Development of the Special Olympics North Carolina MedFest Toolkit
[BACKGROUND] Limited access to quality healthcare for individuals living with an intellectual disability (ILID) has numerous implications, including poorer health outcomes and significant health disparities for the population. Compared to individuals without intellectual disability, ILID experience higher rates of chronic diseases and are less likely to have a primary care provider. There are many contributing reasons for these observed disparities. Identifying access to healthcare for ILID as a significant issue that has implications well beyond the athletic competition, Special Olympics created the MedFest program. MedFest is a community program that forges partnerships between local Special Olympics programs and community agencies to provide free sports physical exams to potential and current Special Olympics athletes. Significant additional benefits of the program are the training and specialized experience in the examination and assessment of ILID for healthcare professionals that participate in the program. [PROJECT IDENTIFICATION AND PURPOSE] The uptake of the MedFest program in communities across North Carolina has been slow. Special Olympics North Carolina (SONC) identified that the growth of the program required intervention as program proliferation was constrained due to the top-down planning strategy that was utilized to plan events. This planning structure required oversight by the state organization and was essential due to the limited resources that were available to support local programs to plan and conduct a MedFest event. To provide local programs with the tools and information needed to plan a MedFest event, SONC actively sought out community partners to create a resource that would empower communities to plan and host a MedFest event. In early 2019, a SONC intern created a draft of a MedFest handbook during her dual enrollment in a Master of Science in Public Health and Master of Physician Assistant Practice program. However, at the end of the student’s internship with SONC, the handbook was incomplete. The SONC Health Director sought out community partners to complete the handbook, which forged a partnership with the ECU College of Nursing and the author. Based upon the large amount of information that required dissemination and a review of the available health sciences literature, a toolkit was selected by the author as the format of the resource that would be developed. Compiling all the available information, current tools, and newly developed tools into a toolkit empowers local communities by offering a central repository of content related to MedFest. Thus, the purpose of this project was to create a toolkit to provide local communities in North Carolina with the resources and tools to plan, implement, and evaluate a MedFest event without significant oversight by the state organization. [FRAMEWORKS FOR SUCCESS] In addition to a thorough literature review, the development of the toolkit was supported by several additional frameworks. First, the Agency for Healthcare Research and Quality’s Publishing and Communications Guidelines provided recommendations on best practices for developing a toolkit. Next, the FRAME-IT framework was selected to ground the planning and evaluation of the toolkit. Additionally, the Quality Implementation Framework provided additional guidance on toolkit planning, dissemination, and sustainability. [TOOLKIT DEVELOPMENT] The development of the toolkit was completed in a planned and systemic manner. A review was completed of the available SONC and Special Olympics International resources, as well as the health sciences literature on toolkits, intellectual disabilities, and preparticipation physical evaluations. Next, a SWOT analysis was conducted, and plans for the toolkit were formed using the Quality Implementation Framework. A toolkit draft was then created with consideration of items from within the AHRQ Toolkit Checklist and the FRAME-IT Framework. Once the draft was created, toolkit stakeholders completed several cycles of toolkit review and feedback that ensured the toolkit met the needs of SONC and efficiently communicated MedFest best practices. The toolkit was then published to the SONC website, and the author requested reviews from current event planners and interested individuals using the FRAME-IT framework. Early adopters were sought out to utilize the toolkit to plan a MedFest event and evaluate the toolkit. [OUTCOMES AND IMPLICATIONS] The toolkit was successfully created and published on the SONC website and is currently being utilized to plan MedFest events in North Carolina. The toolkit is a resource that empowers local communities to plan, implement, and evaluate a MedFest event without significant oversight by the state organization. The use of the toolkit ensures consistency to the athlete experience at events across the state and elevates the quality of care available in the local community. The most significant outcome of the DNP project was the commitment of Special Olympics International to utilize the toolkit to update the international MedFest resources. As part of that commitment, the toolkit was discussed and shared as a resource during a December 2019 web conference that was attended by leaders from 13 Special Olympics state-level programs in the United States. The degree of toolkit utilization at the national and international levels are unknown; however, dissemination of the toolkit beyond North Carolina has far-reaching implications as the DNP project will influence health care access and quality for ILID beyond North Carolina. Another potential benefit of the toolkit is the use by Special Olympics and other community organizations as a model to create and disseminate toolkits on other topics. These may include public health organizations, community health programs, and other philanthropic organizations. Other entities may be interested in the toolkit organization, content, event planning strategies, as well as the creation process. [RECOMMENDATIONS] To further develop the SONC MedFest Toolkit and support its sustainability, several recommendations were developed for SONC. One of the first recommendations made to SONC was to continue the utilization and evaluation of the toolkit to identify areas that need improvement or additional resources. To update toolkit content and to utilize feedback best, an annual review of the toolkit is suggested. It is recommended that SONC continue to develop new partnerships with educational programs across the state that may utilize the toolkit as a form of service-learning and bring a MedFest event to new communities. Recommendations were also made to consider the inclusion of athlete forms and flyers that are in languages other than English to support households that are non-English speaking. Additionally, recommendations were provided for other stakeholders, interested individuals, and prospective toolkit authors.
Beane, Jeremy. (April 2020). Development of the Special Olympics North Carolina MedFest Toolkit (DNP Scholarly Project, East Carolina University). Retrieved from the Scholarship. (http://hdl.handle.net/10342/8401.)
Beane, Jeremy. Development of the Special Olympics North Carolina MedFest Toolkit. DNP Scholarly Project. East Carolina University, April 2020. The Scholarship. http://hdl.handle.net/10342/8401. September 30, 2020.
Beane, Jeremy, “Development of the Special Olympics North Carolina MedFest Toolkit” (DNP Scholarly Project., East Carolina University, April 2020).
Beane, Jeremy. Development of the Special Olympics North Carolina MedFest Toolkit [DNP Scholarly Project]. Greenville, NC: East Carolina University; April 2020.