PRPP-ASSESSMENT TO MEASURE CHANGE 211 8 participation. When the intervention was successful, the demand became more ‘acceptable’ for parents: (Xandra’s mother) “Because we saw that it helped, we also became more enthusiastic. If you have to do things that you do not see helping, then you are less motivated yourself.” Implementation All the children and their parents were supposed to practice the chosen activities between the online sessions but this was sometimes difficult to implement in everyday life. The parents stated that activities took a bit longer than the practice sessions and that they could be difficult to implement into the daily structure, as Yara’s mother stated: “before you know it, the week is gone”. Yara and her caregiver did find a way to make it easier to implement the practice into their everyday lives by pretending that the videos during intervention were a vlog. Practicality To be able to carry out the program successfully, several practical aspects were important. Firstly, the purely online aspect was new to all participants. As Yara said, it was “a bit weird” to just talk online. Secondly, not everyone knew the medium (the digital safe) used for coaching; this medium hindered the intervention with Zach, as his mother stated: “You should use what he understands and not such a difficult system.” Thirdly, the OTs needed to find a way to provide child and parents with the material they wanted to use in order to support the intervention. In all cases, the OTs had sent information (pictograms, cards or examples) to the children’s home. In some cases, this material was given digitally: for example, Yara received instruction videos (vlogs) for doing her make-up. Lastly, the OTs mentioned that the online surroundings made it difficult to try certain tools that are available in the hospital. Xandra’s OT stated: “Themother has purchased a cycling vest herself, but sometimes you miss special tools or things that you have here in the hospital available to try.” Integration One OT was experienced at video coaching but for the other OT it was the first time. Both felt that the intervention was very naturally integrated within their usual practice. They sometimes felt limited by the videos in that they would like the goals to be elaborated on or they were not able to see what they wanted: (Yara’s OT) “I couldn’t really see if she had put the earring through the hole or not.” Both OTs made appointments outside their usual ‘office times’ because this fitted better with the parents and their usual work schedule.
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