Interprofessional Primary Care for Adults with Intellectual and Developmental Disabilities
Bibliographic record
Abstract
Access to high-quality primary care has been identified as a pressing need for adults with intellectual and developmental disabilities (IDD). Adults with IDD live with complex physical and mental health conditions, use health services differently than the general population and continue to face challenges when accessing health services. Interprofessional primary care teams offer comprehensive and coordinated approaches to primary care delivery and are well-positioned to address the needs of adults with IDD and other vulnerable populations. Although interprofessional primary care teams are recommended, there is currently limited understanding of how interprofessional services are delivered and how this approach improves the health of adults with IDD. The overall objective of this research was to gain a detailed understanding of the current provision of interprofessional primary care for adults with IDD. This dissertation presents the results of two studies. A scoping review was completed to examine the provision of interprofessional primary care for adults with IDD in a global context. A multiple case study was also conducted with five interprofessional primary care teams in Ontario, Canada. The aim of this study was to describe interprofessional primary care for adults with IDD within and across models of team-based care in one local health service context. The results of the studies highlight that there are multiple approaches to the provision of interprofessional primary care for adults with IDD. In Ontario, adults with IDD are a small part of the patient population served and overall, this group was poorly identified. Key organizational attributes, as well as the experiences of patients, caregivers and health providers were described. Interestingly, despite the presence of interprofessional health providers, there were limited organizational processes to engage a wide-range of interprofessional services. There was no consistent reporting of outcomes and no processes in place to measure the impact of interprofessional services for this population. Results provide important insights into the current state of interprofessional primary care for adults with IDD in Ontario and highlight a critical need for further work in the field to develop processes to engage in team-based care and demonstrate the value of the approach for this population.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".