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Reports | Abstracts
of Presentations | Presentations
and Publications
Upcoming Presentations
Reports
Abstracts of Presentations
The Canadian Public Health Association (CPHA)
94th Annual Conference
May 10-13, 2003, Calgary, Alberta.
Exploring Service Utilization Patterns to Inform
Child Service Integration Efforts.
John McLennan, Debbie Sheehan, Kent Rondeau,
Ellie Deveau, Michelle Caza.
Abstract: Attempting to integrate services is
a popular strategy aimed at improving health and
social service delivery for special needs children.
Although there are a number of provincial and regional
efforts championed as integrating services for children,
these efforts are not driven by actual family experiences.
This study examines actual health and social services
utilization by young children in four health regions
(2 in Alberta, 2 in Ontario) to provide data that
will guide service planning.
From in-depth individual interviews with parents
of special needs children, service
utilization maps were
constructed demonstrating the sequence of service
use and the
extent of inter-connection between services.
Preliminary analysis indicates emerging patterns
that may inform
service integration efforts. Early patterns include
an apparent dead-end track terminating with the
family physician, service clumping at tertiary
care centres, and multiple complex pathways that
must
be negotiated by parents. Service utilization
maps demonstrating these and other patterns will
be presented.
The discussion will explore the practice and
policy implications of these findings for the
delivery of health and social services for young
children.
Fourth International, Interdisciplinary
Conference: Advances in Qualitative Methods May
2-5, 2003, Banff, Alberta.
Exploring Service System Problems of Children
with Special Needs through Service Utilization Maps.
John D. McLennan, Ellie J. Deveau, Michelle M.
Caza
Abstract: There are a number
of services available for children with special
needs in the community.
However, these services are typically offered
by multiple agencies with different mandates, eligibility
criteria, and service linkages. Despite some
attempts
to integrate and coordinate these various services,
the system continues to be complex and confusing
even for professionals working within the system.
In this study, we have constructed service utilization
maps from indepth interviews with parents of
children with special needs to develop an understanding
of
the health and social service system. These maps
capture important aspects of the complex service
world that families must negotiate. This presentation
will describe the construction of these
maps and the key patterns
and problems identified.
The 31st North American
Primary Care Research Group (NAPCRG) Annual
Meeting October 25-28, 2003, Banff, Alberta.
The
Role of the Primary Care Physician in Facilitating
Access to Services for Special Needs Children (MS
PowerPoint, 350Kb)
Debbie Sheehan, John McLennan, Michelle Caza,
Ellie Deveau
Abstract:
Integrating services is a popular strategy aimed
at improving health and social service delivery
for a number of special populations including
children.
Although there are a number of provincial and
regional efforts in Canada championed as integrating
services
for children, they are not driven by empirical
data. In particular, there is a lack of information
regarding
the role of the family doctor in this process.
Objective: To explore key aspects of service utilization
and
integration for children and their families.
This presentation explores the specific role of
the family
physician as an entry point into the specialty
service world for children with special needs.
Design: Multi-site
case study. Individual interviews and focus groups
with service providers, physicians, administrators,
and parents; survey of parents of special needs
children regarding service experiences and utilization.
Setting: Secondary and tertiary health and social
services in two urban and two rural health regions
in Alberta and Ontario. Participants: Parents
of young children with emotional, behavioral or
developmental
problems; providers and administrators associated
with services for young children. Main and Secondary
Outcome Measures: Service utilization patterns.
Results: Most parents have a family doctor for
their special needs child; family doctor often
not involved
in referral to specialty services; parents make
their own direct referral, or are assisted by
other health, educational or social service providers;
significant time lapse from parent concern to
referral
may be due to a gate keeping role by family physicians.
Conclusions: Identification of children who may
benefit from specialty services is difficult
and the system of care is complex and confusing.
Timely
referral to effective interventions is critical
due to the potential positive impacts from early
intervention. A clearer articulation of the role
of family physician in this, and increased support
in order to enable them to meet parental expectations
is required.
American Academy of
Child & Adolescent
Psychiatry, 50th Annual Meeting
October 14-19, 2003, Miami Beach, Florida.
Pathways into Child Specialty Services
John D. McLennan, Michelle Caza, Ellie Deveau,
Debbie Sheehan, D.R. Offord
Abstract:
The purpose of this project is to determine the
different tracks
that families take to obtain
specialty services for their young children.
Understanding this component may identify problems
that should
be prioritized in reform efforts to improve the
service system. Indepth interviews and surveys
were used to collect data from parents with young
children
with special needs who had received services
at child specialty centers in four health regions
in
Canada. A common track into services was self-referral
by mothers. Initial service contacts included
family doctors, pediatricians, nurses, social
service workers,
and early intervention workers. These contacts
did not necessarily lead to referrals to specialty
services.
Traveling down multiple service tracks appeared
to be the norm. Once families got into one specialty
service, many other specialty services typically
became available. There are multiple pathways
into specialty services. Redundancy in these
entry pathways
may decrease the impact of dead-end tracks. However,
the lack of an efficient and equitable gate-keeping
system may overwhelm the specialty system, may
fail to triage services appropriately, or it
may result
in considerable delays in obtaining services
for children.
10th Annual Qualitative Health Research
Conference
April 30-May 4, 2004, Banff, Alberta.
Children
at the Interface of Child Mental Health
and Child Welfare (MS Powerpoint, 145Kb)
Michelle Caza, John D. McLennan
Abstract: Children in the child welfare system
have high rates of mental health problems. However,
these children frequently do not receive appropriate
mental health services. This problem was investigated
within a case study of services integration for
young children. Data were gathered using semi-structured
interviews and focus groups with key informants
in the child welfare and mental health sectors from
four administrative regions in two provinces. Government
and academic documents were also reviewed. Data
were coded using an editing analysis style. Several
key themes were identified. One of the key themes
was the lack of coordination between child mental
health and child welfare. This may have been a manifestation
of a lack of knowledge regarding service offerings
of the other sector, differing mandates and professional
responsibilities, and client eligibility requirements.
This and other themes will be presented with examples
of attempts to increase collaboration between the
two sectors.
Presentations
and Publications
The
Role of the Primary Care Physician in Facilitating
Access to Services for Special Needs Children (MS
PowerPoint File: January 2004:, 350Kb)
Upcoming Presentations
Society for Research in Child Development
Biennial
Meeting, April 7-10, 2005 Atlanta, Georgia.
Service
priorities for parents of young children with
special needs
John McLennan, Faith Ng, Robin
McWilliam, Michelle Caza.
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