A Scoping Review of Effective Community-Based Primary Healthcare Initiative to Improve Health Outcomes for Persons with Intellectual and Developmental Disabilities
Soroush Khoeiniha, Margherita Cameranesi, Lindsay McCombe, Lisa Demczuk and Shahin Shooshtari
Persons with Intellectual and Developmental Disabilities (IDD) experience poorer health and have more difficulty accessing mainstream healthcare services compared to the general population. To narrow the gap between the health status and healthcare utilization of persons with and without IDD, a number of policies, programs, tools and initiatives have been introduced worldwide, including transitioning persons with IDD residing in institutions to a variety of living arrangements in the community such as group homes. The present scoping review syntheses and critically analyzes empirical evidence on effective healthcare initiatives and programs that best address disparities related to healthcare and social support needs of persons with IDD living in the community. Using an iterative approach, a comprehensive search strategy was constructed to locate literature reviews, as well as quantitative and qualitative empirical studies published between 2008 and 2017. A total of 25 published studies met the inclusion criterion and therefore were included in our analysis.
Results are presented emphasising merits and methodological limitations of included studies, as well as discussing current gaps in the literature and providing recommendations for policy and practice.
Effectiveness of Group Stepping Stones Positive Parenting Program for Children with Autism Spectrum Disorder and Disruptive Behaviour: Program Evaluation from a Large Community Implementation
Jessica Brian, Ami Tint, Julie Chiba Branson and Martha Pilkington
Children on the autism spectrum often experience higher rates of emotional and behavioural difficulties than their typically developing peers. Parenting a child with special needs can place increased stress and demands on parents, and those parents often seek out specialized parenting programs and supports to address the unique needs of their children. This study evaluated the effectiveness of the group Stepping Stones Triple P (SSTP) Program, a 9-week intervention for parents of children with disabilities and behavioural challenges, within the context of a large clinical implementation. Parents of children on the autism spectrum participated in the group SSTP Program and completed measures pre- and post-intervention; 131 families enrolled, and we obtained post-intervention data from 109 on at least some measures. Significant improvements were reported for self-efficacy (Parenting Tasks Checklist; p’s < .001) and parenting over-reactivity and laxness (Parenting Scale; p’s < .001). Reduced parent stress (p < .001) emerged on the Depression Anxiety Stress Scales, and decreases in anxiety (p = .032) and depression (p = .036) approached significance. Improvement was reported, on the Strengths and Difficulties Questionnaire, for children’s overall difficulties, behavioural (conduct) challenges, hyperactivity/inattention, and prosocial behavior (all p’s < .001), but not for emotional symptoms or peer problems. The Parenting Stress Index –Short Form revealed improvements on all domains (p’s range: < .001 to .005). Overall, parents were satisfied with the program, and attrition rates were very low (approx. 15%). This study demonstrates the acceptability, feasibility, and effectiveness of the 9-week group SSTP program, for use with children on the autism spectrum, in a large clinical setting. One logical next step is to explore adaptations to this program for virtual delivery in order to increase access for hard-to-reach families of children on the autism spectrum.