In May, we celebrated some excellent outcomes for rehabilitation-related research funding in NZ. Dr Fiona Graham was one of the successful researchers, receiving support from HRC’s Emerging Researcher First Grant fund.

Fiona is an occupational therapist, currently working as a Senior Lecturer in the Rehabilitation Teaching & Research Unit (RTRU) in the Department of Medicine, Wellington. She was granted $233,618 to trial an Occupational Performance Coaching (OPC) intervention.  As part of her PhD, Fiona developed the family-centred OPC approach - empowering caregivers to support their children's goal achievement in the participation domain of the ICF. This research will evaluate the effectiveness of this intervention in clinical settings.

The research aims to determine if children with neurodisability and their caregivers experience improved health and wellbeing following OPC compared to usual care when delivered in existing service delivery contexts.

The innovatively-designed study will be conducted using a single-blind, 2-arm parallel group, cluster RCT - with clustering happening at the level of the therapist. Post-intervention interviews will also examine caregivers’ experience of OPC in relation to cultural values and expectations. 

Fiona states that it is often difficult for rehabilitation interventions to secure research funding, as rehabilitation deals in the “messy reality of people’s daily life where there is lots of variation in how people live”. This means that it is challenging to meet the rigorous design requirements of research funders like the HRC. “This time we pulled it off and HRC have recognised that research of rehabilitation interventions can’t follow a sample design formula,” Dr Graham says.

Participants will be child-caregiver dyads (cases), with the inclusion criteria that children are aged 2 to 18 years and have a primary diagnosis of neurodisability for which caregivers have sought rehabilitation. Enlisted therapists will be randomised to OPC training (intervention) or usual care (control) groups.  The primary outcome, children’s social participation (Canadian Occupational Performance Measure; COPM) will determine intervention effectiveness and inform the economic analysis.

Fiona’s research has the potential to improve access and equity in rehabilitation for children experiencing neurodisability in NZ. There has also been considerable international interest in OPC, with Fiona being invited to present two international and one national keynote presentations, and 20 invited workshops.

 “I’m also pretty stoked for the families of children with disabilities. They are a small health consumer group and there are no magic answers for the challenges they face. The fact the HRC has awarded this grant to explore ways to improve the quality of their lives and to help them live well despite disability is very exciting.”

Congratulations Fiona!

Contact Fiona on fi.graham@otago.ac.nz if you have any questions about this research.