A New Model of Rehabilitation to Meet the Cultural Needs of American Indian/Alaska Native Children with Disabilities

满足美洲印第安人/阿拉斯加原住民残疾儿童文化需求的新康复模式

• 批准号: 10271270
• 负责人: MOLLY MARIE FUENTES
• 金额: $ 4.06万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-25 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10271270
• 关键词: AIDS prevention; Address; Adult; Advisory Committees; Affect; Alaska Native; American Indians; Caregivers; Caring; Child; Childhood; Classification; Communities; Cultural Backgrounds; Development; Diabetes prevention; Disabled Children; Disabled Persons; Disadvantaged; Enrollment; Evaluation; Extramural Activities; Family; Funding; Future; General Population; Goals; Grant; Health; Health Knowledge, Attitudes, Practice; Health Personnel; Health Services; Impairment; Indigenous; Individual; Inpatients; Intervention; Interview; K-Series Research Career Programs; Life; Literature; Mentorship; Methods; Modeling; Native-Born; Neurologic; Not Hispanic or Latino; Outcome; Outcome Measure; Parents; Pediatric Hospitals; Perception; Persons; Process; Provider; Qualitative Evaluations; Quality of life; Quantitative Evaluations; Randomized Controlled Trials; Rehabilitation Centers; Rehabilitation therapy; Reporting; Research; Research Methodology; Research Personnel; Research Proposals; Respondent; Risk Factors; Service delivery model; Services; Source; Survey Methodology; Surveys; Testing; Training; Wellness Program; World Health Organization; acceptability and feasibility; base; biopsychosocial; career; community based participatory research; design; disability; effectiveness evaluation; effectiveness outcome; experience; functional disability; functional outcomes; healing; health disparity; health inequalities; high risk; improved; improved functioning; innovation; international health organization; native elder; neurological rehabilitation; novel; programs; rehabilitation service; service delivery; skills; social; stakeholder perspectives; therapy design; tribal community; tribal health

Project Summary/Abstract American Indians and Alaska Natives (AI/AN) report disability at higher levels than the general population. Social connection through participation in traditional cultural activities is an important part of AI/AN health and wellness. In a preliminary study, AI/AN children and youth with disabilities experienced barriers to participation in traditional cultural activities related to their functional impairments. The children and youth did not have their cultural needs discussed during their rehabilitation sessions, despite participation in desired activities being a goal of rehabilitation programs and several of the barriers having potential solutions through rehabilitation interventions. Without culturally-centered rehabilitation services, AI/AN children with disabilities will not receive the full potential benefit of rehabilitation services, thus reducing their ability to attain optimal functional and wellness outcomes. A systematic approach to designing and testing culturally-centered rehabilitation services for AI/AN children with disabilities is necessary. The goal of this proposal is to integrate stakeholder perspectives into a novel model of culturally-centered rehabilitation and test the acceptability and feasibility of this model during rehabilitation services for AI/AN children with neurological impairments. In Aim 1, we will develop and administer a survey to understand pediatric rehabilitation professionals’ knowledge, attitudes, and behaviors when serving AI/AN children and their perceived barriers and facilitators for culturally-centered care. In Aim 2, we will collaboratively develop a novel model of culturally-centered rehabilitation with a stakeholder advisory committee, and with input from a panel of experts in AI/AN health, AI/AN disability, and pediatric rehabilitation health services. The stakeholder advisory committee will consist of AI/AN users of neurological rehabilitation services, parents or guardians of AI/AN children using neurological rehabi litation services, AI/AN and non-AI/AN pediatric rehabilitation professionals, AI/AN elders, and AI/AN traditional healers. Finally, in Aim 3, we will test the acceptability and feasibility of the novel culturally-centered rehabilitation service model during pediatric neurological rehabilitation services, using quantitative and qualitative evaluations. This research plan is part of a K23 proposal designed to provide scholarly training, mentorship, and support for Dr. Fuentes to gain skills and experience needed to be an independent investigator conducting community-based and stakeholder-engaged research to design effective, culturally-appropriate interventions to improve the health and functional outcomes of AI/AN children with disabilities. To achieve this objective, she will pursue training in: (1) community-based participatory research and stakeholder-engaged research; (2) survey research methods; (3) modified Delphi processes; and (4) the design, implementation, and evaluation of a rehabilitation service model.

项目概要/摘要 美洲印第安人和阿拉斯加原住民 (AI/AN) 报告的残疾程度高于一般人群。 通过参与传统文化活动进行的社会联系是 AI/AN 健康和健康的重要组成部分 在一项初步研究中，有残疾的 AI/AN 儿童和青少年的参与存在障碍。 儿童和青少年在传统文化活动中没有遇到与他们的功能障碍有关的问题。 尽管参与期望的活动是他们的康复课程中讨论的文化需求 康复计划的目标以及通过康复可能解决的一些障碍 如果没有以文化为中心的康复服务，AI/AN 残疾儿童将无法获得治疗。 康复服务的全部潜在益处，从而降低他们获得最佳功能和能力的能力 设计和测试以文化为中心的康复服务的系统方法。 该提案的目标是整合利益相关者。 透视以文化为中心的康复新模式，并测试其可接受性和可行性 在为患有神经障碍的 AI/AN 儿童提供康复服务期间，我们将采用这种模式。 制定和实施一项调查，以了解儿科康复专业人员的知识、态度和 为 AI/AN 儿童提供服务时的行为以及他们认为以文化为中心的护理的障碍和促进因素。 在目标 2 中，我们将与利益相关者合作开发一种以文化为中心的康复新模式 咨询委员会，并听取了 AI/AN 健康、AI/AN 残疾和儿科专家小组的意见 康复健康服务利益相关者咨询委员会将由神经系统的 AI/AN 用户组成。 康复服务、使用神经康复服务、AI/AN 的 AI/AN 儿童的父母或监护人 最后，在 Aim 中。 3、我们将在期间测试以文化为中心的新型康复服务模式的可接受性和可行性 儿科神经科康复服务，采用定量和定性评估。 是 K23 提案的一部分，旨在为 Fuentes 博士提供学术培训、指导和支持 获得成为一名独立调查员进行基于社区和 利益相关者参与研究，设计有效的、适合文化的干预措施，以改善健康 为了实现这一目标，她将继续接受培训。 (1) 基于社区的参与性研究和利益相关者参与的研究；(2) 调查研究； 方法；(3) 改进的德尔菲流程；以及 (4) 修复的设计、实施和评估 服务模式。