Bridging research and practice: a mixed-methods implementation protocol supporting powered mobility use in early childhood settings for children with cerebral palsy

OBJECTIVE: To evaluate the feasibility, acceptability, and fidelity of a clinician training and subsequent home-based, parent-led powered mobility (PM) intervention for young children with cerebral palsy (CP; Gross Motor Function Classification System Levels IV-V) in early childhood settings. METHODS: This single-arm, mixed-methods feasibility trial will take place in partnership with two early childhood programs in Oregon. Phase 1 consists of a needs assessment to identify current practices and determinants of PM implementation, and Phase 2 engages with a Community Advisory Board to co-design the clinician training and implementation strategies. In Phase 3, up to 55 clinicians will participate in training focused on integrating PM into routine care, applying caregiver coaching practices, and using implementation strategies. These clinicians will then coach caregivers to deliver a 12-week, home-based PM intervention using the Explorer Mini with up to 12 children aged 12-32 months. Outcomes include feasibility (recruitment, retention, acceptability, and appropriateness), implementation fidelity (adherence, dosage, quality, participant responsiveness, and program differentiation), and preliminary caregiver and child outcomes. Quantitative and qualitative data will be analysed descriptively and thematically to inform refinement of future implementation strategies. IMPACT: This study will advance understanding of how PM interventions can be implemented in early childhood systems, through needs assessment, co-design, and feasibility testing. Findings will inform scalable models for clinician training and caregiver coaching, supporting ON Time access to mobility for young children with significant motor impairments.