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More participation, choice making and meaningful activities in everyday life for people with intellectual disabilities?: Evaluation of Active Support and Frontline Practice Leadership in group homes in Sweden
Marie Cederschiöld University, Department of Social Work.ORCID iD: 0000-0002-2115-9913
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

Active Support is an internationally well-researched staff practice to improve quality of life for people with intellectual disabilities living in group homes. However, research findings from Sweden are lacking about Active Support. The aim of this doctoral thesis was to investigate the two-year effect of Active Support, including Frontline Practice Leadership, in Swedish group homes for people with intellectual disabilities.

Four group homes participated in this intervention project. A mixed methods approach was used, combining interviews with managers and service users, observations of leadership and staff-service users’ interactions and staff questionnaires. Data was collected on repeated occasions, both before and after the training, to evaluate the longitudinal effects of Active Support training.

Results showed that better support was given in all four group homes after Active Support training. Services users said that their influence, choices and emotional support had improved. Observations over two years confirmed that staff-serviceusers’ interactions had improved with more activity and choices. Practice leadership, a part of Active Support, was important for working with Active Support and feedback sessions were particularly important to continuously develop staff support.This intervention project shows that Active Support is a promising staff practice that develops staff´s support skills in group homes in Sweden. These findings also show the importance that people with intellectual disabilities are heard when evaluating new staff practices.

Place, publisher, year, edition, pages
Stockholm: Marie Cederschiöld högskola , 2025. , p. 183
Series
Avhandlingsserie inom området Människan i välfärdssamhället, ISSN 2003-3699 ; 22
Keywords [en]
Intellectual disability, Active Support, Staff practice, Frontline Practice Leadership, Interviews, Staff development, Group homes
National Category
Social Work
Research subject
Människan i välfärdssamhället, Socialt arbete
Identifiers
URN: urn:nbn:se:esh:diva-11376Libris ID: 5qw1170v3vr7fqvsISBN: 978-91-985807-1-6 (print)OAI: oai:DiVA.org:esh-11376DiVA, id: diva2:1954296
Public defence
2025-05-23, Aulan, Campus Ersta, Stigbergsgatan 30, Stockholm, 09:00
Opponent
Supervisors
Available from: 2025-04-30 Created: 2025-04-24 Last updated: 2025-04-30Bibliographically approved
List of papers
1. A Scoping Review of Outcomes Measured and Involvement of People With Intellectual Disabilities in Active Support Research
Open this publication in new window or tab >>A Scoping Review of Outcomes Measured and Involvement of People With Intellectual Disabilities in Active Support Research
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2024 (English)In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 37, no 6, p. 1-14, article id e13309Article in journal (Refereed) Published
Abstract [en]

Background: Active Support is a staff practice that aims to increase engagement of people with intellectual disabilities. This study seeks to: (1) identify the outcomes of staff using Active Support and how these are measured; (2) identify how the views of people with intellectual disabilities have been included in Active Support research.

Method: A scoping review was conducted of peer-reviewed articles about Active Support published between 2009 and 2023.

Results: Sixteen articles were identified. Outcomes included engagement, the quality of staff support, choice and challenging behaviour. Structured observations were the most frequently used measurement method. Only two studies explored people with intellectual disabilities' perspectives about Active Support.

Conclusions: Consistent use of similar measures is a strength of Active Support research. Including perspectives of people with intellectual disabilities may provide insight into dimensions of support not been measured and assist in further developing these measures and Active Support practice.

Keywords
Active support, Engagement, Intellectual disability, Quality of life, Staff support
National Category
Social Work
Research subject
Människan i välfärdssamhället, Socialt arbete
Identifiers
urn:nbn:se:esh:diva-11370 (URN)10.1111/jar.13309 (DOI)001330267600001 ()39397250 (PubMedID)
Available from: 2025-04-23 Created: 2025-04-23 Last updated: 2025-04-24Bibliographically approved
2. Active support as good support in group homes?: A longitudinal interview study with service users
Open this publication in new window or tab >>Active support as good support in group homes?: A longitudinal interview study with service users
2025 (English)In: Journal of Intellectual & Developmental Disability, ISSN 1366-8250, E-ISSN 1469-9532, Vol. 50, no 1, p. 33-44Article in journal (Refereed) Published
Abstract [en]

Background: Support from staff plays an important role in quality of life for people with intellectual disability. This study focuses on service users’ views of Active Support as good support and whether Active Support increases the quality of everyday support in group homes.

