Exploring the Poststroke Experiences and Needs of South Asian Communities Living in High-Income Countries: Findings from a Scoping Review.

Caregivers Ethnicity Scoping review Stroke

Journal

Journal of racial and ethnic health disparities
ISSN: 2196-8837
Titre abrégé: J Racial Ethn Health Disparities
Pays: Switzerland
ID NLM: 101628476

Informations de publication

Date de publication:
29 Jun 2023
Historique:
received: 02 11 2022
accepted: 22 04 2023
revised: 18 04 2023
medline: 29 6 2023
pubmed: 29 6 2023
entrez: 29 6 2023
Statut: aheadofprint

Résumé

Despite the high prevalence of stroke among South Asian communities in high-income countries, a comprehensive understanding of their unique experiences and needs after stroke is lacking. This study aimed to synthesize the literature examining the experiences and needs of South Asian community members impacted by stroke and their family caregivers residing in high-income countries. A scoping review methodology was utilized. Data for this review were identified from seven databases and hand-searching reference lists of included studies. Study characteristics, purpose, methods, participant characteristics, results, limitations, recommendations, and conclusions were extracted. Data were analyzed using descriptive qualitative analysis. In addition, a consultative focus group exercise with six South Asian community members who had experienced a stroke and a program facilitator was conducted to inform the review interpretations. A total of 26 articles met the inclusion criteria and were analyzed. Qualitative analysis identified four descriptive categories: (1) rationale for studying the South Asian stroke population (e.g., increasing South Asian population and stroke prevalence), (2) stroke-related experiences (e.g., managing community support versus stigma and caregiving expectations), (3) stroke service challenges (e.g., language barriers), and (4) stroke service recommendations to address stroke service needs (e.g., continuity of care). Several cultural factors impacted participant experiences, including cultural beliefs about illness and caregiving. Focus group participants from our consultation activity agreed with our review findings. The clinical and research recommendations identified in this review support the need for culturally appropriate services for South Asian communities across the stroke care continuum; however, more research is necessary to inform the design and structure of culturally appropriate stroke service delivery models.

Identifiants

pubmed: 37382872
doi: 10.1007/s40615-023-01613-6
pii: 10.1007/s40615-023-01613-6
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. W. Montague Cobb-NMA Health Institute.

