Training programme for community service providers who support adults with intellectual disabilities: A systematic quantitative literature review of single-case research.

BACKGROUND: Research on training direct support professionals to address challenging behaviour exhibited by adults with intellectual disabilities is essential in generating effective training approaches for this sector. This systematic review's objective was to evaluate the effects of training types and whether specific training delivery components influenced outcomes. METHODS: Following PRISMA (2020) guidelines, 16 single-case design studies were included that directly evaluated behaviour change of service providers training for adults with intellectual disabilities in community settings. Study quality was assessed using Horner et al. (Exceptional Children, 2005, 71(2), 165-180) criteria. The database searched included Academic Search Complete, CINAHL, Embase, ERIC, Psych Info, and Web of Science. RESULTS: Descriptive analysis of effect size outcomes suggested that all training types were associated with improved outcomes. Further, in situ training was associated with improved service provider performance. Interestingly, feedback was associated with poorer service provider performance. CONCLUSIONS: We provide possible explanations for this surprising outcome and propose future research.

A model for fostering community capacity to support adults with intellectual disabilities who engage in challenging behaviour: A scoping review.

Developmental support agencies support many adults with intellectual disabilities in the community. Unfortunately, these adults often exhibit high rates of challenging behaviour, which present significant pressures on these service providers. Agencies need to develop effective means of increasing their capacity to provide quality support. Previous systematic reviews found that training staff in positive behaviour supports can improve outcomes; however, the factors facilitating training's effects, long-term effectiveness, and outcomes for service users have yet to be determined. We conducted a scoping review of 98 journal articles and book chapters to develop a model for fostering capacity development drawing from Organizational Behaviour Management and Knowledge Translation theories. Some relevant factors include features of the inner and outer organizational contexts, training approaches (e.g., behavioural skills training & in-situ coaching), ongoing support and feedback. This model may lead to more effective and enduring treatment programs and improved support for adults with intellectual disabilities.

OC25 - Helping parents spot the deteriorating child: co-production of safety-netting interventions.

UNLABELLED: Theme: Child protection and managing risk. INTRODUCTION: Providing families with a safety net of information is a crucial component in the care of children with acute illnesses at home (Jones et al 2013). Safety netting is recommended by UK national bodies and has been found to reduce re-consultation safely (Maguire et al 2011). AIM: To provide parents with information to help them determine when to seek help for an acutely ill child. METHODS: Research programme encompassed five projects: a systematic review; a qualitative exploration of safety netting information used by parents and professionals; a mixed methods development of content, format and delivery modes for the first intervention; video capture of children with acute illness; and co-design of the content of the intervention with parents and professionals. CONCLUSION: ASK SNIFF projects repeatedly demonstrate the need for professionally endorsed, co-produced safety-netting resources for parents with varying information needs, literacy levels and ability to use information technology.

OC26 - Parents of young children in research: informants, consultants and collaborators.

UNLABELLED: Theme: ETHICAL ISSUES: dignity and humanity. INTRODUCTION: Patient and public involvement in research is recognised as best practice in the UK, as services developed with service users are more likely to meet their needs. In child health this often means engaging with parents of young children. AIM: To share experiences of engaging with parents of young children in research projects at varying levels of participation. METHODS: Methods include parents as participants, as parent panels and as research team members reflecting various steps on the participation ladder (Hart 1992). RESULTS: Parents report personal benefits and a range of different challenges when engaging in child health research which impact the management/delivery of research projects. CONCLUSION: Key elements of working with parents include time to plan involvement, building respect/mutual understanding, equal access to project activities, continual support for parents, reward and recognition. Research projects need to cost and plan for parents' engagement in research for it to be successful.

Patients' satisfaction and wait times at Guelph General Hospital Emergency Department before and after implementation of a process improvement project.

OBJECTIVE: A process improvement program (PIP) was implemented in the emergency department (ED) at Guelph General Hospital in July 2009. The purpose of this study was to examine patients' satisfaction and wait times by level of Canadian Triage and Acuity Scale (CTAS) score before and 6 months after implementation of this program. METHODS: Two samples were recruited: one was recruited before implementation of the PIP, January to June 2009 (T1), and one was recruited 6 months after implementation, January to June 2010 (T2). Patients were contacted by telephone to administer a survey including patient satisfaction with quality of care. Time to physician initial assessment, numbers left without being seen, and length of stay (LOS) were obtained from hospital records to compare wait times before and 6 months after implementation of the PIP. RESULTS: Patients (n = 301) reported shorter wait times after implementation (e.g., 12% reported seeing a physician right away at T1 compared to 29% at T2). Time to physician initial assessment improved for patients with CTAS scores of III, IV, and V (average decrease from 2.1 to 1.7 hours), fewer patients (n = 425) left without being seen after implementation, and the mean and 90th percentile of LOS decreased for all patients except the mean LOS for discharged patients with a CTAS score of I. Total time spent in the ED for admitted patients decreased from 11.11 hours in the 2009 period to 9.95 in the 2010 period, and for nonadmitted patients, the total time decreased from 3.94 to 3.29 hours. The overall satisfaction score improved from a mean of 3.17 to 3.4 (of 4; p < 0.001). CONCLUSION: Implementation of the ED PIP corresponded with decreased wait times, increased patient satisfaction, and improved patient flow for patients with CTAS scores of III, IV, and V.