Exploring health professionals’ perceptions of acceptability, facilitators, and barriers to using a conceptual framework for community rehabilitation in small, medium urban and rural settings in Manitoba.
Bibliographic record
Abstract
Background: In Canada, individuals are living longer with chronic health conditions. Estimates suggest one-third of individuals need rehabilitation at some point during their illness or injury. Community Rehabilitation (CR) services can support these individuals to continue living in their communities, but existing service delivery is disjointed and disorganized. To address this gap. the Conceptual Framework for Adult Community Rehabilitation (CFACR), was created with input from Manitoba stakeholders in a large urban setting, to inform CR policy design, service, care planning, and research. However, Manitoba includes other settings with distinct features. Purpose: The purpose of this study was to better understand what is needed to implement the CFACR in small, medium urban, and rural contexts in Manitoba by exploring 1) health professionals’ perceived acceptability of the CFACR, and 2) barriers and facilitators to the use of the CFACR in their setting. Methods: In this qualitative descriptive study, I interviewed health professionals in relevant settings in Manitoba. I used directed content analysis guided by the Consolidated Framework for Implementation Research, which can identify determinants of implementation and inform implementation planning. Results: Six health professionals from two health regions participated. All participants perceived the CFACR as acceptable, included relevant constructs and aligned with practice goals, but emphasized the need for flexibility in the constructs to be responsive to practice needs. Key facilitators identified to support using the framework in these settings included compatibility with organizational and professional service goals and suitability to address patient needs. Identified barriers related to lack of resources, current care model, health system transformation, client flow, communication, client capacity, and logistics and workplace safety issues. Discussion: Participants positively perceived the CFACR, and compatible with service delivery aims but the identified barriers indicate that implementation needs support from external actors (i.e., government), and allocation of resources to community services. Research is needed to determine if barriers are specific to certain service settings (e.g., rural). Conclusion: The CFACR is acceptable in small, medium urban, and rural settings in Manitoba, fits with the goals of service delivery and practice, but barriers may challenge the feasibility of implementing it.
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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 | 0.020 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.009 | 0.009 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".