ABSTRACT

Introduction: The My Abilities First (MAF) tool is an educational approach that employs accessible and inclusive technology, focusing on the valorization of the abilities of people with disabilities. The successful implementation of MAF depends, among other factors, on the appropriate means of information and training for managers, professionals, caregivers, and people with disabilities themselves, to ensure effective use with a positive impact on the recognition of the abilities of people with disabilities in society. Objective: To present a process for the implementation of the MAF tool in Specialized Centers for Child Rehabilitation in the Brazilian context. Method: This thesis encompasses qualitative, descriptive, reflective, and interpretative research, based on Participatory Action Research (PAR) and Patient and Public Involvement (PPI), with data analysis conducted using Reflexive Thematic Analysis (RTA). A total of 28 participants, including 12 physiotherapists, 4 occupational therapists, 10 children, and 2 adolescents, accompanied by their caregivers, contributed by responding to a sociodemographic/clinical questionnaire and participating in workshops, semi-structured interviews, and focus groups to discuss two themes: Positive health approaches and the MAF Tool. The study protocol was approved by a local ethics committee, opinion number 4,779,175. Thus, this doctoral thesis comprised a study "Implementation of the My Abilities First Tool in Specialized Centers for Child Rehabilitation," which resulted in three articles: Article I characterized by the formulation of a study protocol containing all the methodological aspects described previously; Article II analyzed the responses from semi-structured interviews, and Article III analyzed the discussions held in focus groups. Results and Conclusions: Three articles encompass the findings of this thesis: Article I, Implementation of the My Abilities First Tool for Empowering Children and Adolescents with Disabilities: A Study Protocol, that presented literary, ethical, and methodological aspects that guided the subsequent articles; Article II, Implementation of the My Abilities First Tool: a qualitative study on the perceptions of professionals, caregivers, children, and adolescents with disabilities, that identified 2 themes: (1) Perceptions regarding the MAF tool as an educational and contributory process to enhance the inclusion and participation of children and adolescents with disabilities, and (2) Barriers and facilitators for the implementation process of the MAF tool. The implementation of the MAF tool was identified as a driving factor in promoting equity and increased participation of children and adolescents with disabilities in various settings, including health, education, and leisure; Article III, Implementation of the My Abilities First Tool: a qualitative study on the experiences of professionals, children/adolescents with disabilities, and caregivers, that identified 3 themes: (1) Perceptions of physiotherapists, occupational therapists, children, and adolescents with disabilities and their caregivers regarding positive health attitudes and the valorization of abilities, (2) Attitude change regarding the abilities of children and adolescents with disabilities, and (3) Facilitators and barriers in the implementation of the MAF tool. These 3 themes reflect the participants' understanding of the study's themes, experiences with MAF in the routine of children and adolescents with disabilities, and the process to implement the MAF tool. The implementation of the MAF tool was recognized as an innovation due to its abilities-focused approach. There was a recognized need to confront social, attitudinal, communication, and informational barriers to adapt and apply the tool more effectively in various contexts, such as health, education, and leisure. The importance of valuing the individual abilities of children and adolescents was recognized to better promote inclusion and participation.