This thesis explores the concept of family engagement in education and school-based rehabilitation services and contributes to practice and policy implications. / In pediatric occupational therapy, family-centered service is an essential part of practice. Working with families, occupational therapists facilitate capacity-building to enable parents to participate in their child’s occupational therapy services and make informed choices to best support their child. Family engagement can be particularly challenging in the school-based context, but without this engagement, services are at risk of being less meaningful and impactful for children. In this thesis, I explore the unique nature of the educational context, contribute to the conceptual development of ‘family engagement’, provide an in-depth analysis of family engagement in school-based occupational therapy, and generate stakeholder-informed solutions for occupational therapy practice. The first manuscript depicts a concept analysis that critically analyzes the concept of family engagement as discussed in the education literature. I suggest implications for professionals working with families and children in educational settings, including a proposed definition to contribute to further concept development. In the second manuscript, I present a qualitative description study exploring occupational therapists’ experiences on the development of family-therapist relationships using the Partnering for Change service delivery model. Through analysis of the data, I identify several factors influencing family-therapist relationships and recommend strategies to improve relationship-building. In the last study, I present an interpretive description study exploring family engagement in school-based occupational therapy services from the perspectives of both occupational therapists and families. Based on the findings, I recommend service transformation to improve family engagement, and to increase the value of these services for children and their families. Specific strategies for therapists, organizations, schools, regulatory colleges, and professional practice groups are outlined in this thesis to facilitate family engagement in school-based occupational therapy practice. Ensuring families are able to engage in services may lead to more individualized and impactful services in the school setting. / Thesis / Doctor of Philosophy (PhD) / Pediatric occupational therapists aim to partner with the family in all aspects of a child’s service. However, this is difficult for school-based occupational therapists. Families are not typically present at the school when therapists provide services for children, making it difficult to build relationships. This thesis explores factors that impact on how families are able to engage in the school-setting, and on how to provide families with better support. The first study examines how families engage in children’s education, and what this means for school-based therapists. The second study explores therapists’ views of what influences family-therapist relationships in a school-based service delivery model called Partnering for Change. The final study explores family engagement in school-based occupational therapy from the perspective of both families and therapists. Findings from all three studies contribute to a better understanding of what family engagement means in the school-setting, and how to build stronger family-therapist relationships in school-based occupational therapy services.

The purpose of the study was to explore the leadership actions and activities that contributed to the implementation of a schoolwide family engagement initiative in a school. A qualitative content analysis of secondary data design was used to investigate the intentional actions and activities of a school leadership team during the implementation of a family engagement initiative within an elementary school. The Coherence Framework (Fullan & Quinn, 2016) provided a lens for which to investigate schoolwide change across drivers and sub-drivers. The findings of this study describe intentional leadership actions and activities when communicating with families, conducting formal assessments, and facilitating professional development. Patterns from the analysis indicate school leaders engage in intentional leadership actions and activities across all drivers and sub-drivers within the Coherence Framework (Fullan & Quinn, 2016). Family engagement practices are driven by core beliefs and consideration of the establishment of collective efficacy within the Coherence Framework may better support implementation of school change within family engagement implementation.

The early childhood education (ECE) workforce provides care and education to young children, birth to age five. Little research examines how teachers are trained to interact with and support families. Policy is identified as a way to increase qualification attainment, however, how policy may best support qualification attainment is widely unstudied. The current study seeks to fill this gap to understand how states differ in order to best support policy advancement. This involves a qualitative policy analysis using emergent techniques for all 50 states. Policies regulating ECE teacher qualification attainment, specifically mentioning family engagement are examined. Results demonstrate that policies regulating family engagement in qualification attainment for the ECE are overall, minimal. Only 30 states include mention of family engagement in policy. This research provides insight into how family engagement is supported in the workforce at a national level, and subsequently, how family engagement is supported throughout individual states.

PHDPH / Department of Public Health / Family involvement in caring for mentally ill patients in long-term mental healthcare institutions is defined as a strategy in which family members and long-term healthcare professionals become partners to provide the best possible care for a person with mental illness. The study seeks to develop a model to promote family involvement in long-term mental health care institutions in Limpopo Province, South Africa. Mixed methods was used. Unstructured interviews were conducted with 21 family members and 6 focused group discussions with MHCUs in qualitative phase. Self-administered questionnaires were used to collect data from 360 nurses in the quantitative phase. Data was analysed independently of which convergent analytic approach was used to merge the two data sets. iv The study reports that the MHCUs’ attitudes towards families contribute to poor involvement by family members in the care/visit of the MHCUs while admitted in long-term mental health care. The rejection of the MHCUs also came up strongly during data analysis. Nurses perceived that insufficient family involvement hinders the provision of mental health care services. Eight steps in the Walker and Avant Method were adapted to clarify and distinguish the definition of the main concepts. A model to promote family involvement was conceptualised using the six areas as described by Dickoff, James and Wiedenbach (1968). A model was validated against its rationale and purpose of the study. Justification on the contribution of the family involvement in mental health care revealed that “family involvement in caring for MHCUs” is an engagement and encourages family members to participate in the diagnosis, treatment and recovery process. Study recommended that a developed model should be implemented in health establishments providing mental health services. Policies should be reviewed to include activities which the families should be notified of immediately the mentally ill patient is declared to receive mental health care, treatment and rehabilitation. Developed model should be piloted and evaluated to identify areas that will further improve the quality of mental health services. / NRF

