1. Development version 19/06/2012 1 of 48 Effectiveness of a postural care training programme © 2012 Effectiveness of a postural care education programme Chief Investigator (EKHUFT & CCCU) Eve Hutton, eve.hutton@nhs.net Research Associate (CHSS, UKC) Sarah Hotham Co-Investigator (CHSS, UKC) Annette King Co- Investigator (CHSS, UKC ) Kate Hamilton-West

2. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Background Occupational Therapists & Physiotherapists support children at school. More children are educated in mainstream schools. Parents & teachers lack knowledge & confidence. This can affect a child’s function & well being (Hutton & Coxon 2011).

3. Development version 19/06/2012 3 of 48 Effectiveness of a postural care training programme © 2012 The A-Z of postural care

4. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Aim The aim of the study is to determine whether the intervention ( a postural care education programme) improves parents’ and teachers’ knowledge and confidence in providing postural care

5. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Methods Intervention targeted at two groups: Inclusion criteria : care for a child who attends a mainstream primary school. 1.Parents 2.Teachers and Teaching Assistants Sample size: minimum 66 (based on G*Power calculation). Aimed to recruit 25-30 through each therapy team.

6. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Methods: Recruitment 3 x Therapy Team Admin based in therapy team invites parents Therapists identify children Research team invites teaching staff Therapists identify schools

7. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Intervention Two key aims: 1.To improve knowledge and understanding of postural care 2.To improve confidence in providing postural care Facilitated by physiotherapists and occupational therapists in each locality. Intervention take place over 6-weeks consists of 3 main parts: 1.Postural Care Training 2-hour workshop 2.One-to-one visit 3.Telephone support

8. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Evaluation of Intervention Use validated outcome measure. Baseline measurements. Prior to start of training workshop participants complete postural care questionnaire (Time 1). End of 6-week intervention complete postural care questionnaire again (Time 2). Changes in knowledge, understanding and confidence? ANOVAs comparing Time 1 vs. Time 2. Focus groups and child interviews to gather qualitative feedback.

9. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Outcome Measure Majority of questions scored on a 4 point-Likert scale (1= Strongly disagree to 4 = Strongly agree). Higher scores = more knowledge /understanding & confidence. “ I understand how postural care may affects a child’s physical health” “I feel confident about providing postural care” Higher scores =more concerns. “ I am concerned I might be doing more harm than good”

10. Development version 19/06/2012 10 of 48 Effectiveness of a postural care training programme © 2012 Timeline: May – August 2013 May: T2 data collection & Focus groups July: T2 data collection & Focus groups Aug: Analysis of qualitative & quantitative data Sept: Final report

11. Development version 19/06/2012 11 of 48 Effectiveness of a postural care training programme © 2012 Results (Time 1): N = 71

12. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Results: Reliability Cronbach’s Alpha : Above.70 indicates satisfactory reliability 1.Knowledge and Understanding (21 items) : α =.87 2.Confidence (23 items) : α =.85 3.Concerns (7 items) : α =.84

13. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Results: Correlations Preliminary data from Time 1 outcome measure. Years of experience related to higher levels of confidence, lower levels of concerns. Positive correlation between levels of knowledge and confidence. Higher levels of knowledge = higher levels of confidence. Negative correlation between levels of concerns, knowledge and confidence. Lower levels of concerns = higher levels of knowledge and confidence.

14. Development version 19/06/2012 14 of 48 Effectiveness of a postural care training programme © 2012 Results: Area Breakdown

15. Development version 19/06/2012 15 of 48 Effectiveness of a postural care training programme © 2012 Results: Parents vs. Teaching Staff * p <.05

16. Development version 19/06/2012 Effectiveness of a postural care training programme © 2012 Cost analysis and qualitative study NHS costs of the intervention Via process logs of activities Feedback from participants Group discussion and interviews with workshop participants Group discussion with therapist about their experience Interviews with children who have experience of postural care Using visual communication approach (talking mats)

17. Development version 19/06/2012 17 of 48 Effectiveness of a postural care training programme © 2012 Final Thoughts Impact: On-going partnership between the researchers and service users throughout. A parent is a co-applicant & other parents & teachers have been involved in the design & development of the intervention. Linking parents and teachers – sharing experiences. Highlights importance of postural care for the child and the need for a ‘whole school approach’. Implications: Promote knowledge sharing & closer working between parents, therapists & teachers.

18. Development version 19/06/2012 18 of 48 Effectiveness of a postural care training programme © 2012 Thanks This presentation presents independent research commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG- 0110-21045). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health