Background Family caregivers of individuals with neurodevelopmental disabilities (NDDs) often experience stress, anxiety, and depression; however, few evidence-based interventions are designed to improve their mental well-being. To address this gap, we developed an acceptance and commitment training (ACT) group–based workshop cofacilitated by trained caregivers and clinicians (Caring for the Caregiver Acceptance and Commitment Training [CC-ACT]). Objective This study evaluates the real-world implementation of this innovative, evidence-based ACT workshop aimed at enhancing caregiver mental health and resilience. Methods Guided by the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) implementation science framework, this study examines the workshop across these 5 domains. We delivered the CC-ACT workshops virtually or in-person across 11 intervention sites in Canada, including hospital and community agencies that provide services to children with NDDs and their families. Family caregivers (ie, a parent, grandparent, or adult sibling) of someone with an NDD were eligible to participate in the workshops, with site-specific criteria set by each host agency. Caregivers participated in preintervention, postintervention, and 3-month follow-up assessments measuring stress, resilience, and self-compassion using validated instruments (21-item Depression, Anxiety and Stress Scale; Parenting Stress Index, 4th Edition; Brief Family Distress Scale; Multi-System Model of Resilience Inventory; and Self-Compassion Scale–Short Form), alongside ACT process measures (Cognitive Fusion Questionnaire, Valued Living Questionnaire, and Acceptance and Action Questionnaire-II). Implementation fidelity was assessed through checklists and surveys. Focus groups with caregiver facilitators, clinician facilitators, workshop participants, and organizational leaders were held to qualitatively evaluate the implementation process and the caregiver-clinician cofacilitation model. Qualitative data will be analyzed using descriptive content analysis, a flexible approach that can be used to systematically summarize different types of qualitative data. Quantitative data will be analyzed through repeated measures ANOVA and mixed-effects modeling, with subgroup analyses and multiple imputation for missing data. Results The CC-ACT workshops successfully reached 195 caregivers of individuals with NDDs. Two focus groups that included 5 caregiver workshop participants, 13 facilitators, and 5 organizational leaders were conducted. We anticipate that the workshops will demonstrate positive impacts on caregiver well-being, with variability in effectiveness based on participant characteristics and real-world implementation contexts. The findings are expected to identify key predictors of outcomes, equity and access barriers, and best practices for scaling and sustaining high-fidelity, adaptable caregiver interventions across diverse Canadian settings. Funding began in January 2022, data collection was completed in 2024, and data analyses will be completed by the end of 2025. Conclusions The CC-ACT workshop is a promising approach to enhancing the mental well-being of caregivers of individuals with NDDs. The RE-AIM framework helps capture process data systematically, documenting the balance between fidelity and adaptation. The study findings should support the refinement of implementation strategies and support the broader scalability of the intervention to diverse community settings. International Registered Report Identifier (IRRID) DERR1-10.2196/75049

Purpose This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care. Design/methodology/approach In this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations. Findings Themes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care. Originality/value This project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.

OBJECTIVE:To update the 2011 Canadian guidelines for primary care of adults with intellectual and developmental disabilities (IDD).METHODS:Family physicians and other health professionals experienced in the care of people with IDD reviewed and synthesized recent empirical, ecosystem, expert, and experiential knowledge. A system was developed to grade the strength of recommendations.RECOMMENDATIONS:Adults with IDD are a heterogeneous group of patients and have health conditions and factors affecting their health that can vary in kind, manifestation, severity, or complexity from those of others in the community. They require approaches to care and interventions that are adapted to their needs. These guidelines provide advice regarding standards of care. References to clinical tools and other practical resources are incorporated. The approaches to care that are outlined here can be applied to other groups of patients that have impairments in cognitive, communicative, or other adaptive functioning.CONCLUSION:As primary care providers, family physicians play a vital role in promoting the health and well-being of adults with IDD. These guidelines can aid their decision making with patients and caregivers.