Références

Bank TW. World Bank country and lending groups. 2022. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups . Accessed 1 Oct 2022.
Li L, et al. Trends in stroke incidence in high-income countries in the 21st century: population-based study and systematic review. Stroke. 2020;51(5):1372–80.
pubmed: 32208842 pmcid: 7185053 doi: 10.1161/STROKEAHA.119.028484
Teasell R, et al. Canadian stroke best practice recommendations rehabilitation recovery and community participation following stroke Part one rehabilitation and recovery following stroke 6th edition update. Int J Stroke. 2020;15(7):763–88.
pubmed: 31983296 doi: 10.1177/1747493019897843
Zawawi NSM, et al. The unmet needs of stroke survivors and stroke caregivers: a systematic narrative review. J Stroke Cerebrovasc Dis. 2020;29(8):104875.
pubmed: 32689648 doi: 10.1016/j.jstrokecerebrovasdis.2020.104875
McKevitt C, et al. Self-reported long-term needs after stroke. Stroke. 2011;42(5):1398–403.
pubmed: 21441153 doi: 10.1161/STROKEAHA.110.598839
Lin B-L, et al. Unmet care needs of community-dwelling stroke survivors: a systematic review of quantitative studies. BMJ Open. 2021;11(4):e045560–e045560.
pubmed: 33879490 pmcid: 8061855 doi: 10.1136/bmjopen-2020-045560
Haacke C, et al. Long-term outcome after stroke. Stroke. 2006;37(1):193–8.
pubmed: 16339458 doi: 10.1161/01.STR.0000196990.69412.fb
Chohan SA, Venkatesh PK, How CH. Long-term complications of stroke and secondary prevention: an overview for primary care physicians. Singapore Med J. 2019;60(12):616–20.
pubmed: 31889205 pmcid: 7911065 doi: 10.11622/smedj.2019158
Lu Q, et al. Living on the edge: family caregivers’ experiences of caring for post-stroke family members in China: a qualitative study. Int J Nurs Stud. 2019;94:1–8.
pubmed: 30928717 doi: 10.1016/j.ijnurstu.2019.02.016
Haji Mukhti MI, et al. Family caregivers’ experiences and coping strategies in managing stroke patients during the COVID-19 pandemic: a qualitative exploration study. Int J Environ Res Public Health. 2022;19(2):942.
pubmed: 35055764 pmcid: 8775342 doi: 10.3390/ijerph19020942
World Bank. World Bank country and lending groups. 2021. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups . Accessed 21 Sep 2021.
Phan TG, Haseeb A, Beare R, Srikanth V, Thrift AG, Ma H. Googling the lifetime risk of stroke around the world. Front Neurol. 2020;11:729–729.
Johnson W, et al. Stroke: a global response is needed. Bull World Health Organ. 2016;94(9):634.
pubmed: 27708464 pmcid: 5034645 doi: 10.2471/BLT.16.181636
Verkuyten M. Discourses of ethnic minority identity. Br J Soc Psychol. 1997;36(4):565–86.
doi: 10.1111/j.2044-8309.1997.tb01150.x
Gezmu T, et al. Risk factors for acute stroke among South Asians compared to other racial/ethnic groups. PLoS ONE. 2014;9(9):e108901.
pubmed: 25268987 pmcid: 4182514 doi: 10.1371/journal.pone.0108901
McNaughton H, et al. Ethnicity and functional outcome after stroke. Stroke. 2011;42(4):960–4.
pubmed: 21311061 doi: 10.1161/STROKEAHA.110.605139
Chiu M, et al. Comparison of cardiovascular risk profiles among ethnic groups using population health surveys between 1996 and 2007. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 2010. 182(8): E301-E310.
Khan NA, et al. Temporal trends in stroke incidence in South Asian, Chinese and white patients: a population based analysis. PLoS ONE. 2017;12(5):e0175556.
pubmed: 28545076 pmcid: 5436629 doi: 10.1371/journal.pone.0175556
Dhamoon MS, et al. Stroke recurrence among South Asians with diabetes in Ontario. Canada Int J Stroke. 2016;11(8):890–7.
pubmed: 27306364 doi: 10.1177/1747493016654488
United Nations. Methodology. Standard country or area codes for statistical use (M49). 2021. Available from: https://unstats.un.org/unsd/methodology/m49/ . Accessed 21 Sep 2021
Gunarathne A, et al. Glycemic status underlies increased arterial stiffness and impaired endothelial function in migrant South Asian stroke survivors compared to European Caucasians: pathophysiological insights from the West Birmingham Stroke Project. Stroke. 2009;40(7):2298–306.
pubmed: 19520993 doi: 10.1161/STROKEAHA.109.548388