Method: Nine service users were interviewed at baseline and at follow-up one year after staff received Active Support training. Thematic analyses were used to develop themes.

Results: Three main themes were created: (1) Home is more than just a place, it is a feeling; (2) Good care is caring with accessible communication; and (3) Time is precious. Participants were more satisfied with most of the support at follow-up, particularly choice-making, control in everyday life, relationships, and emotional support.

Conclusions: Active Support corresponds well with service users’ perceptions of good support. Infuture studies of Active Support service users’ voices should be a part of the follow-up.

Keywords
Active support, Intellectualdisability, Interviews, Grouphomes, Support workers, Ethic of care
National Category
Social Work
Research subject
Människan i välfärdssamhället, Socialt arbete
Identifiers
urn:nbn:se:esh:diva-11372 (URN)10.3109/13668250.2024.2400097 (DOI)001321382100001 ()39957526 (PubMedID)
Available from: 2025-04-24 Created: 2025-04-24 Last updated: 2025-04-24Bibliographically approved
3. The effect of Frontline Practice Leadership in Swedish Group Homes: Observations of Frontline Managers and their Experiences
Open this publication in new window or tab >>The effect of Frontline Practice Leadership in Swedish Group Homes: Observations of Frontline Managers and their Experiences
(English)In: Article in journal (Other academic) Submitted
Abstract [en]

Background: Frontline Practice Leadership, closely associated with the staff practice of Active Support, is a form of leadership that aims to enhance the quality in support in group homes for people with intellectual disabilities. This study examines the longitudinal two-year effect of Frontline Practice Leadership training in four Swedish group homes.

Method: A combination of observations in four group homes and interviews with three managers. The 49 observations involved 28 support workers and three first-line managers.

Results: Practice leaders improved their skills to coach and supervise staff in everyday support after training. Repeated observations with feedback sessions were considered crucial to increasing the quality of support.

Conclusions: Findings suggest that Frontline Practice Leadership is important for Active Support implementation in a Swedish context.

Keywords
Intellectual disabilities, Frontline Practice Leadership, Active Support, Group homes, Management
National Category
Social Work
Research subject
Människan i välfärdssamhället, Socialt arbete
Identifiers
urn:nbn:se:esh:diva-11373 (URN)
Available from: 2025-04-24 Created: 2025-04-24 Last updated: 2025-04-24Bibliographically approved
4. Implementation and Evaluation of Active Support in Swedish group homes
Open this publication in new window or tab >>Implementation and Evaluation of Active Support in Swedish group homes
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(English)In: Article in journal (Other academic) Submitted
Abstract [en]

Background: People with intellectual disabilities experience worse living conditions and health than the general population. To enhance the quality of life for those living in group homes, skilled staff support is needed. This study aimed to implement the staff practice Active Support in four Swedish group homes for people with intellectual disabilities and evaluate its effectiveness in a Swedish setting.

Methods: Changes in the quality of staff support were examined through 53 structured observations in four group homes before, during and two years after staff received Active Support training. Questionnaires were used twice to examine the adaptive behaviour and variety of support needs in service users.

Results: The quality of support improved after the training in all four group homes. The most substantial increase was found after one year, results which remained or even increased in year two. The service users had a range of adaptive behaviour levels, and small improvements were found during the second measurement period, but did not reach statistical significance.

Conclusion: Active Support improve the quality of support to people with intellectual disabilities in group homes in a long-term perspective and seems to benefit people with a range of adaptive behaviours. Therefore, continued implementation of Active Support in Sweden holds promise for improving the quality of life of people with intellectual disabilities.

National Category
Social Work
Research subject
Människan i välfärdssamhället, Socialt arbete
Identifiers
urn:nbn:se:esh:diva-11374 (URN)
Note

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Available from: 2025-04-24 Created: 2025-04-24 Last updated: 2025-04-24Bibliographically approved

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