Context, Mechanisms and Outcomes of Reasonable Adjustments Across Acute Hospital Settings for People With Intellectual Disabilities: A Scoping Review Protocol.

This is a protocol for a Campbell scoping review. The objective is to map the existing evidence on the implementation of reasonable adjustments in acute hospital settings for people with intellectual disabilities, using a realist lens. This involves examining how contextual factors interact with underlying mechanisms to influence outcomes related to equitable access, quality of care, and health experiences. In the context of healthcare for people with intellectual disabilities, reasonable adjustments can help bridge health inequities. There is a strong evidence base in the literature for reasonable adjustments, however there is little evidence of implementation across acute hospitals. Exploring this topic using a realist lens of context, mechanism and outcomes may help identify the underlying factors influencing implementation of reasonable adjustments in clinical practice. The review will follow the JBI scoping review methodology and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Evidence sources examining reasonable adjustments implemented by healthcare staff to support people with intellectual disabilities in acute hospital settings will be included. A comprehensive search strategy will be applied across the following information sources: MEDLINE, CINAHL, Academic Search Complete, Embase, Scopus, Web of Science Core Collection, PsycINFO, JBI Evidence Synthesis, and The Cochrane Database of Systematic Review. Additionally, a rigorous search of grey literature will be conducted across defined databases, search engines and repositories. Sources will be limited to the English language, with no time limit imposed. Data will be extracted using a table designed for the review and following qualitative content analysis, results will be presented in tabular form with narrative summaries.