In the changing field of education, there is awareness of the benefits of parental involvement on student achievement and the impact teachers have on the success of parental involvement programs. However, teachers may rely significantly on their personal experiences as a source of reference for parental involvement and subsequently impact student achievement. There is a gap in the research about the lived experiences of teachers regarding their perspectives and support of parental involvement in the classroom. The purpose of this phenomenological study was to explore teachers' lived experiences and attitudes concerning parental involvement and student achievement. The conceptual framework for the study was supported by Bandura's social cognitive theory and Bandura's self-efficacy theory. A phenomenological research design and purposeful sampling was used to conduct face-to-face, semistructured interviews with 10 participants who were currently employed teachers with at least 5 years of experience and who had an awareness of parental involvement. Data collected from interviews were analyzed using the modified van Kaam method of analysis described by Moustakas. The 3 main themes that emerged from the data were a history of high parental involvement, the fostering of open and positive communication, and teacher-parent relationship building. Understanding how teachers' experiences influence parental involvement could result in a positive social change for education by creating awareness among educators and caregivers and by improving support for students.

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Background: This thesis aimed to develop, implement, and evaluate a multi-faceted integrated knowledge translation (iKT) intervention to disseminate and support adoption of the ‘F-words in Childhood Disability’. Grounded in the WHO’s ICF framework, the ‘F-words’ (Function, Family, Fitness, Fun, Friends, and Future) offer a holistic family-centred approach to childhood disability. Methods: This thesis was guided by the action cycle of Graham et al.’s (2006) knowledge-to-action (KTA) framework. Chapter 2 reports a knowledge translation (KT) initiative (i.e., an online video) to disseminate the ‘F-words’ and explore people’s reception of these ideas. Chapter 3’s scoping review identifies and assesses KT strategies that directly target families raising children and youth with special health care needs. Chapter 4 describes a pilot study to evaluate the usability and utility of an online ‘F-words’ KT resource. Chapter 5 reports a case study of our longitudinal KT research program, and uses Diffusion of Innovation (DOI) theory to understand the factors that contributed to the adoption of the ‘F-words’. Results: Multi-faceted KT strategies, co-developed with stakeholders, were essential to moving the ‘F-words’ into practice. The video (Chapter 2) reached >700 views in two months and 98% of 137 survey respondents indicated they ‘extremely liked’/‘liked’ the ideas. The scoping review (Chapter 3) identified six studies, all of which evaluated educational materials and deemed them to be useful and important to families. The pilot evaluation (Chapter 4) revealed the online resource to have positive usability and utility for families and service providers. The case study (Chapter 5) highlighted that diffusion, dissemination and implementation strategies were all needed and that DOI factors (i.e., the innovation characteristics, communication channels, social networks, and time) contributed to the adoption of the ‘F-words’. Based on a multi-faceted integrated KT research program we now have extensive examples of ‘F-words’ adoption by families, service providers, and health care organizations. Conclusions: This thesis illustrates a step-wise theory-informed approach to the development and evaluation of a multi-faceted iKT intervention. By studying each step of the action cycle, this work contributes new knowledge to both the processes involved in disseminating research evidence, and associated outcomes from a multi-faceted iKT intervention. Findings from this thesis contribute new discoveries to both KT practice and science. / Thesis / Doctor of Philosophy (PhD) / In the 21st century, research supports a holistic family-centred approach to childhood disability. Unfortunately, a research to practice gap remains, and the professional-led biomedical approach still informs many practices. In 2012, Rosenbaum and Gorter published “The ‘F-words’ in childhood disability: I swear this is how we should think!” They highlighted the importance of ‘Function, Family, Fitness, Fun, Friends, and Future’, grounded in the World Health Organization’s framework for health. This thesis developed and evaluated a knowledge translation research program to move the ‘F-words’ into practice. Objectives, all achieved, were to: i) apply strategies to spread awareness of the ‘F-words’ and explore people’s reception of these ideas; ii) identify and assess strategies to share research with families; iii) develop and evaluate an online resource to support use of the ‘F-words’; and iv) study the processes involved and factors that contributed to the ‘F-words’ adoption. These findings have implications for both doing and studying knowledge translation.

