Implementation and impact: integrating a parenting intervention into routine care for children with early neurological conditions
摘要
Children with neurological/neurodevelopmental conditions experience behavioral regulation challenges, yet few receive support in hospitals. Interact-North is a tele-health intervention providing individualized behavioral coaching and neurological and health-related psychoeducation to parents of children with neurological/neurodevelopmental conditions. This study assessed its implementation in a pediatric tertiary hospital. Objectives included: (1) assess organizational readiness, (2) co-design service pathways, and (3) evaluate implementation outcomes and sustainability.
MethodsGuided by The Implementation Roadmap, we evaluated Interact-North’s implementation across three hospital divisions. A mixed-methods design was used to assess organizational readiness, co-develop clinical service pathways, and evaluate outcomes through surveys, program administrative metrics, field notes, and semi-structured interviews.
ResultsClinicians reported high organizational readiness, strong perceived fit, and high program acceptability. Clinical service pathways were co-developed iteratively over a 6-month period during which 167 families were referred, 108 enrolled, and 75 completed. Fidelity was high (90%), as was perceived effectiveness noted by improvements in behavioral concerns. Key implementation facilitators included program adaptability, alignment with clinical needs, and enhanced continuity of care. Sustainability ratings were high across domains, except for funding stability.
ConclusionsThe implementation of Interact-North represents a scalable model to address the gap in psychosocial support for families, but funding remains a barrier.
ImpactEarly behavior and emotional regulation challenges impact up to 40% of young children followed in early neurological and neurodevelopmental hospital clinics, yet there are limited embedded interventions. This study demonstrates that an evidence-based family-centered tele-health behavioral and psychosocial intervention can be successfully implemented within pediatric specialty hospital divisions. Results support strong clinician engagement, program fidelity, and meaningful acceptability and effectiveness outcomes for families. Findings provide a scalable model for implementing early behavioral interventions for children with early neurological/neurodevelopmental conditions seen in the hospital.