Dana Anaby Dana Anaby Martha Werler Mary A. Khetani Mary A. Khetani Mary A. Khetani Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study Frontiers in Pediatrics attendance involvement pediatric rehabilitation craniofacial microsomia childhood-onset disability |
| title | Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study |
| title_full | Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study |
| title_fullStr | Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study |
| title_full_unstemmed | Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study |
| title_short | Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study |
| title_sort | caregiver strategies supporting community participation among children and youth with or at risk for disabilities a mixed methods study |
| topic | attendance involvement pediatric rehabilitation craniofacial microsomia childhood-onset disability |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1345755/full |
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