The roles of females have changed significantly over the past years as females increasingly are entering the labour market in South Africa. This resulted in females having to fulfil multiple roles simultaneously, for example being mother, wife and employee. Therefore the statement can be made that females have a work life and a family life to contend with. This can be enriching, seeing that these domains can generate experiences and resources, which females can use in other domains to enhance the quality. The general objective of this study was to explore various relationships that females experience between work resources, home resources, work engagement, family engagement and work-family enrichment. A cross-sectional survey design was used in this study. A combined purposive and convenience non-probability sample of female workers (N = 420) was taken across the spectrum of several industries in South Africa. Measuring instruments were used for biographical characteristics, work resources (self-developed), home resources (self-developed), work-family enrichment (MACE Work-Family Enrichment Instrument), work engagement (Utrecht Engagement Scale) and family engagement (adapted Utrecht Work Engagement Scale). Omegas and Cronbach’s alpha coefficients were used to determine the reliability of the findings, while correlations were employed to identify significant relationships between the constructs. The dual work-family enrichment models and the mediating effect of the various dimensions of work-to-family enrichment, as well as family-to-work enrichment, were also tested by the Mplus statistical programme. Two models in which work-family enrichment and family-work enrichment act as mediators were also tested. The results indicated a positive statistical significant relationship between work resources, and work-family enrichment; also between home resources, and family-work enrichment; and between work-family enrichment and work engagement. However, a very small, but statistical significant, relationship was shown to exist between family-work enrichment and family engagement. Work-family enrichment also mediated the relationship, with a large effect, between work resources, with work engagement as outcome and family-work enrichment mediated the relationship, with a small effect, between home resources, with family engagement as outcome. Recommendations were made for organisations to follow up and for future research on the topic. / MCom (Industrial Psychology), North-West University, Potchefstroom Campus, 2014

The roles of females have changed significantly over the past years as females increasingly are entering the labour market in South Africa. This resulted in females having to fulfil multiple roles simultaneously, for example being mother, wife and employee. Therefore the statement can be made that females have a work life and a family life to contend with. This can be enriching, seeing that these domains can generate experiences and resources, which females can use in other domains to enhance the quality. The general objective of this study was to explore various relationships that females experience between work resources, home resources, work engagement, family engagement and work-family enrichment. A cross-sectional survey design was used in this study. A combined purposive and convenience non-probability sample of female workers (N = 420) was taken across the spectrum of several industries in South Africa. Measuring instruments were used for biographical characteristics, work resources (self-developed), home resources (self-developed), work-family enrichment (MACE Work-Family Enrichment Instrument), work engagement (Utrecht Engagement Scale) and family engagement (adapted Utrecht Work Engagement Scale). Omegas and Cronbach’s alpha coefficients were used to determine the reliability of the findings, while correlations were employed to identify significant relationships between the constructs. The dual work-family enrichment models and the mediating effect of the various dimensions of work-to-family enrichment, as well as family-to-work enrichment, were also tested by the Mplus statistical programme. Two models in which work-family enrichment and family-work enrichment act as mediators were also tested. The results indicated a positive statistical significant relationship between work resources, and work-family enrichment; also between home resources, and family-work enrichment; and between work-family enrichment and work engagement. However, a very small, but statistical significant, relationship was shown to exist between family-work enrichment and family engagement. Work-family enrichment also mediated the relationship, with a large effect, between work resources, with work engagement as outcome and family-work enrichment mediated the relationship, with a small effect, between home resources, with family engagement as outcome. Recommendations were made for organisations to follow up and for future research on the topic. / MCom (Industrial Psychology), North-West University, Potchefstroom Campus, 2014

The purpose of this study was to examine teacher and parent perceptions of the impact of a high-family engagement model, Academic Parent-Teacher Teams (APTT). Teacher and parent surveys were administered to determine the relationship between the following variables: teacher leadership, administrative support, parental perceptions of effectiveness of communications, parental perceptions of convenience of scheduling of meetings, parental perceptions of usefulness of meetings, family engagement, and student academic achievement. Data from a Pearson correlation and a regression test were analyzed to determine which variables had the greatest significance on the impact of APTT on family engagement and student academic achievement. Based on the results of the study, parental perception of effectiveness of communications, parental perception of convenience of scheduling of meetings, and parental perception of usefulness of meetings had the greatest significance with family engagement and student academic achievement. Recommendations were suggested for policy-makers, district leaders, educational leaders, teachers, and future researchers.