Collaboration between Public Health and Schools: An Example of an Integrated Community Social Care Model.

Introduction: There is a need to improve public health interventions to promote youth social and emotional development in close collaboration with schools, families and local communities. A close intersectoral collaboration between the regional public health, schools and school boards was established to co-construct and implement "Positive Intervention (PI)" in the Eastern Townships region (Quebec, Canada). This paper describes its implementation according to the "Integrated Community Care (ICC)" framework. Description: PI is a collaborative and personalized intervention leaning toward an integrated community social care model. In fact, PI relies on the close proximity between Public Health and their educational counterpart as well as their individual temporality. However, PI offered mainly social services and its relationships with Primary Care services was not yet a priority. Discussion: The results show that it is possible to develop and implement an intervention promoting positive mental health in children, with and for local organisations. The level of integration between schools and Public Health services achieved after only 6 months of implementation is encouraging. Conclusion: More research is needed to thoroughly document the implementation, social validity, and effects of such an intervention by taking in the point of view of all stakeholders.

Introduction: Il est nécessaire d'améliorer les interventions de santé publique pour promouvoir le développement social et émotionnel des jeunes en étroite collaboration avec les écoles, les familles et les communautés locales. Une telle collaboration intersectorielle entre la santé publique régionale, les écoles et les commissions scolaires a été mise en place pour coconstruire et mettre en œuvre l'Intervention positive (IP) en Estrie (Québec, Canada). Cet article décrit sa mise en œuvre initiale selon le cadre conceptuel des soins de santé et services sociaux intégrés en proximité des communautés. Description: L'IP est une intervention collaborative et personnalisée qui s'inscrit dans un modèle de services sociaux intégrés en proximité des communautés. En fait, l'IP s'appuie sur une forte proximité entre les services de santé publique et les milieux scolaires, ainsi qu'un ajustement à la temporalité des partenaires. Cependant, l'IP offre principalement des services sociaux et ses relations avec les services de soins primaires n'étaient pas encore une priorité. Discussion: Les résultats montrent qu'il est possible de développer et de mettre en œuvre une intervention de promotion de la santé mentale positive chez les enfants, avec et pour les organisations locales. Le niveau d'intégration entre les écoles et les services de santé publique atteint après seulement six mois de mise en œuvre est encourageant. Conclusion: Des recherches supplémentaires sont nécessaires pour documenter de manière approfondie la mise en œuvre, la validité sociale et les effets d'une telle intervention en prenant en compte le point de vue de toutes les parties prenantes.

[Description of a Pilot Project for Pediatric Occupational Therapy in Daycare and Community Settings]. / Description d'un projet pilote d'ergothérapie pédiatrique en milieux de garde et communautaires.

Background. Occupational therapy interventions that promote and prevent children's health and well-being aim to reduce health inequalities and foster protective factors. The purpose of this study is to describe a pilot community-based occupational therapy project for preschoolers in partnership with community organizations and childcare services. Method. A participatory action research approach was implemented with support from an advisory committee. An occupational therapist provided community-based occupational therapy services in a tiered organization model over one year. Findings. Services were offered in three tiers: 7 awareness workshops for parents and caregivers (Tier 1), 57 visits and 27 consultations in 8 community agencies (Tier 2), and 23 individual follow-ups (Tier 3). Implications. There is an opportunity to implement with community agencies and daycare settings an occupational therapy service based on community-based rehabilitation for children under 5 years of age.

Description. Les interventions ergothérapiques en promotion et prévention de la santé et du bien-être des enfants visent à réduire les inégalités de santé et favoriser les facteurs de protection. But. Cette étude vise à décrire un projet pilote de service d'ergothérapie à base communautaire, pour les enfants d'âge préscolaire, en partenariat avec les organismes communautaires et les milieux de garde. Méthodologie. Une approche de recherche-action participative avec soutien d'un comité aviseur a été mis en place. Une ergothérapeute a offert des services d'ergothérapie communautaire selon un modèle d'organisation par paliers durant un an. Résultats. Les services étaient offerts selon trois paliers : 7 ateliers de sensibilisation pour parents et intervenants (palier 1), 57 visites et 27 consultations dans 8 organismes communautaires (palier 2) et 23 suivis individuels (palier 3). Conséquences. Il est possible d'implanter un service d'ergothérapie s"inspirant de la réadaptation à base communautaire avec les organismes communautaires offrant des services aux enfants de 5 et moins et les milieux de garde.

Interrater reliability of Algo used by non-occupational therapist members of homecare interdisciplinary teams.

PURPOSE: To determine if non-occupational therapists (non-OTs) with different job titles using Algo, a clinical algorithm for recommending bathroom modifications (e.g., bath seat) for community-dwelling elders in "straightforward" situations, will make clinically equivalent recommendations for standardized clients. METHOD: Eight non-OTs (three social workers, two physical rehabilitation therapists, two homecare aides and one auxiliary nurse) were trained on Algo and used it with six standardized clients. Bathroom adaptations recommended (one of nine options) by non-OTs were compared to assess interrater agreement using Fleiss adapted kappa. RESULTS: Estimated kappa was 0.43 [0.36; 0.49] qualified as a moderate agreement, according to Landis and Koch's arbitrary divisions, among the recommendations of non-OTs. However, clinical equivalence is reached, since safety and client needs were met when raters selected two different options (e.g., with or without a seat back). CONCLUSIONS: Non-OTs using Algo in the same simulated clinical scenarios recommend clinically equivalent bathroom adaptations, increasing the confidence regarding the interrater reliability of Algo used by non-OT members of homecare interdisciplinary teams Implications for Rehabilitation In homecare services, non-occupational therapists from different health care disciplines (e.g., homecare aides, social workers, physical rehabilitation therapists) may be asked to select assistive devices for the hygiene care of clients living at home. Algo was designed to guide non-occupational therapists in the selection of assistive devices when performed with clients in straightforward cases. This study indicates that non-occupational therapists using Algo recommend similar and acceptable bathroom adaptations to enhance client safety.