Background: Establishing research partnerships can help close the research-practice gap. The Integrated Knowledge Translation Guiding Principles were developed in a spinal cord injury research context as a resource to facilitate research partnerships. Research funders play a significant role in the spinal cord injury research system. However, how funders define, require, evaluate, support research partnerships is rarely reported. This study identified spinal cord injury research funders in Canada and the United States, identified their approaches to supporting research partnerships, and explored organizational perspectives of principles of partnership. Methods: An environmental scan was conducted through five steps: (1) identifying spinal cord injury research organizations that funded the greatest number of spinal cord injury research publications in Canada and the United States between 2017 and 2022; (2) identifying one funding program related to research partnerships of each funder; (3) extracting online information of the programs; (4) interviewing funder informants; and (5) descriptive and deductive content analysis. The five steps were completed between April 2022 and September 2024. An additional data collection was conducted in July 2025 on a relevant National Institutes of Health funding program. Results: Sixteen organizations and seventeen partnership-supportive programs were identified. Six programs defined partnerships as researchers and research users engaging throughout the research process. Eleven programs required applicants to describe the partnership in applications and explicitly stated their peer review evaluation criteria. The programs supported research partnerships through remuneration for partners' engagement (n = 6), facilitating connections between researchers and potential partners (n = 3), and helping applicants prepare applications (n = 4). The programs had few strategies to evaluate awarded partnerships post-grant. Three descriptive categories emerged from the interviews: (1) Varied support for research partnerships; (2) Minimal capacity for partnership evaluation post-grant; and (3) Need for tools and resources to further support research partnerships. Conclusion: Differences existed in how spinal cord injury research funders in Canada and the United States defined, required, evaluated, and supported research partnerships. The results provided an initial landscape of funders' role in the spinal cord injury research system and may inform strategic efforts to optimizing meaningful engagement in a broader health research context.
People with disabilities continue to face significant barriers when flying, despite decades of policies enacted to protect their rights and ensure equitable and dignified access. These challenges are often linked not to a lack of policy but to inconsistencies, fragmentation, and unclear responsibilities across operators and jurisdictions. This review examines international, U.S., and Canadian air travel policies to assess their comprehensiveness, coherence, and alignment across jurisdictions, to promote accessible air travel for travelers with disabilities. We conducted a structured policy review following Arksey and O’Malley’s framework. We systematically identified, selected, charted, and analyzed 28 U.S. policies, Canadian policies, and international guidelines. Policy content was compared using the themes of a scoping review on air travel experiences of people with disabilities and the Disability Policy Lens to examine definitions, aims, and coverage. Findings highlighted substantial variation across jurisdictions in the allocation of responsibilities among actors and the specificity of policy provisions. These variations contribute to uneven interpretation and implementation of accessibility measures, shaping inconsistent travel experiences for people with disabilities. International guidelines have the potential to serve as an important reference point, but currently lack comprehensiveness. There is a need for greater cross-jurisdictional coherence in air travel policies.
IntroductionCanada maintains a universal, publicly funded health care system, although provinces and territories retain flexibility and independence in determining eligibility and funding levels for services and supplies. This flexibility and independence can lead to variability in health care delivery and therefore downstream health outcomes between provinces for the same health condition. Over 80,000 Canadians live with spinal cord injury (SCI), which causes motor paralysis and dysfunctions in multiple body systems. These dysfunctions are managed as multiple chronic health conditions to maintain life after injury. Thus, we identified whether and how a critical subset of health services, supplies, and equipment needed to sustain life after SCI are delivered at the provincial and federal levels for: attendant services for activities of daily living, medical supplies to manage neurogenic bladder and bowel function, and manual and power wheelchairs (WCs).MethodsA scoping policy review of online documentation identified eligibility criteria, assessment processes, coverage characteristics, quality and quantity limitations, delivery mechanisms, and any quality assurance processes. Key informant (KI) interviews were analyzed descriptively and thematically to verify policy documentation and identify additional documentation when needed, and to indicate gaps between policy and application.ResultsWidespread discrepancies and inadequacies were found in the quality and level of SCI-related health care. Policies indicated means-testing for attendant services in 5/10 provinces; 9/10 for bladder and bowel supplies; and 4/10 for WCs. Public funding is often reduced or withdrawn at very low incomes. Provinces without means-testing loan WCs from restricted equipment pools. KI interviews indicated profound negative implications of stated inadequacies on health and life quality. National programs for Veterans and Indigenous Canadians do not means-test, but eligibility and service restrictions were reported to confer additional hardships on Indigenous Canadians.DiscussionIn contrast to other forms of care (e.g., dialysis for kidney disease), SCI-related health care appears inadequate, highly variable, and focused upon social and financial factors rather than medical need. For those with SCI, age restrictions further limit access to health care. Future research of countries with similar decentralized, multiregional health care systems would aid in developing national standards and best practice delivery mechanisms.
IMPORTANCE:Accessible home modifications (HMs) can positively influence the lives of people with disabilities (PwDs). Occupational therapists may recommend HMs, but implementation often falls to clients. Research on the experiences of PwD related to implementing accessible HMs in a North American context is lacking. OBJECTIVE:To describe the process and impacts of implementing accessible HMs from PwDs' perspective. DESIGN:Qualitative descriptive design with semistructured interviews with codebook thematic analysis to identify themes. PARTICIPANTS:Community-dwelling adults with musculoskeletal and sensory disabilities (n = 31) and 2 cohabiting caregivers from Ontario, Canada, who had either made HMs or required accessible housing. Fourteen of these participants also had professional expertise related to accessible housing. OUTCOMES AND MEASURES:The primary outcome was participant perspectives and experiences related to HMs. No standardized measures or hypotheses were used, consistent with the exploratory qualitative design. RESULTS:Four themes emerged that depict the process and impacts of implementing HMs: (1) impacts of an unmet need for HMs, (2) barriers to and (3) facilitators of effective HMs, and (4) outcomes and benefits of having HMs. Issues related to independence, safety, and dignity, as well as how structural, financial, and attitudinal barriers intersect in decision-making. Participants also described a lack of guidance on how to approach the HM process. CONCLUSIONS AND RELEVANCE:Findings highlight the importance of HMs to achieve person-environment fit. Given the complexities of the HM process, occupational therapists are well positioned to support individuals in navigating this process and to contribute to broader advocacy efforts. Plain-Language Summary: This study looked at how people with disabilities make their homes more accessible or how they assist others with this process and the challenges they run into. People who took part said they had to find information on their own and speak up for themselves. They described their independence, individual needs, and finances as being important. The results highlight the importance of helping people make their homes more accessible and ways that occupational therapists can help.
This article describes the development of priorities and actions to improve the state of research, policy, and practice related to accessible housing in Canada for persons with disability or with accessible housing needs. A modified Delphi approach with an expert cross-sectoral panel was used to gain convergence on a set of priorities for advancing the accessible housing field in Canada. This included circulating an anonymous pre-meeting survey (N = 49) followed by an in-person planning meeting (N = 45). The expert panel at the in-person meeting identified three clusters of priorities from an initial list of 21 priorities, which included: 1) engaging with all levels of government to support accessible housing efforts; 2) developing educational resources to raise awareness about accessible housing, and creating services to facilitate locating and acquiring accessible housing; and 3) fostering meaningful engagement across key interest groups and sectors to find solutions to enact positive change in this space. The findings provide an initial roadmap for bringing greater cohesion to the accessible housing field, which will enable cross-sectoral partnerships and collective action towards informing the next generation of accessible housing standards, regulations and practices for people with accessible housing needs.