Khan NA, et al. Risk factors, quality of care and prognosis in South Asian, East Asian and White patients with stroke. BMC Neurol. 2013;13(1):1–8.
doi: 10.1186/1471-2377-13-74
Khan NA, et al. Outcomes after acute myocardial infarction in South Asian, Chinese, and white patients. Circulation. 2010;122(16):1570–7.
pubmed: 20921444 doi: 10.1161/CIRCULATIONAHA.109.850297
Statistics Canada. Visible minority of person. 2021. Available from: https://www23.statcan.gc.ca/imdb/p3Var.pl?Function=DECI&Id=257515 . Accessed 5 Aug 2022.
Office for National Statistics. Population estimates by ethnic group and religion, England and Wales: 2019. 2021 [cited 2022 August 5]; Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/populationestimatesbyethnicgroupandreligionenglandandwales/2019 .
Canada, S. Immigration and diversity: population projections for Canada and its regions, 2011 to 2036. 2017; Available from: https://www150.statcan.gc.ca/n1/pub/91-551-x/91-551-x2017001-eng.htm .
Jain PC, Oommen GZ. South Asian migration to gulf countries. Policies, Development: History; 2016.
Peach C. South Asian migration and settlement in Great Britain, 1951–2001. Contemp South Asia. 2006;15(2):133–46.
doi: 10.1080/09584930600955234
Visaria A, et al. Effectiveness of a cultural stroke prevention program in the United States—South Asian health awareness about stroke (SAHAS). J Immigr Minor Health. 2021;23(4):747–54.
pubmed: 32813225 doi: 10.1007/s10903-020-01071-w
Yeung EH, et al. The experiences and needs of Chinese-Canadian stroke survivors and family caregivers as they re-integrate into the community. Health Soc Care Community. 2015;23(5):523–31.
pubmed: 25443438 doi: 10.1111/hsc.12164
Singh P, Jayakaran P, Mani R, Hale L. The experiences of Indian people living in New Zealand with stroke. Disabil Rehabil. 2022;44(14):3641–9.
pubmed: 33535831 doi: 10.1080/09638288.2021.1878294
Amin MS, Ahmed I, Ahmed N. Perceptions of stroke amongst the young British Bangladeshi community: where should we be targeting stroke education in the future? Cerebrovasc Dis. 2011;31(2):293.
Katbamna S, et al. Balancing satisfaction and stress: carer burden among White and British Asian Indian carers of stroke survivors. Ethn Health. 2017;22(4):425–41.
pubmed: 27744714 doi: 10.1080/13557858.2016.1244740
Chen T, et al. Long-term unmet needs after stroke: systematic review of evidence from survey studies. BMJ Open. 2019;9(5):e028137.
pubmed: 31110106 pmcid: 6530326 doi: 10.1136/bmjopen-2018-028137
Wray F, Clarke D. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies. BMJ Open. 2017;7(10):e017944.
pubmed: 28988185 pmcid: 5640038 doi: 10.1136/bmjopen-2017-017944
Hafsteinsdóttir TB, et al. Educational needs of patients with a stroke and their caregivers: a systematic review of the literature. Patient Educ Couns. 2011;85(1):14–25.
pubmed: 20869189 doi: 10.1016/j.pec.2010.07.046
Lee N, Aries A, Hunter S. The long-term needs of stroke survivors: a systematic review. Int J Stroke. 2014;9:42–42.
Kokorelias KM, et al. Exploring the poststroke experiences and unmet needs of South Asian communities in high-income countries: a scoping review protocol. BMJ Open. 2022;12(4):e059017.
pubmed: 35477869 pmcid: 9047763 doi: 10.1136/bmjopen-2021-059017
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
doi: 10.1080/1364557032000119616
Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(1):1–9.
doi: 10.1186/1748-5908-5-69
Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(1):69.
pubmed: 20854677 pmcid: 2954944 doi: 10.1186/1748-5908-5-69
Tricco AC, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73.
pubmed: 30178033 doi: 10.7326/M18-0850
Tillman LC. Culturally sensitive research approaches: an African-American perspective. Educ Res. 2002;31(9):3–12.
doi: 10.3102/0013189X031009003
Rangel DE, Valdez CR. A culturally sensitive approach to large-scale prevention studies: a case study of a randomized controlled trial with low-income Latino communities. J Prim Prev. 2017;38(6):627–45.
pubmed: 28866843 pmcid: 5682206 doi: 10.1007/s10935-017-0487-2
