BACKGROUND: Return-to-school processes indicate ‘when’ to initiate activities and ‘what’ activities should be accomplished, but are missing ‘how’ to implement the process. The SCHOOLFirst website provides the ‘how’ through building concussion knowledge, creating a supportive culture and defining roles. Due to the involvement of pre-service teachers in schools during training and imminent transition to becoming teachers, it is important that pre-service teachers are trained in concussion and can optimally support current and future students. OBJECTIVE: To determine: 1) pre-service teachers’ knowledge and confidence surrounding the return-to-school process before and after using the SCHOOLFirst website; 2) the usability, intended use and satisfaction of the SCHOOLFirst website from the perspective of pre-service teachers. METHODS: Thirty pre-service teachers completed the demographic survey, knowledge and confidence survey, System Usability Scale, and satisfaction and intended use survey after participating in a workshop. RESULTS: Significant increases in concussion knowledge (Z = –4.093, p < 0.001) and confidence in helping students return-to-school (Z = –4.620, p < 0.001) were measured after using the SCHOOLFirst website. Participants were satisfied with the SCHOOLFirst website (93.4%) and intend to use it in the future when supporting a student post-concussion (96.4%). CONCLUSION: The SCHOOLFirst website is a valuable tool for pre-service teachers to support students’ return-to-school post-concussion.
Background Clinical practice guidelines are systematically developed statements that assist clinicians in making evidence informed decisions regarding patient care. Within pediatric concussion, the Ontario Neurotrauma Foundation released the Guidelines for Diagnosing and Managing Pediatric Concussion in 2014. The purpose of this study was to evaluate the 2014 guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluation tool, in addition to a brief knowledge translation survey, and to utilize the collected feedback from end users to inform improvements to support an updated version. An integrated knowledge translation approach was employed using clinical experts as guideline appraisers. Methods A purposive sample of researchers, physicians, allied health professionals, policy makers, educators and knowledge translation experts involved in updating the guidelines (N = 31) completed the AGREE II Likert scale survey regarding the 2014 guideline, and provided written justifications for their ratings. Domain and item AGREE II scaled scores were reported stratified by demographic factors, and written justifications were synthesized using content analysis to determine areas of improvement for the 2014 guideline. Results Appraisers scored the editorial independence (88.9%) and scope and purpose (80.8%) domains the highest, indicating high quality. The guidelines scored the lowest in the applicability domain (69.3%). Participants with less than 10 years of experience in their respective disciplines, as well as physicians and allied health professionals consistently provided higher ratings across domains compared to other professions. Conclusions The process of evaluating the 2014 guideline resulted in these important outcomes: (1) identified areas of the guideline that may have affected the lack of previous clinical uptake while abiding by a clinical practice guideline development framework; (2) shared and informed decision making regarding content and format of the revised clinical practice guideline; and (3) targeted content, clinical questions and dissemination strategies, which are key to clinical uptake.
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Background: Spinal Muscular Atrophy (SMA) is a progressive neuromuscular disorder that causes muscle weakness and is a leading genetic cause for infant mortality worldwide. While no definitive cure exists, the approval of three genetic based therapies since 2018 in Canada has lead to significant improvements in muscle function for children with SMA. With that, there are no evidence-based rehabilitation interventions and minimal evidence on the combined effects of genetic based therapies and rehabilitation. The objective of the study is to assess the feasibility of a twice-weekly outpatient rehabilitation intervention focusing on gross and fine motor function to inform the methodology and sample size of a definitive clinical trial. Methods: The study is a single centre, non-randomized pilot and feasibility trial to explore an outpatient rehabilitation intervention for children 6 months to 3 years old with SMA treated with genetic based therapies. Participation in the study will occur over a 25-week period, with a baseline assessment visit followed by a 12-week intervention period and 12-week non-intervention period. The rehabilitation intervention comprises weekly physical and occupational therapy for 11 weeks. Assessments will occur at Baseline (week 0), End-of-Intervention/Early Withdrawal (week 12) and Follow-up (week 24). Pre-determined feasibility indicators will evaluate study feasibility across process, resource, management and scientific domains. Discussion: The proposed twice-weekly outpatient rehabilitation intervention will be the first step towards filling the need for an evidence-based rehabilitation intervention for children with SMA treated with genetic based therapies. In the future, a definitive trial will measure the efficacy of the intervention.
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