Strategies Developed by Service Providers to Enhance Treatment Engagement by Immigrant Parents Raising a Child with a Disability

摘要

Barriers associated with treatment engagement exist at multiple levels for immigrant parents (IP) raising a child with a disability (e.g. divergent beliefs between family and service providers (SP) concerning the child's diagnosis and treatment, poor therapeutic alliance, limited language skills, daily stresses, lack of flexibility and complexity of the health care system, the SP's lack of training in cultural sensitivity). The SP have a primary role to play in the families' engagement process. Presently, little is known about SP's knowledge of barriers and strategies to enhance the engagement in treatment by IP raising a child with a disability. The aim of this qualitative study is to contribute to filling this gap. Semi-structured interviews were conducted with 21 SP from three large cities from Canada. Participants are SP including speech language pathologists, social workers, physiotherapists, occupational therapists, specialized educators, and psychologists who work with children with a language, motor, hearing or visual disability on a regular basis. Data analysis included inductive and iterative processes typically used for qualitative research as well as a thematic content analysis approach. To address the barriers that diminish the IP's engagement in their child's treatment, the SP highlighted three primary strategies: (a) overcoming the language barrier; (b) developing a shared understanding of the child's disability, and (c) helping the parents to understand the treatment process. A conceptual framework is presented which illustrates barriers and facilitators of IP's engagement. These findings suggest that several adaptations are needed within the health care services for the IP. They can help guide clinical practice in order to increase the level of treatment engagement of the IP raising a child with a disability.