Home programmes based on evidence of best practice for children with unilateral cerebral palsy: Occupational therapists' perceptions

Introduction Evidence-based occupational therapy home programmes for children with unilateral cerebral palsy have demonstrated efficacy; however, uptake into routine practice is varied. The aim of this study was to gain a deeper understanding of the therapist-perceived supports and barriers to using occupational therapy home programmes for children with unilateral cerebral palsy, based on evidence of best practice in the United Kingdom. Method Fourteen occupational therapists completed semi-structured telephone interviews. Using a qualitative framework analysis approach, support and barrier factors were indexed against the Theoretical Domains Framework, before being categorised more broadly using the Capability, Opportunity, Motivation and Behaviour Model. Findings Common supports included: (a) strong leadership within the team to facilitate the translation of occupational therapy home programmes and evidence-based interventions into service-specific protocols; (b) knowledge exchange within professional networks and (c) mentorship. Common barriers included: (a) lack of resources; (b) restricted opportunities to review occupational therapy home programmes and (c) difficulties keeping up-to-date with the evidence in this area. Conclusion To be effective, occupational therapy home programmes need to be based on evidence of best practice; analysis indicated an urgent need to capture outcomes, record parental practice, further integrate 'occupation' within goal-setting, and develop use of conceptual models of practice to both enhance family-centred care and articulate the profession's unique contribution.