McGowan J, et al. PRESS peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol. 2016;75:40–6.
pubmed: 27005575 doi: 10.1016/j.jclinepi.2016.01.021
Babineau J. Product review: covidence (systematic review software). J Can Health Libr Assoc/J de l’Association des bibliothèques de la santé du Can. 2014;35(2):68–71.
doi: 10.5596/c14-016
McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22(3):276–82.
doi: 10.11613/BM.2012.031
Balk E. Assessing the accuracy of Google translate to allow data extraction from trials published in non-English languages. Rockville, Maryland: Agency for Healthcare Research and Quality US; 2013.
Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8(1):1–10.
doi: 10.1186/1471-2288-8-45
Houghton C, et al. Rigour in qualitative case-study research. Nurse Res. 2013;20(4):12–7.
Parveen S, Morrison V, Robinson CA. Ethnicity, familism and willingness to care: Important influences on caregiver mood? Aging Ment Health. 2013;17(1):115–24.
pubmed: 22934683 doi: 10.1080/13607863.2012.717251
Saleem TZ, et al. Views and preferences of people from ethnic minority backgrounds in the UK in improving participation in a palliative care stroke questionnaire. Palliat Med. 2010;24:S5–229.
Auton MF. Making stroke services equitable for minority groups: the potential role of cultural competence. Doctoral thesis, ProQuest Dissertations Publishing, University of Central Lancashire. 2013.
Stott H, et al. ‘Somebody stuck me in a bag of sand’: lived experiences of the altered and uncomfortable body after stroke. Clin Rehabil. 2021;35(9):1348–59.
pubmed: 33706575 pmcid: 8358539 doi: 10.1177/02692155211000740
Singh H, et al. A qualitative study exploring the experiences of individuals living with stroke and their caregivers with community-based poststroke services: a critical need for action. PLoS ONE. 2022;17(10):e0275673.
pubmed: 36215245 pmcid: 9550061 doi: 10.1371/journal.pone.0275673
Singh H, et al. Exploring the experiences of Chinese and South Asian participants in culturally-tailored stroke programs. Eur Stroke J. 2022;7:464–5.
Katbamna S, Manning L, Mistri A, Johnson M, Robinson T. Balancing satisfaction and stress: carer burden among White and British Asian Indian carers of stroke survivors. Ethn Health. 2017;22(4):425–41.
Perry SI, et al. Perceptions of community services among Asian and white stroke survivors and their carers an exploratory study. Ethn Health. 1999;4(1–2):101–5.
pubmed: 10887466 doi: 10.1080/13557859998236
Katbamna S, Johnson M, Robinson T, Manning L. Ethnic differences in caring for stroke survivors: observations from study of white British and British Indian informal carers. Int J Stroke. 2014;9:16–16.
Moorley C, et al. Impact of stroke: a functional, psychological report of an inner-city multiracial population. Primary Health Care. 2014;24(4):26–34.
doi: 10.7748/phc2014.04.24.4.26.e871
Vyas MV. The Association between immigration status and stroke incidence, care and outcomes. ProQuest Dissertations Publishing, University of Toronto. 2021.
Greenwood N, et al. Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors. BMJ Open. 2016;6(1):e009498.
pubmed: 26826148 pmcid: 4735197 doi: 10.1136/bmjopen-2015-009498
Khan NA, et al. Secondary prevention treatment after acute stroke in older South Asian, Chinese and other Canadians: a retrospective data analysis. Can Med Assoc Open Access J. 2017;5(3):E702–9.
Palin C, Hegarty B. Abstract 117: A hospital and home befriending project for Bengali and English speaking people living with stroke and aphasia–initial outcomes. Int J Stroke. 2010;5(Supplement 3):60.
Katbamna S, et al. Do they look after their own? Informal support for South Asian carers. Health Soc Care Community. 2004;12(5):398–406.
pubmed: 15373818 doi: 10.1111/j.1365-2524.2004.00509.x
Pound C, Greenwood N. The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups. Disabil Rehabil. 2016;38(20):1987–99.
pubmed: 26728779 doi: 10.3109/09638288.2015.1107783
Katbamna S, Johnson M, Robinson T, Manning L. Ethnic differences in caring for stroke survivors: observations from study of white British and British Indian informal carers. Int J Stroke. 2014;9:16–16.
