Hybrid approaches to allied health services for children and young people: a scoping review.
Tal Krasovsky, Patrice L Weiss, Liat Gafni-Lachter and 2 others
PMID 39030627WHAT IT FOUND
Hybrid in-person and remote allied health services for children and young people were inconsistently defined and mostly mental health or CBT studies.
PT, OT and SLP evidence was sparse, and controlled evidence was limited, so do not assume remote works for hands-on care.
Key findings
01Hybrid services were defined inconsistently; where reported, the mean remote-to-in-person ratio was 57.8%.
02Most hybrid services in the review targeted psychological wellbeing; only three studies involved occupational therapy, two physical therapy, and two speech and language pathology.
03Only 13 of 21 studies had a control group; four reported significant between-group differences favoring hybrid services, and one reported a short-term difference favoring in-person control.
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
This was a scoping review, not a quality-assessed effectiveness review, so it maps what has been done rather than proving what works. The search was English-language only and was part of a larger life-span project, so child-specific terms were not used in the initial search. Only 21 studies were included, and sample sizes ranged from 1 to 223, so the evidence base is small and uneven. Definitions of hybrid services and remote/in-person ratios were inconsistent; asynchronous duration was often not reported. Many studies lacked a control group; eight studies were non-controlled, and three were case reports or case series. Outcome measures varied widely and were often non-standardised; cost-effectiveness was not measured. Software was often custom-built, and scalability, training and technical support were not consistently discussed. Positive findings often came from within-group or descriptive results, not controlled comparisons.
Declared interests
The work was funded by the Chief Scientist's Office at the Israeli Ministry of Health and the Helmsley Charitable Fund. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not conclude that hybrid PT, OT or SLP services are proven effective for children and young people. The review found inconsistent definitions, few PT, OT and SLP studies, and limited controlled evidence; most included work was mental health or CBT, and several positive results were within-group or descriptive.