The factors contributing to teacher predictions of spelling ability, and the accuracy of their assessments

In this study, teachers of kindergarten and Grade 1 French-speaking students indicated the likelihood their students would develop later writing difficulties. Results showed that language measures, language background, the education levels of parents, and home literacy practices predicted whether children would be identified as at-risk. Moreover children’s oral language skills accounted for even more of the variance in teacher ratings than other variables. Spelling performance assessed 1-year later from a subset of children indicated that the teacher predictions were accurate. Thus, teachers appear to be an effective source for predicting children’s future literacy performance

Understanding clinicians' strategies for providing gender-sensitive care: an exploration among pediatric rehabilitation health care providers

This is an Accepted Manuscript of an article published by Taylor& Francis in Disability and Rehabilitation October 23rd 2020, available online: https://doi.org/10.1080/09638288.2020.1836270Purpose Although there is an increasing awareness of the critical role of gender within pediatric rehabilitation, little is known about the strategies that clinicians use to provide such care. The purpose of this study was to explore clinicians’ strategies for providing gender-sensitive care within a pediatric rehabilitation hospital. Methods We used a qualitative needs assessment design and a convenience sampling strategy to recruit clinicians from a pediatric rehabilitation hospital. We conducted interviews with 23 pediatric rehabilitation health care providers from various disciplines. We applied a thematic analysis to the interview transcripts. Results Our analysis revealed the following themes regarding clinicians’ strategies in providing gender-sensitive care: (1) awareness of gender biases and not making assumptions; (2) recognizing gender-based vulnerabilities; (3) respecting patient values, preferences and needs; and (4) advocacy. Conclusion Health care providers working within pediatric rehabilitation have several strategies for providing a gender-sensitive care approach to clients.Funding for this study was provided, in part, by the Canadian Institutes of Health Research and Social Sciences and Humanities Research Council (CIHR-SSHRC) Partnership grant and the Kimmel Family Fund through the Holland Bloorview Kids Rehabilitation Hospital

The training needs for gender-sensitive care in a pediatric rehabilitation hospital: a qualitative study

Abstract Background Gender is an important social determinant of health; however, clinicians often lack training in how to provide gender-sensitive care. Offering appropriate and relevant training could help to address some gender-based health inequalities. Our objective was to identify and describe the training needs for gender-sensitive care among pediatric rehabilitation healthcare providers. Methods This study used an interpretive descriptive qualitative design to conduct interviews with 23 pediatric rehabilitation healthcare providers (19 women, 3 men, 1 transgender man), from a pediatric rehabilitation hospital in a large urban center, in Ontario, Canada from a range of disciplines. Interviews were transcribed verbatim and analyzed using an open-coding inductive thematic analysis. Results Our analysis revealed the following themes: [1] lack of knowledge about gender-sensitive care and the need for more training; [2] content of the desired training (i.e., gender differences, effective communication and how to practice gender-sensitive care) and [3] delivery method of the training. Conclusions Enhanced gender-sensitive training for healthcare providers is required for optimizing patient outcomes and addressing gender-based health inequalities. Educators in pediatric rehabilitation should consider developing gender-sensitive care training that is embedded within post-graduate education and also continuing education within hospitals and community care centers

Challenges with providing gender-sensitive care: exploring experiences within pediatric rehabilitation hospital

This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation June 24th 2020, available online: https://www.tandfonline.com/10.1080/09638288.2020.1781939Purpose The purpose of this study was to explore the perceived challenges with providing a gender-sensitive care approach among pediatric rehabilitation care providers. Methods Using a qualitative needs assessment design and a purposive sampling strategy, we recruited clinicians from a Canadian pediatric rehabilitation hospital. We conducted interviews with 23 pediatric rehabilitation healthcare providers (19 women, 3 men, 1 transgender man) from a range of disciplines. Three coders performed a thematic analysis of the transcripts. Results Our analysis revealed the following themes regarding the perceived challenges in providing a gender-sensitive care approach: (1) a lack of training and experience; (2) gender differences and stereotypes; (3) binary documentation and potential for misgendering; (4) the complexity of gender identity; and (5) the gender of the clinician. Conclusions Pediatric rehabilitation care providers face many challenges in offering a gender-sensitive care approach and need further training and systemic support.Funding for this study was provided by the Canadian Institutes of Health Research-Social Sciences and Humanities Research Council (CIHR-SSHRC) Partnership Grant (01561-000 and 895-2018-4002) and the Kimel Family Fund through the Holland Bloorview Kids Rehabilitation Hospital

Outcomes of gender-sensitivity educational interventions for healthcare providers: A systematic review

Background: Although gender plays an important role in health, most healthcare providers lack knowledge in providing gender-sensitive care. Offering gender-sensitivity training for healthcare providers can help to address gender-based health inequalities. Method: A mixed-methods systematic review of gender-sensitivity training programmes or interventions for healthcare providers was undertaken to assess their outcomes and to document areas for future research. Comprehensive searches of seven international databases were conducted for peer-reviewed literature published between 1998 and 2018. Eligible studies included at least one outcome related to gender-sensitivity training for healthcare providers. Results: Twenty-nine studies met the inclusion criteria. Fourteen studies focused on gender-sensitivity in reducing gender bias towards men and women, and 15 studies focused on addressing the needs of lesbian, gay, bisexual and transgender (LGBT) patients. Thirty-seven percent of studies showed a significant improvement in gender-related knowledge, attitudes or practice after the training. Multiple training methods were used to teach gender-sensitive care. Common content of the training included learning sex/gender terminology, understanding gender issues and inequalities in health, stigma and discrimination and communication skills. The duration and frequency of interventions ranged considerably. Sex differences in training outcomes also occurred among the learners. Conclusion: Review findings highlight that although gender-sensitivity training for healthcare providers is increasing, there is insufficient evidence to determine its effectiveness. Additional, more rigorously designed studies are needed to assess the long-term implications on learner behaviours and practices, especially across a wide variety of healthcare providers.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded through a Canadian Institutes of Health Research and Social Sciences and Humanities Research Council (CIHR-SSHRC) partnership grant and also the Kimmel Family Fund