Lo CC, et al. Explaining health outcomes of Asian immigrants: does ethnicity matter? J Racial Ethn Health Disparities. 2020;7(3):446–57.
pubmed: 31768963 doi: 10.1007/s40615-019-00673-x
Ramazanu S, Chiang VCL, Valimaki M. The experiences and evaluation of a complex intervention for couples coping with stroke. J Neurosci Nurs. 2021;53(1):18–23.
pubmed: 33252412 doi: 10.1097/JNN.0000000000000564
Greenwood N, Cloud G, Bowling A, Mein G, Ellmers T, Holley J. Accessing and engaging with social care services: the experiences of Black and Minority Ethnic and White British carers of stroke survivors. Int J Stroke. 2014;9:52–52.
Mahendra N. South Asian stories: firsthand client perspectives on barriers to accessing speech-language pathology services. Perspect Commun Disord Sci Cult Linguistically Diverse (CLD) Popul. 2012;19(1):29–36.
Moorley C. Life after stroke: Releasing the cultural hostage. Int J Stroke. 2015;10:25–25.
Chiang S-W, Wu S-C, Peng T-C. The experience to implement palliative care in long-term care facilities: a grounded theory study of caregivers. Asian Nurs Res. 2021;15(1):15–22.
doi: 10.1016/j.anr.2020.10.006
Pound C, Greenwood N. The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups. Disabil Rehabil. 2016;38(20):1987–99.
pubmed: 26728779 doi: 10.3109/09638288.2015.1107783
Worth A, et al. Vulnerability and access to care for South Asian Sikh and Muslim patients with life limiting illness in Scotland: prospective longitudinal qualitative study. BMJ. 2009;338:b183. https://doi.org/10.1136/bmj.b183 .
Effendy C, et al. Comparison of problems and unmet needs of patients with advanced cancer in a European country and an Asian country. Pain Pract. 2015;15(5):433–40.
pubmed: 24666769 doi: 10.1111/papr.12196
Blix BH, Hamran T. “They take care of their own”: healthcare professionals’ constructions of Sami persons with dementia and their families’ reluctance to seek and accept help through attributions to multiple contexts. Int J Circumpolar Health. 2017;76(1):1328962.
pubmed: 28587573 pmcid: 5497550 doi: 10.1080/22423982.2017.1328962
Bower K, et al. Self-management of upper limb recovery after stroke: how effectively do occupational therapists and physiotherapists train clients and carers? Br J Occup Ther. 2012;75(4):180–7.
doi: 10.4276/030802212X13336366278130
Cameron JI, et al. A feasibility and pilot randomized controlled trial of the “Timing it Right Stroke Family Support Program.” Clin Rehabil. 2015;29(11):1129–40.
pubmed: 25552525 doi: 10.1177/0269215514564897
Kokorelias KM, et al. Towards a universal model of family centered care: a scoping review. BMC Health Serv Res. 2019;19(1):1–11.
doi: 10.1186/s12913-019-4394-5
Chiu C-C, et al. Multidisciplinary care after acute care for stroke: a prospective comparison between a multidisciplinary post-acute care group and a standard group matched by propensity score. Int J Environ Res Public Health. 2021;18(14):7696.
pubmed: 34300144 pmcid: 8303420 doi: 10.3390/ijerph18147696
Lip GY, et al. Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke. Eur Heart J. 2022;43(26):2442–60.
pubmed: 35552401 pmcid: 9259378 doi: 10.1093/eurheartj/ehac245
Chenoweth L, Gietzelt D, Jeon Y-H. Perceived needs of stroke survivors from non-English-speaking backgrounds and their family carers. Top Stroke Rehabil. 2002;9(1):67–79.
pubmed: 14523723 doi: 10.1310/D392-NUL6-2J35-5EGM
Al Shamsi H, et al. Implications of language barriers for healthcare: a systematic review. Oman Med J. 2020;35(2):e122.
pubmed: 32411417 pmcid: 7201401 doi: 10.5001/omj.2020.40
Liu TW, Ng SS, Ng GY. Translation and initial validation of the Chinese (Cantonese) version of community integration measure for use in patients with chronic stroke. BioMed Res Int. 2014;2014:623836. https://doi.org/10.1155/2014/623836 .
Waibel S, et al. The influence of patient-clinician ethnocultural and language concordance on continuity and quality of care: a cross-sectional analysis. CMAJ Open. 2018;6(3):E276-e284.
pubmed: 30026191 pmcid: 6182102 doi: 10.9778/cmajo.20170160
