Exploratory study on the adaptation of online services offered to people with disabilities, in the context of the COVID-19 pandemic.

Aim: During the COVID-19 pandemic, many community organizations offering services to people with disabilities (PWD) changed their service delivery, switching from in-person to remote services. However, little is known about what it was like for organizations to quickly pivot their service delivery. The study explored barriers and facilitators to access community services for PWD and identified potential improvements to these services.Methods: The study used a mixed method, multiple case study design, which included a convenience sample of 27 participants recruited from four community organizations delivering services to PWD. Participating staff and members participated in six different focus groups and completed a questionnaire about their level of satisfaction regarding the evolution of the services. Inductive thematic analysis was conducted on the focus group data and the data from the questionnaires were descriptively analyzed.Results: The thematic analyses revealed four themes: "Succeeding in adapting the interventions to continue providing services", "Enjoying a lot of new things about the new online modality", "Key elements that have facilitated the transition" and "Facing some difficulties implementing online services". The median satisfaction score demonstrated that the participants were satisfied with the services. The success of these organizational changes relied on the adoption of new methods and approaches to service delivery.Conclusion: Through this study, barriers and facilitators that the organizations and their beneficiaries have experienced during the pandemic were identified as well as suggestions for improvement. The organizations consider maintaining online services beyond the pandemic to offer PWD easier access to community services.

People with disabilities and professionals were satisfied with online community services developed during the pandemic.Individual with disabilities were more satisfied about the accessibility and the way of delivering online services than the staff.Facilitators for online service delivery included the choice of low-risk services to offer to their members, the use of the Zoom platform to deliver the service and the flexibility of the internal organization.Barriers to online service delivery included challenges related to communication, both among members and between staff and members, composing with a small screen for the staff and the members and for organizations to reach all their members ­ especially the oldest ones.

Assessment of Users' Needs and Expectations Toward Clinical Practice Guidelines to Support the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury.

OBJECTIVE: Stakeholder engagement in clinical practice guideline (CPG) creation is thought to increase relevance of CPGs and facilitate their implementation. The objectives were to survey stakeholders involved in the care of adults with traumatic brain injury (TBI) regarding general perceptions of CPGs, key elements to be included, and needs and expectations about format and implementation strategy. SETTINGS: Hospitals and inpatient and outpatient rehabilitation facilities providing services to persons with TBI. PARTICIPANTS: Stakeholders identified as primary end users of the CPG: clinicians, hospital leaders, health system managers, and funders in Quebec and Ontario (Canada). DESIGN: Cross-sectional online survey conducted between May and September 2014. RESULTS: In total, 332 individuals expressed their needs and expectations. Despite positive perceptions of CPGs, only a small proportion of respondents used them. Intensity and frequency of interventions, behaviors disorders and cognitive function impairment, and social participation and community life were important subjects to cover in the CPG. Finally, respondents asked for specific recommendations including a ranking of recommendations based on level of underlying evidence. CONCLUSION: Respondents have important expectations toward a CPG. We anticipate that early and meaningful engagement of end users could facilitate CPG implementation.

Absenteeism screening questionnaire (ASQ): a new tool for predicting long-term absenteeism among workers with low back pain.

INTRODUCTION: Over the last decades, psychosocial factors were identified by many studies as significant predictive variables in the development of disability related to common low back disorders, which thus contributed to the development of biopsychosocial prevention interventions. Biopsychosocial interventions were supposed to be more effective than usual interventions in improving different outcomes. Unfortunately, most of these interventions show inconclusive results. The use of screening questionnaires was proposed as a solution to improve their efficacy. The aim of this study was to validate a new screening questionnaire to identify workers at risk of being absent from work for more than 182 cumulative days and who are more susceptible to benefit from prevention interventions. METHODS: Injured workers receiving income replacement benefits from the Quebec Compensation Board (n = 535) completed a 67-item questionnaire in the sub-acute stage of pain and provided information about work-related events 6 and 12 months later. Reliability and validity of the 67-item questionnaire were determined respectively by test-retest reliability and internal consistency analysis, as well as by construct validity analyses. The Cox regression model and the maximum likelihood method were used to fix a model allowing calculation of a probability of absence of more than 182 days. Criterion validity and discriminative capacity of this model were calculated. RESULTS: Sub-sections from the 67-item questionnaire were moderately to highly correlated 2 weeks later (r = 0.52-0.80) and showed moderate to good internal consistency (0.70-0.94). Among the 67-item questionnaire, six sub-sections and variables (22 items) were predictive of long-term absence from work: fear-avoidance beliefs related to work, return to work expectations, annual family income before-taxes, last level of education attained, work schedule and work concerns. The area under the ROC curve was 73%. CONCLUSIONS: The significant predictive variables of long-term absence from work were dominated by workplace conditions and individual perceptions about work. In association with individual psychosocial variables, these variables could contribute to identify potentially useful prevention interventions and to reduce the significant costs associated with LBP long-term absenteeism.

Validation of an adaptation of the stress process model for predicting low back pain related long-term disability outcomes: a cohort study.

STUDY DESIGN: Twelve-month cohort study. OBJECTIVE: The aim of the study was to examine the ability of an adaptation of the stress process model to predict different outcomes among low back pain (LBP) sufferers. SUMMARY OF BACKGROUND DATA: Recently, the stress process model was adapted and was shown to be useful to partially explain long-term disability related to low back pain, an important occupational health problem. METHODS: French-speaking compensated workers on sick leave because of subacute common LBP (N=439) completed a questionnaire including the adapted stress process model's factors: life events and appraisal, cognitive appraisal of LBP, emotional distress, avoidance coping strategies, and functional disability. Six and 12 months later, participants gave information about their work status, number of days of absence, and functional disability. Regression analyses were performed to identify significant predictive factors of these outcomes. Pain intensity, fear of work, gender, and presence of pain radiating below the knee were used as control variables. RESULTS: Number of days of absence, functional disability, and absence from work were predicted at 6 and 12 months by cognitive appraisal of LBP and emotional distress. Functional disability was predicted in addition by functional disability at study entry (T1). When the control variables were considered, number of days of absence was predicted at 6 months by cognitive appraisal, fear of work, and being a male, and, in addition, by emotional distress at 12 months. Functional disability was predicted by functional disability t1, emotional distress, cognitive appraisal of LBP, and fear of work at 6 months, and by the same factors and variables at 12 months, except for functional disability t1. Regarding absence from work, it was predicted at 6 months by fear of work and being a male, and at 12 months by cognitive appraisal of LBP and fear of work. CONCLUSION: In association with fear of work, 2 factors from the adapted stress process model are significantly useful for predicting LBP related long-term disability outcomes and could be targeted by preventive interventions.