Implementation strategies for early hand therapy for young children with cerebral palsy

AIM: To select and prioritize implementation strategies for early hand therapy for children under 2 years old with suspected or confirmed cerebral palsy. METHOD: This implementation study used a mixed-methods sequential explanatory design guided by the Consolidated Framework for Implementation Research. First, implementation strategies were mapped to previously identified Canadian barriers and facilitators to early hand therapy delivery. Semi-structured interviews regarding these strategies were conducted with three participant groups across Canada: parents of children aged 6 years or younger with cerebral palsy (n = 9); paediatric occupational therapists (n = 10); and leads or managers of paediatric occupational therapy programmes (n = 6). Interview data were analysed thematically. Next, 12 participants (n = 4 per participant group) completed a modified nominal group technique exercise to create actionable descriptions and prioritize strategies. RESULTS: Twenty-one implementation strategies were mapped to identified barriers and facilitators. Thematic analysis of semi-structured interviews identified 11 strategies within three categories based on the source: occupational therapists and clinics; research and community groups; and health care systems. The nominal group technique prioritized the top three strategies: (1) develop a roadmap to therapy; (2) raise awareness; and (3) create a therapy guidebook. INTERPRETATION: Eleven actionable strategies were identified to support early hand therapy delivery for young children with cerebral palsy.