Developing an Interprofessional Pediatric Rehabilitation Model of Care in Northern Cree First Nation Communities: Protocol for a Needs Assessment and Codeveloped Intervention With a Qualitative and Participatory Action Approach
Bibliographic record
Abstract
BACKGROUND: In Canada, the Indigenous population is the youngest and fastest growing, yet ongoing health disparities for Indigenous peoples are widely recognized. There is a concerning lack of research on childhood disabilities and health conditions in Indigenous populations in Canada. For children with disabilities and chronic health conditions, ongoing access to rehabilitation services, such as occupational therapy, physical therapy, speech-language pathology, and audiology, is critical in promoting positive health and developmental outcomes. Elders and the Peter Ballantyne Cree Nation health services board have guided a critical priority for addressing access challenges to pediatric rehabilitation in 3 specific northern Indigenous communities. OBJECTIVE: The purpose of this manuscript is to outline the protocol for a community-directed needs assessment and subsequent development of a multidisciplinary pediatric rehabilitation service in 3 specific northern Indigenous communities. METHODS: The study involves 3 phases. In phase 1, the needs assessment process was led by 2 physiotherapy clinician researchers and 2 graduate students working with health care professionals in pediatric speech-language pathology, audiology, physiotherapy, and occupational therapy with experience in both private and public health entities. The process consisted of multiple parts, which included a community-led request, a preliminary literature review, survey development, interview guide development, communication and feedback with health care professionals, a test phase with pediatric family members, and finalization of the survey and interview guides for deployment. In phase 2, the findings from phase 1 will inform the codevelopment of a pilot hybrid-care, interprofessional pediatric rehabilitation clinic for each of the communities. In phase 3, a stakeholder meeting will take place to facilitate knowledge sharing and open discussion regarding the implementation of phase 2 as well as considerations for the sustainability of this model of care. RESULTS: The final survey was multidisciplinary, with 6 content areas covered in 15 items. Guides for 1-on-1 interviews and sharing circles included 10 questions for community members and 12 questions for health care providers. Participant recruitment began in April 2024. Final results are anticipated in early 2026. CONCLUSIONS: This manuscript details the process of a community-directed needs assessment, which will inform the development and implementation of a model of care for pediatric rehabilitation services. Our process was driven by a request from the community for a needs assessment and emphasized the involvement of key stakeholders early and often during assessment development. A clear purpose of the project was identified with community direction. We used multidisciplinary inputs from both public and private sectors and maintained clear goals during our survey question design process. This study aims to inform the codevelopment and implementation of an interdisciplinary, hybrid model of pediatric rehabilitation care for remote First Nation communities, ultimately leading to improved access to patient- and family-centered care for pediatric rehabilitation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/69438.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.069 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.012 | 0.005 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.007 | 0.009 |
| Research integrity | 0.005 | 0.009 |
| Insufficient payload (model declined to judge) | 0.031 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".