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"I Can't Do It All, Even Though I Want To": A Qualitative Investigation of Implementation Barriers and Facilitators for School-Based Speech-Language Pathologists in Concussion Management.

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Title: "I Can't Do It All, Even Though I Want To": A Qualitative Investigation of Implementation Barriers and Facilitators for School-Based Speech-Language Pathologists in Concussion Management.
Authors: O'Brien, Katy H.1,2 katy.obrien@allina.com, Kemp, Amy M.3, Pei, Yalian4, Lundinee, Jennifer P.5,6
Source: Language, Speech & Hearing Services in Schools. Apr2026, Vol. 57 Issue 2, p616-633. 18p.
Subject Terms: *Speech therapists, *Re-entry students, *Diffusion of innovations, *Qualitative research, *Speech-language pathology, *Clinical competence, *Research methodology, *Health promotion, *School health services, Evaluation of human services programs, Interviewing, Judgment sampling, Descriptive statistics, Sound recordings, Thematic analysis, Evidence-based medicine, Data analysis software, Brain concussion, Psychosocial factors
Abstract: Purpose: The purpose of this study was to examine implementation barriers and facilitators related to evidence-based concussion management among school-based speech-language pathologists (SLPs). Using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, we explored how innovation, recipient, context, and facilitation factors influence SLPs' ability to bridge the know-do gap in return-to-learn (RTL) care for students with concussion. Method: We conducted qualitative semistructured interviews with 10 schoolbased SLPs purposively selected to reflect varying confidence levels regarding concussion management using a framework-informed hybrid deductive-inductive approach. The i-PARIHS framework guided interview development and thematic analysis to identify barriers and facilitators across framework constructs. Results: Implementation barriers and facilitators mapped to all four i-PARIHS constructs. Innovation barriers included limited awareness of RTL protocols (only one of 10 participants knew district protocols) and assessment challenges in establishing baselines and differentiating concussion-related difficulties. Recipient facilitators encompassed professional growth mindset and consultation model preferences, with nine of 10 participants expressing confidence in providing concussion services despite acknowledging knowledge gaps. Context was the primary barrier domain, involving resource constraints including large (up to 150 students) or complex caseloads, high workload demands, and communication gaps between medical and educational settings. Facilitation included peer networks as primary knowledge sources, but limited access to concussion-specific continuing education created barriers. A cross-cutting professional growth mindset demonstrated SLPs' readiness to participate in RTL implementation despite current limitations. Discussion: While SLPs possess strong individual characteristics supporting RTL and concussion care delivery, significant organizational barriers limit evidencebased concussion care delivery. Implementation strategies should leverage SLPs' growth mindset and peer consultation preferences while addressing multilevel contextual barriers through systematic training programs, consultation-based service models, and improved medical-school communication protocols. [ABSTRACT FROM AUTHOR]
Copyright of Language, Speech & Hearing Services in Schools is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: "I Can't Do It All, Even Though I Want To": A Qualitative Investigation of Implementation Barriers and Facilitators for School-Based Speech-Language Pathologists in Concussion Management.
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  Data: <searchLink fieldCode="JN" term="%22Language%2C+Speech+%26+Hearing+Services+in+Schools%22">Language, Speech & Hearing Services in Schools</searchLink>. Apr2026, Vol. 57 Issue 2, p616-633. 18p.
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  Data: *<searchLink fieldCode="DE" term="%22Speech+therapists%22">Speech therapists</searchLink><br />*<searchLink fieldCode="DE" term="%22Re-entry+students%22">Re-entry students</searchLink><br />*<searchLink fieldCode="DE" term="%22Diffusion+of+innovations%22">Diffusion of innovations</searchLink><br />*<searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br />*<searchLink fieldCode="DE" term="%22Speech-language+pathology%22">Speech-language pathology</searchLink><br />*<searchLink fieldCode="DE" term="%22Clinical+competence%22">Clinical competence</searchLink><br />*<searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br />*<searchLink fieldCode="DE" term="%22Health+promotion%22">Health promotion</searchLink><br />*<searchLink fieldCode="DE" term="%22School+health+services%22">School health services</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+of+human+services+programs%22">Evaluation of human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Judgment+sampling%22">Judgment sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Sound+recordings%22">Sound recordings</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Evidence-based+medicine%22">Evidence-based medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+concussion%22">Brain concussion</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Purpose: The purpose of this study was to examine implementation barriers and facilitators related to evidence-based concussion management among school-based speech-language pathologists (SLPs). Using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, we explored how innovation, recipient, context, and facilitation factors influence SLPs' ability to bridge the know-do gap in return-to-learn (RTL) care for students with concussion. Method: We conducted qualitative semistructured interviews with 10 schoolbased SLPs purposively selected to reflect varying confidence levels regarding concussion management using a framework-informed hybrid deductive-inductive approach. The i-PARIHS framework guided interview development and thematic analysis to identify barriers and facilitators across framework constructs. Results: Implementation barriers and facilitators mapped to all four i-PARIHS constructs. Innovation barriers included limited awareness of RTL protocols (only one of 10 participants knew district protocols) and assessment challenges in establishing baselines and differentiating concussion-related difficulties. Recipient facilitators encompassed professional growth mindset and consultation model preferences, with nine of 10 participants expressing confidence in providing concussion services despite acknowledging knowledge gaps. Context was the primary barrier domain, involving resource constraints including large (up to 150 students) or complex caseloads, high workload demands, and communication gaps between medical and educational settings. Facilitation included peer networks as primary knowledge sources, but limited access to concussion-specific continuing education created barriers. A cross-cutting professional growth mindset demonstrated SLPs' readiness to participate in RTL implementation despite current limitations. Discussion: While SLPs possess strong individual characteristics supporting RTL and concussion care delivery, significant organizational barriers limit evidencebased concussion care delivery. Implementation strategies should leverage SLPs' growth mindset and peer consultation preferences while addressing multilevel contextual barriers through systematic training programs, consultation-based service models, and improved medical-school communication protocols. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Language, Speech & Hearing Services in Schools is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=192859147
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      – Type: doi
        Value: 10.1044/2025_LSHSS-25-00134
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      – Code: eng
        Text: English
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        PageCount: 18
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    Subjects:
      – SubjectFull: Speech therapists
        Type: general
      – SubjectFull: Re-entry students
        Type: general
      – SubjectFull: Diffusion of innovations
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      – SubjectFull: Qualitative research
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      – SubjectFull: Speech-language pathology
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      – SubjectFull: Clinical competence
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      – SubjectFull: Research methodology
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      – SubjectFull: Health promotion
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      – SubjectFull: School health services
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      – SubjectFull: Evaluation of human services programs
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      – SubjectFull: Judgment sampling
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      – SubjectFull: Evidence-based medicine
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      – SubjectFull: Data analysis software
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      – SubjectFull: Brain concussion
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      – SubjectFull: Psychosocial factors
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      – TitleFull: "I Can't Do It All, Even Though I Want To": A Qualitative Investigation of Implementation Barriers and Facilitators for School-Based Speech-Language Pathologists in Concussion Management.
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              Text: Apr2026
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              Y: 2026
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