Multi-stakeholder qualitative assessment of IDHealth service for adults with intellectual disabilities (AWID): a case study of specialised support system

IDHealth was developed to address treatment gaps experienced by adults with intellectual disabilities (AWIDs) and their caregivers within Singapore’s healthcare system. This study aims to review the effectiveness of IDHealth, which takes a person- and family-centred approach, exploring success and areas for improvement of the service model to inform future planning. A multi-stakeholder qualitative study was conducted, involving life-event guided interviews with service users (AWIDs and their caregivers) and focus group discussions with collaborators who provide related specialist or complementary services. Thematic analysis, grounded in critical realist lens, was undertaken. Themes are presented in italics . 36 service users and 15 collaborators took part in the study. Both groups commended that IDHealth delivered tailored support to individual needs, provided care beyond medical issues, built a trusting relationship with patients , and achieved positive health outcomes . Both groups also noted ways in which IDHealth provided knowledge transfer to caregivers . Distinctly, service users commented on the addressing of individual-level needs, including how IDHealth facilitated AWID’s participation in the community . In contrast, the collaborators highlighted macro-level effects on health systems, emphasizing how IDHealth assisted in reducing overall health system burden by creating a positive ripple effect within the health system. Building on IDHealth’s successes and efforts, a virtuous cycle of improved health outcomes has been established. However, both groups also identified areas for improvement. They emphasized the need to curate greater resources to caregivers . Also, insufficient access to services during urgent medical situations was a common concern. Collaborators advocated for service expansion to mitigate this issue. Service users reiterated individual-level needs, such as a limited range of social engagement activities and personnel to meet specific needs. In contrast, collaborators highlighted macro-level issues, including the necessity for capacity building among healthcare providers and establishing a brand image to spread the word to increase service awareness and uptake. To sustain and enhance the virtuous cycle, which is built on service successes, we propose the ACTS model to address the identified areas for improvement and provide tailored, comprehensive support to AWIDs and their caregivers.