INTRODUCTION: The increasing viability of family led interventions leads occupational therapists to alter traditional methods of addressing intervention by incorporating tools like home programmes to enhance rehabilitation and thus improve client participation within their environment. This mixed-methods study aimed to identify and measure factors affecting adherence to a home programme and to describe barriers and facilitators to their effective delivery.

METHODS:  Cross-sectional survey of parents of children participating in a rehabilitation clinic, convenience sampling of 70 parents was undertaken and 8 parents participated in in-depth interviews.

RESULTS: Children in the study were aged between 6 months and 9 years with a neurodevelopmental disability, receiving occupational therapy at a rehabilitation clinic. The quantitative data indicates that the providing parents with videos (p= 0.048, OR=1.47) and incorporating home programmes into daily routines (p=0.045, OR=1.84) are perceived as facilitators for the adherence to a home programme, whereas using the child as a model (p=.036, OR=3.51) and incorporating the home programme into daily routine (p=0.020, OR=2.83) are perceived as facilitators to implementing the repetitions required. The qualitative data identified poor communication by the therapist about the importance of home programmes and non-practical suggestions for home therapy as barriers to effective implementation.

CONCLUSION: There are several areas for improvement in the frameworks that guide the implementation of home programmes. These have been highlighted by this study through an understanding of the perceived beliefs of caregivers about therapy, their levels of adherence, and the facilitators and barriers that they feel guide the therapeutic process.