Getting inTOUCH: outcomes of a knowledge translation intervention for tactile assessment knowledge, barriers, and practice in paediatric therapists working with children with cerebral palsy.

Abstract

<b>Background:</b> Tactile impairments are common in children with cerebral palsy (CP), however assessment is not routinely carried out by therapists. We investigated a multi-faceted <i>Knowledge Translation</i> intervention to improve <i>Knowledge,</i> remove <i>Barriers</i> and enhance <i>Practice</i> of tactile assessments by paediatric therapists. <b>Method:</b> Twelve therapists from a state-wide service for children with CP (seven physiotherapists, five occupational therapists; 12 female) received: written information, demonstration videos, a face-to-face workshop, equipment provision, and on-call mentoring. Therapists completed pre-post-intervention questionnaires reporting their perceived tactile assessment <i>Knowledge,</i> current <i>Practices</i> and implementation <i>Barriers</i>. <b>Results:</b> Following intervention, therapists improved <i>Knowledge</i> of correct (1) tactile impairment prevalence in children with CP (pre 3/12; post 9/12), (2) tactile assessment items (e.g. Registration - pre 1/12; post 9/12; Localisation - pre 2/12; post 10/12), and (3) equipment choice (e.g. Monofilaments - pre 1/12; post 10/12). Tactile assessment <i>Practice</i> improved slightly. All major clinician-level implementation <i>Barriers</i> were resolved and less obvious organisational-level <i>Barriers</i> were identified for follow-up. <b>Conclusion:</b> A 12-month multi-faceted <i>Knowledge Translation</i> intervention can improve tactile assessment <i>Knowledge,</i> resolve major clinician-level implementation <i>Barriers</i>, and identify less obvious organisational-level <i>Barriers</i> to be addressed to achieve maximum <i>Practice</i> improvement. Ongoing multi-faceted knowledge translation processes are essential for high-performing organisations. Implications for rehabilitation A multi-faceted knowledge translation intervention significantly improved paediatric therapists' <i>knowledge</i> of the items and equipment necessary for tactile assessment. A 12-month intervention can address clinician-level <i>barriers</i> of knowledge, confidence, and access to equipment and assist in the identification of less obvious organisational-level barriers. Consideration of motivational readiness for change, intervention timelines, monitoring of emergent barriers, and fitting tactile assessment into a broader assessment framework are critical for improving uptake of tactile assessment in <i>practice</i>.