A New Model of Rehabilitation to Meet the Cultural Needs of American Indian/Alaska Native Children with Disabilities

项目摘要/摘要 美国印第安人和阿拉斯加原住民(AI/AN)报告的残疾水平高于一般人口。 通过参与传统文化活动建立社会联系是人工智能/AN健康和 身体健康。在初步研究中，AI/AN残疾儿童和青年遇到了参与障碍 在与他们的功能障碍有关的传统文化活动中。孩子们和年轻人没有他们的 在康复会议期间讨论的文化需求，尽管参加所需的活动是一种 康复方案的目标和通过康复可能解决的几个障碍 干预措施。如果没有以文化为中心的康复服务，AI/AN残疾儿童将得不到 康复服务的全部潜在好处，从而降低他们实现最佳功能和健康的能力 健康结果。设计和测试以文化为中心的康复服务的系统方法 对于AI/AN来说，残疾儿童是必要的。该提案的目标是整合利益相关者 透视以文化为中心的康复新模式，并测试 这一模式在为有神经损伤的AI/AN儿童提供康复服务期间进行。在目标1中，我们将 制定和实施一项调查，以了解儿科康复专业人员的知识、态度和 服务人工智能/人工智能儿童时的行为及其感知的障碍和以文化为中心的护理促进者。 在目标2中，我们将与利益相关者合作开发一种以文化为中心的康复新模式 咨询委员会，并由人工智能/人工智能健康、人工智能/残疾和儿科专家小组提供意见 康复保健服务。利益相关者咨询委员会将由神经学的人工智能/人工智能用户组成 康复服务，使用神经康复服务的AI/AN儿童的父母或监护人，AI/AN 以及非AI/AN儿科康复专业人员、AI/AN长辈和AI/AN传统治疗师。最后，在AIM中 3、我们将测试以文化为中心的新型康复服务模式的接受性和可行性 儿科神经康复服务，采用定量和定性评估。这项研究计划 是K23提案的一部分，旨在为Fuentes博士提供学术培训、指导和支持 获得成为独立调查员所需的技能和经验，进行基于社区的和 利益相关者参与的研究，以设计有效的、文化上适当的干预措施，以改善健康 以及AI/AN残疾儿童的功能结果。为了实现这一目标，她将继续接受培训 在：(1)以社区为基础的参与性研究和利益相关者参与的研究；(2)调查研究 方法；(3)改进的德尔菲流程；(4)康复方案的设计、实施和评估 服务模式。

Project Summary/Abstract American Indians and Alaska Natives (AI/AN) report disability at higher levels than the general population. Social connection through participation in traditional cultural activities is an important part of AI/AN health and wellness. In a preliminary study, AI/AN children and youth with disabilities experienced barriers to participation in traditional cultural activities related to their functional impairments. The children and youth did not have their cultural needs discussed during their rehabilitation sessions, despite participation in desired activities being a goal of rehabilitation programs and several of the barriers having potential solutions through rehabilitation interventions. Without culturally-centered rehabilitation services, AI/AN children with disabilities will not receive the full potential benefit of rehabilitation services, thus reducing their ability to attain optimal functional and wellness outcomes. A systematic approach to designing and testing culturally-centered rehabilitation services for AI/AN children with disabilities is necessary. The goal of this proposal is to integrate stakeholder perspectives into a novel model of culturally-centered rehabilitation and test the acceptability and feasibility of this model during rehabilitation services for AI/AN children with neurological impairments. In Aim 1, we will develop and administer a survey to understand pediatric rehabilitation professionals’ knowledge, attitudes, and behaviors when serving AI/AN children and their perceived barriers and facilitators for culturally-centered care. In Aim 2, we will collaboratively develop a novel model of culturally-centered rehabilitation with a stakeholder advisory committee, and with input from a panel of experts in AI/AN health, AI/AN disability, and pediatric rehabilitation health services. The stakeholder advisory committee will consist of AI/AN users of neurological rehabilitation services, parents or guardians of AI/AN children using neurological rehabi litation services, AI/AN and non-AI/AN pediatric rehabilitation professionals, AI/AN elders, and AI/AN traditional healers. Finally, in Aim 3, we will test the acceptability and feasibility of the novel culturally-centered rehabilitation service model during pediatric neurological rehabilitation services, using quantitative and qualitative evaluations. This research plan is part of a K23 proposal designed to provide scholarly training, mentorship, and support for Dr. Fuentes to gain skills and experience needed to be an independent investigator conducting community-based and stakeholder-engaged research to design effective, culturally-appropriate interventions to improve the health and functional outcomes of AI/AN children with disabilities. To achieve this objective, she will pursue training in: (1) community-based participatory research and stakeholder-engaged research; (2) survey research methods; (3) modified Delphi processes; and (4) the design, implementation, and evaluation of a rehabilitation service model.