Background Family‐centred care (FCC) is a model for rehabilitation practice that focuses on collaborative partnerships between providers and clients (i.e., children and their caregivers). FCC is a best‐practice standard and is expected to yield better outcomes for children and greater caregiver satisfaction with rehabilitation services. A commonly cited barrier to implementing FCC is perceptions about caregiver capability to contribute to designing an initial plan of care, due to lack of skill and/or interest. Objectives The aim of this study is to address FCC barriers through three objectives: (a) report the proportion of caregivers that created multiple care plans using PEM+, an electronic health tool, (b) assess the proportion of caregivers that created complete and participation‐focused care plan(s) and that exceeded criteria of a complete plan, and (c) describe characteristics of caregivers that did not create a complete care plan. Methods Study objectives were addressed via secondary analyses of a subset of data from the PEM + pilot trial. Participants were caregivers (N = 18) of children with developmental disabilities (aged 0–5 years) receiving rehabilitation services in an early childhood programme. A deductive analytic approach was used to code care plan content to criteria and to determine proportion of caregivers with a complete and participation‐focused care plan and those that exceeded the criteria. Results Multiple care plans were created by 72% of the caregivers, 83% caregivers created at least one care plan that was complete and participation‐focused per criteria, and 83% exceeded the criteria. Conclusion The high occurrence of caregivers who developed multiple care plans and who developed high‐quality care plans, in their completeness and participation‐focused features, suggests that caregivers are interested and capable of participating in a collaborative goal setting process when using PEM+. This indicates that FCC is feasible to implement in clinical workflow with the use of an electronic health tool, which may better facilitate such care. PEM+ warrants further efficacy testing prior to implementation.

Importance: Evidence on common types of participation-focused caregiver strategies can help occupational therapy practitioners to take an evidence-based approach to designing participation-focused practice. Objective: To identify and explore types of caregiver strategies to support young children’s participation in valued occupations in the home and community. Design: Qualitative study using a subset of data collected online with the Young Children’s Participation and Environment Measure (YC–PEM). Narrative responses about strategy use were content coded to the family of Participation-Related Constructs (fPRC) framework using a deductive analytic approach to identify relevant types of participation-focused strategies used in the home and community. Responses were further analyzed within each relevant fPRC construct using an inductive analytic approach to identify the scope of strategies used for each construct. Setting: Early intervention. Participants: Caregivers (N = 106) of young children receiving early intervention. Outcomes and Measures: Caregivers’ strategies to support their child’s home and community participation, provided by the YC–PEM. Results: Caregivers most commonly adapted the child’s environment or context to support their child’s home and community participation (45.06%). The least common focus of caregiver strategies was the child’s activity competencies (11.16%). Three or more types of caregiver strategies were identified for each participation-related construct. Conclusion and Relevance: Results indicated that caregivers used a range of strategies related to each of the participation-related constructs to support their child’s participation in home and community occupations, most commonly targeting the environment. Occupational therapy practitioners can select from this range of strategies when planning participation-focused early intervention with families. What This Article Adds: This study yields new evidence on the scope of caregiver strategy use to support young children’s participation in home and community occupations. Occupational therapy practitioners can apply this evidence to anticipate common areas of caregiver strategy use in participation-focused practice with families in early intervention.

Date Presented 03/26/20 This study evaluated the feasibility, acceptability, and preliminary effects of PEM+, a web-based care-planning application that was designed with and for caregivers to help OTs enact family-centered and participation-focused care with children and families. Results indicate that PEM+ has potential as an innovative option for improving caregiver confidence when creating participation-focused care plans in OT. Primary Author and Speaker: Vivian Villegas Contributing Authors: Vera Kaelin, Jessica Jarvis, Dana Anaby, Rachel Teplicky, Mary Khetani

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