Reply To: Discussion Forum 1

[Yasmin Garcia Mendez]

What evidence do I have (or need) to identify those factors and levels posing the greatest barriers to rehabilitation in my population?
The is sociodemographic data but no other evidence a part from that as long as I know. I will need to do a literature search on the specific information needed. The STARS, ATA-C and rATA tools may help to collect specific information on factors at each specific level environment. For example, these tools might help to get information at the institutional and superstructural levels, and might proportionate few at the community level. rATA might help to get more information at the individual and household level but might need to be modified to get more information on the knowledge, skills and self-efficacy of the individual as well as the household support and social networks.
For AT intervention, I need to get information on public policy, institutional capacity and functioning, community barriers to access AT services, characteristics of the individual to select best AT intervention, barriers to access and use the AT, etc.

How does my own professional expertise and organizational access suggest where I might be most be effective in developing and launching an intervention?
I will be more effective in developing and launching an intervention at the superstructural level. As we work by providing technical support and cooperation to Ministries of Health in the region of the Americas. We don’t have contact with patients or their families, we can create impact by helping the governments to improve their policies, create their strategic plans on rehab and AT, supporting identifying priority actions to strengthen rehab in health sector, etc.

What formative research might be needed to understand the precise intervention that would be most appropriate and impactful towards overcoming the challenges I identify?
Research on interventions that affect and promote the governments uptake of initiatives to strengthen rehab in health systems and increase financing for AT and rehab. How to increase the governments interest and the political will for AT and rehab. How to increase political support.

When considering potential interventions, what factors related to implementation do I need to consider?
individual factos, household and familial factors, community factors, institutional factors, public policy factors.

What implicit biases may be at work in my culture or context and how do those implicit biases impact an individual’s ability to access and benefit from rehabilitation?
There are implicit biases related to the tone of the skin, socioeconomic status, disability, age, gender, and sexual orientations. Those factors impact the individuals ability to access and benefit from rehab in terms of affordability, effectiveness, equity, and time.