Foronda C. A theory of cultural humility. J Transcult Nurs. 2020;31(1):7–12.
pubmed: 31516091 doi: 10.1177/1043659619875184
Horton RC, Irwin KE. Providing culturally competent acute care physical therapy for a complex medical patient of Amish heritage. J Acute Care Phys Ther. 2018;9(3):121–35.
doi: 10.1097/JAT.0000000000000080
Marrone SR. Case study: culturally competent healthcare organizations for Arab Muslims. In: Global Applications of Culturally Competent Health Care: Guidelines for Practice. Springer; 2018. p. 221–7.
doi: 10.1007/978-3-319-69332-3_25
Wilbur K, et al. Developing workforce diversity in the health professions: a social justice perspective. Health Prof Educ. 2020;6(2):222–9.
Gov.uk. Population of England and Wales. 2020. Available from: https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/national-and-regional-populations/population-of-england-and-wales/latest#:~:text=4.2%20million%20people%20(7.5%25),Pakistani%20ethnic%20group%20(2.0%25) . Accessed 8 Aug 2022.
Hanel PHP, et al. Cross-cultural differences and similarities in human value instantiation. Frontiers in Psychology. 2018;9.
Katan D. Defining culture, defining translation. In: The Routledge handbook of translation and culture. Abingdon: Routledge; 2018. p. 17–47.
Mazanec P, Panke J. Cultural considerations in palliative care. In: Social Aspects of Care. New York: Oxford University Press; 2015.
Nichols M, et al. Crafting community-based participatory research stroke interventions. Stroke. 2022;29(2):680–8.
doi: 10.1161/STROKEAHA.121.035306
Hussain-Gambles M, Atkin K, Leese B. South Asian participation in clinical trials: the views of lay people and health professionals. Health Policy. 2006;77(2):149–65.
pubmed: 16216378 doi: 10.1016/j.healthpol.2005.07.022
Kraft SA, et al. Demonstrating ‘respect for persons’ in clinical research: findings from qualitative interviews with diverse genomics research participants. J Med Ethics. 2021;47(12):e8–e8.
doi: 10.1136/medethics-2020-106440
LaPlante A, et al. Enrollment, retention, and strategies for including disadvantaged populations in randomized controlled trials: a systematic review protocol. Syst Rev. 2021;10(1):1–7.
doi: 10.1186/s13643-021-01790-7
Heller C, et al. Strategies addressing barriers to clinical trial enrollment of underrepresented populations: a systematic review. Contemp Clin Trials. 2014;39(2):169–82.
pubmed: 25131812 pmcid: 6936726 doi: 10.1016/j.cct.2014.08.004
Gray LM, et al. Expanding qualitative research interviewing strategies: Zoom video communications. Qualit Rep. 2020;25(5):1292–301.

Auteurs

Kristina M Kokorelias (KM)

Department of Medicine, Geriatrics Program, Sinai Health System, University Health Network, Toronto, Canada.

Jill I Cameron (JI)

Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

Nancy M Salbach (NM)

The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

Heather Colquhoun (H)

Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

Sarah E P Munce (SEP)

Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Michelle L A Nelson (MLA)

Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada.

Julia Martyniuk (J)

Gerstein Science Information Centre, University of Toronto Libraries, University of Toronto, Toronto, Canada.

Carolyn Steele Gray (C)

Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada.

Terence Tang (T)

Institute for Better Health, Trillium Health Partners, Toronto, Canada.

Sander L Hitzig (SL)

Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.

M Patrice Lindsay (MP)

Heart and Stroke Foundation, Toronto, Canada.

Mark T Bayley (MT)

The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada.

Rosalie H Wang (RH)

Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

Navaldeep Kaur (N)

Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

Hardeep Singh (H)

Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. hardeepk.singh@utoronto.ca.
The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada. hardeepk.singh@utoronto.ca.
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. hardeepk.singh@utoronto.ca.

Classifications MeSH