PTOTSLPQualitativeFrontiers in rehabilitation sciences2022

An interdisciplinary nationwide complex intervention for lifespan neurodevelopmental service development: Underpinning principles and realist programme theory.

Donald Maciver, Marion Rutherford, Lorna Johnston and 3 others

PMID 36794269

WHAT IT FOUND

Stakeholders identified seven practitioner-level mechanisms for successful service change: being action-oriented, providing concise evidence-informed information, and being an accessible team.

These principles guided the National Autism Implementation Team in Scotland.

Key findings

01The programme theory identified seven practitioner-level mechanisms, including being action-oriented, providing accessible concise evidence-informed information, and being an accessible team.

02Macro-level mechanisms involved engaging routinely with national strategic groups and engaging the apparatus of government to secure resources and leadership.

03Institutional mechanisms focused on having a national focus, promoting universal inclusive practice, and facilitating multi-professional neurodevelopmental networks.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study did not evaluate direct clinical interventions or outcomes for service users or families. The researchers acknowledged an insider perspective which may have influenced the analysis. The findings are specific to the Scottish context and may not be directly transferable to other health or education systems. The study relied on stakeholder perceptions rather than objective measures of service change.

Declared interests

The research was funded by the Scottish Government. No other conflicts of interest were declared.

The easy way to misread this

Do not interpret the programme theory as evidence that the NAIT intervention improved patient outcomes. The study did not evaluate clinical effectiveness or service user impacts, focusing instead on the mechanisms of service development.

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