Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Patient-reported outcome measure (PROM) adoption with youth with intellectual and developmental disabilities (IDD) faces obstacles but is important for client-centered care. We collected data from pediatric practitioners who work with youth with IDD (N = 113) about factors influencing PROM adoption and the frequency of PROM use by age. Results suggest evidence, time, and accessibility are important factors for PROM adoption, and clinicians infrequently use PROMs with this population.
Primary Author and Speaker: Kimberly Greenberg
Additional Authors and Speakers: Ariel E. Schwartz
Contributing Authors: Jessica Kramer
INTRODUCTION: Occupational therapy practice guidelines emphasize providing client-centered care, but the adoption of patient reported outcome measures (PROMs) with youth with intellectual/developmental disabilities (IDD) faces obstacles (Kramer et al., 2012). To increase their adoption, it is critical to 1) identify what factors influence pediatric providers’ adoption of PROMs in pediatric practice settings and 2) study how often PROMs are used across age groups.
DESIGN: We used a descriptive survey to collect data from pediatric practitioners who were recruited through professional contacts and social media. Our inclusion criteria were the following: professional license or certificate in rehab or education; at least 6 months of professional experience with youth with IDD ages 8-21; experience administrating PROMs or experience using the Pediatric Evaluation of Disability Inventory/PEDI-Computer Adaptive Test.
METHOD: Participants ranked factors that influence their decision to adopt youth PROMs based on barriers and supports identified in PROM literature (Foster et al., 2018); we analyzed these rankings across settings (rehabilitation, school) and roles (administrative, clinical). They also indicated how often they administer PROMs with youth with IDD (sometimes, rarely, never); we calculated the mean response in each age group and examined patterns across age groups (elementary, middle school, high school/transition age).
RESULTS: 113 pediatric practitioners (occupational therapist = 48, physical therapist = 32, physician = 16, other = 17) responded to the survey with an average of 15 years of experience working with children and youth ages 8-21 with IDD. Accessibility and appropriateness, psychometric evidence, and time were most frequently ranked among the top three factors that influence practitioners' adoption of PROMs. Practitioners reported ‘never or rarely’ using PROMs 39-65% of the time across age groups.
CONCLUSION: Our results suggest that pediatric practitioners may be infrequently using PROMs with youth with IDD because of perceived inaccessibility and time requirements of PROMs and practice-environment barriers, including access to evidence and caseload demands. Because PROMs can facilitate client-centered care, addressing these potential barriers to adoption may improve rehabilitation practice.
IMPACT: Recognition of factors that influence PROM adoption may lead to strategies that increase their use across diverse settings, roles, and age groups, thereby supporting occupational therapy’s provision of client-centered care for youth with IDD.
References
Foster, A., Croot, L., Brazier, J., Harris, J., & O’Cathain, A. (2018). The facilitators and barriers to implementing patient reported outcome measures in organisations delivering health related services: A systematic review of reviews. Journal of Patient-Reported Outcomes, 2(1). https://doi.org/10.1186/s41687-018-0072-3
Kramer, J. M., Walker, R., Cohn, E. S., Mermelstein, M., Olsen, S., O’Brien, J., & Bowyer, P. (2012). Striving for shared understandings: Therapists’ perspectives of the benefits and dilemmas of using a child self-assessment. OTJR: Occupation, Participation and Health, 32(1_suppl), S48–S58. https://doi.org/10.3928/15394492-20110906-02