Resume Objectif Mettre a jour les Lignes directrices consensuelles canadiennes 2011 en matiere de soins primaires aux adultes ayant une deficience developpementale. Methodes Des medecins de famille et d’autres professionnels de la sante experimentes dans les soins aux personnes ayant des DID ont examine et synthetise les recentes connaissances empiriques, d’ecosystemes, expertes et experientielles. Un systeme a ete concu pour categoriser la qualite des recommandations. Recommandations Les adultes ayant des DID sont un groupe heterogene de patients qui presentent des affections medicales et des facteurs qui influent sur leur sante, qui different de ceux qui touchent les autres membres de la communaute de par leur nature, leurs manifestations, leur gravite ou leur complexite. Ces personnes necessitent une approche de soins et des interventions adaptees a leurs besoins. Les presentes lignes directrices offrent des conseils en matiere de normes de soins. Nous avons incorpore des references a des outils cliniques et a d’autres ressources pratiques. Les approches de soins decrites ici s’appliquent aussi a d’autres groupes de patients ayant un deficit cognitif ou de la communication, ou d’autres deficits des fonctions adaptatives. Conclusion A titre de fournisseurs de soins de premiere ligne, les medecins de famille jouent un role vital de promotion de la sante et de bien-etre aupres des adultes ayant des DID. Ces lignes directrices peuvent les aider a prendre des decisions avec les patients et les aidants naturels.

OBJECTIVETo delineate the factors inherent in caring for patients with intellectual and developmental disabilities (IDD) that lead to complexity and to provide perspectives and techniques mapped to the phases of the clinical encounter.SOURCES OF INFORMATIONThe authors of the physical health section of the 2018 Canadian consensus guidelines on the primary care of adults with IDD consisted of family physicians, all of whom practise comprehensive family medicine with additional clinical experience in care of adults with IDD. These authors reviewed evidence on which their recommendations are based and these recommendations have undergone a rigorous peer review to ensure that they deserve special attention because they highlight what is different from what a family physician would consider to constitute "normal care" for the general population.MAIN MESSAGEAdditional factors across the phases of clinical encounters with patients with IDD include the need for the following: an initial assessment that identifies genetic or neurologic conditions to guide anticipatory care and isolates unique barriers to health promotion and chronic disease management; adaptations to history taking, particularly for patients who are unable to describe symptoms owing to cognitive and communication deficits; overcoming challenges to performing physical examinations and certain investigations; addressing uncertainty in the formulation of hypotheses to establish an appropriate diagnosis; and involvement of resources of the developmental services sector to provide a management plan as well as an adapted empathetic approach in order to integrate the patient's illness experience.CONCLUSIONAlthough each patient with IDD is unique, and care of patients with IDD requires knowledge of certain conditions, these considerations are readily identifiable, and family physicians as expert generalists are well equipped to provide excellent care to patients with IDD.

OBJECTIVE:To demonstrate how family physicians can contribute to a piece of the journey of improving quality-of-life outcomes for people with intellectual and developmental disabilities (IDD) when they undergo the transition from adolescence to adulthood.SOURCES OF INFORMATION:The "Primary care of adults with intellectual and developmental disabilities. 2018 Canadian consensus guidelines" literature review and interdisciplinary input.MAIN MESSAGE:Family physicians should be proactive in anticipating and supporting the transition of people with IDD from adolescence to adulthood. Interventions should be guided by a developmental perspective regarding the person with IDD and a life-cycle approach to supporting families. Family physicians also have a role in helping people with IDD and their families to navigate successfully through changing community-based support systems in their province, especially health care and social services systems. Therefore, family physicians should be aware of current services available in their regions.CONCLUSION:Community and team-based family physicians can optimize the quality of life of people with IDD and their families by adopting a proactive developmental and systems approach to preparing youth with IDD for adulthood. In doing so, they exemplify the 4 principles of family medicine.

Whether a link exists between the two orienting processes of saccade preparation and visuospatial attention has typically been studied by using either sensory cues or predetermined rules that instruct subjects where to allocate these limited resources. In the real world, explicit instructions are not always available and presumably expectations shaped by previous experience play an important role in the allocation of these processes. Here we examined whether manipulating two experiential factors that clearly influence saccade preparation--the probability and timing of saccadic responses--also influences the allocation of visuospatial attention. Occasionally, a visual probe was presented whose spatial location and time of presentation varied relative to those of the saccade target. The proportion of erroneous saccades directed toward this probe indexed saccade preparation, and the proportion of correct discriminations of probe orientation indexed visuospatial attention. Overall, preparation and attention were significantly correlated to each other across these manipulations of saccade probability and timing. Saccade probability influenced both preparation and attention processes, whereas saccade timing influenced only preparation processes. Unexpectedly, discrimination ability was not improved in those trials in which the probe triggered an erroneous saccade despite particularly heightened levels of saccade preparation. To account for our results, we propose a conceptual dual-purpose threshold model based on neurophysiological considerations that link the processes of saccade preparation and visuospatial attention. The threshold acts both as the minimum activity level required for eliciting saccades and a maximum level for which neural activity can provide attentional benefits.