New ways to get policy into practice: A mixed-method participatory study of care coordination and street-level bureaucrats

Purpose - Health service effectiveness continues to be limited by misaligned objectives between policy makers and frontline clinicians. While capturing the discretion workers inevitably exercise, the concept of “street-level bureaucracy” has tended to artificially separate policy makers and workers. The purpose of this paper is to understand the role of social-organizational context in aligning policy with practice. Design/methodology/approach - This mixed-method participatory study focuses on a locally developed tool to implement an Australia-wide strategy to engage and respond to mental health services for parents with mental illness. Researchers: completed 69 client file audits; administered 64 staff surveys; conducted 24 interviews and focus groups (64 participants) with staff and a consumer representative; and observed eight staff meetings, in an acute and sub-acute mental health unit. Data were analyzed using content analysis, thematic analysis and descriptive statistics. Findings - Based on successes and shortcomings of the implementation (assessment completed for only 30 percent of clients), a model of integration is presented, distinguishing “assimilist” from “externalist” positions. These depend on the degree to which, and how, the work environment affords clinicians the setting to coordinate efforts to take account of clients’ personal and social needs. This was particularly so for allied health clinicians and nurses undertaking sub-acute rehabilitative-transitional work. Originality/value - A new conceptualization of street-level bureaucracy is offered. Rather than as disconnected, it is a process of mutual influence among interdependent actors. This positioning can serve as a framework to evaluate how and under what circumstances discretion is appropriate, and to be supported by managers and policy makers to optimize client-defined needs

New ways to get policy into practice: A mixed-method participatory study of care coordination and street-level bureaucrats

Purpose: Health service effectiveness continues to be limited by misaligned objectives between policy makers and frontline clinicians. While capturing the discretion workers inevitably exercise, the concept of “street-level bureaucracy” has tended to artificially separate policy makers and workers. The purpose of this paper is to understand the role of social-organizational context in aligning policy with practice. Design/methodology/approach: This mixed-method participatory study focuses on a locally developed tool to implement an Australia-wide strategy to engage and respond to mental health services for parents with mental illness. Researchers: completed 69 client file audits; administered 64 staff surveys; conducted 24 interviews and focus groups (64 participants) with staff and a consumer representative; and observed eight staff meetings, in an acute and sub-acute mental health unit. Data were analyzed using content analysis, thematic analysis and descriptive statistics. Findings: Based on successes and shortcomings of the implementation (assessment completed for only 30 percent of clients), a model of integration is presented, distinguishing “assimilist” from “externalist” positions. These depend on the degree to which, and how, the work environment affords clinicians the setting to coordinate efforts to take account of clients’ personal and social needs. This was particularly so for allied health clinicians and nurses undertaking sub-acute rehabilitative-transitional work. Originality/value: A new conceptualization of street-level bureaucracy is offered. Rather than as disconnected, it is a process of mutual influence among interdependent actors. This positioning can serve as a framework to evaluate how and under what circumstances discretion is appropriate, and to be supported by managers and policy makers to optimize client-defined needs

The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology : a systematic review and meta-analysis

Background Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management, are part of recommended treatment; however, no systematic review has evaluated the effects of depression self-management interventions for this population. The primary objective was to examine the effect of self-management interventions on reducing depressive symptomatology in adults with chronic disease(s) and co-occurring depressive symptoms. Secondary objectives were to evaluate the effect of these interventions on improving other psychosocial and physiological outcomes (e.g., anxiety, glycemic control) and to assess potential differential effect based on key participant and intervention characteristics (e.g., chronic disease, provider). Methods Studies comparing depression self-management interventions to a control group were identified through a) systematic searches of databases to June 2018 [MEDLINE (1946 -), EMBASE (1996 -), PsycINFO (1967 -), CINAHL (1984 -)] and b) secondary 'snowball' search strategies. The methodological quality of included studies was critically reviewed. Screening of all titles, abstracts, and full texts for eligibility was assessed independently by two authors. Data were extracted by one author and verified by a second. Results Fifteen studies were retained: 12 for meta-analysis and three for descriptive review. In total, these trials included 2064 participants and most commonly evaluated interventions for people with cancer (n = 7) or diabetes (n = 4). From baseline to < 6-months (T1), the pooled mean effect size was - 0.47 [95% CI -0.73, - 0.21] as compared to control groups for the primary outcome of depression and - 0.53 [95% CI -0.91, - 0.15] at >= 6-months (T2). Results were also significant for anxiety (T1) and glycemic control (T2). Self-management skills of decision-making and taking action were significant moderators of depression at T1. Conclusion Self-management interventions show promise in improving depression and anxiety in those with concomitant chronic physical disease. The findings may contribute to the development of future Self-management interventions and delivering evidence-based care to this population. Further high-quality RCTs are needed to identify sources of heterogeneity and investigate key intervention components