Development and implementation of a paediatric rehabilitation care path for hard-to-reach families: a case report M. Phoenix*†‡ and P. Rosenbaum*†§ *CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada †School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada ‡KidsAbility Centre for Child Development, Waterloo, ON, Canada, and §Department of Pediatrics, McMaster University, Hamilton, ON, Canada Accepted for publication 21 August 2014 Keywords childhood disability, engagement, hard-to-reach, parents, paediatric rehabilitation knowledge brokering Correspondence: Michelle Phoenix, Institute for Applied Health Sciences, McMaster University, Faculty of Health Sciences, 1400 Main St. West, Room 403, Hamilton, ON, Canada L8S 1C7 E-mail: phoenimp@mcmaster.ca Abstract Service providers, policy makers and researchers are increasingly concerned with service provisions for hard-to-reach families.These are defined as families who are eligible for a service, but are difficult for service providers to identify or engage. In our setting, hard-to-reach families were those who missed appointments without prior notice, a problem that was inefficient for the organization, frustrating for clinicians and did not meet child or family needs. This case report describes the development of a care path to promote engagement with hard-to-reach families (MATCH: Making Alternative Therapy Choices Happen) and its adoption among clinicians within a community-based paediatric rehabilitation centre in Ontario, Canada.The care path was developed and implemented at a pilot site at KidsAbility Centre for Child Development (KidsAbility), which allowed us to tailor the care path using clinician input via questionnaires, and to monitor use of the care path. Following pilot implementation clinicians reported being satisfied with the approach and perceived improved child and family outcomes.The care path was expanded to four service sites using a Knowledge Brokering model. After training, clinicians reported a good understanding of the care path: 87% felt that they would have an opportunity to use it within six months, however only 68% felt ready to use it.Challenges to offering MATCH and continuing training preferences were investigated.The MATCH care path illustrates a practical application of the principles of best-practice for engaging hard-to-reach families, tailored for a specific paediatric rehabilitation setting. Continued research is planned to further define the hard-to-reach families within paediatric rehabilitation, determine how hard-to-reach families view engagement in services, and evaluate the effectiveness of MATCH implementation in reducing missed appointments and promoting family engagement in paediatric rehabilitation services. Background Hard-to-reach families are defined as people who ‘are eligible for assistance, but who do not usually take up the help available, or are difficult for service providers to identify and engage’ (Cortis 2012, p. 1, 1). Conversely, services may be ‘hard-to- access’, indicating that characteristics of families or individuals are not the only factors that determine service use (Barrett 2008; Coe et al. 2008; Winkworth et al. 2010; Boag-Munroe & Evangelou 2012). There are often diverse and complex reasons why a family may not access or engage in education, health or social services Child: care, health and development Case Report doi:10.1111/cch.12194 1 © 2014 John Wiley & Sons Ltd