Community perspectives: evaluation of a community-based rehabilitation program in Southern Belize one year post-implementation.
To examine community perspectives regarding the strengths, weaknesses, opportunities, and threats of a community-based rehabilitation (CBR) program in Toledo District, Belize.



A participatory approach was implemented using the CBR Matrix as a conceptual framework. Semi-structured interviews were conducted with CBR community partners and program participants living in Toledo District. Respondents were recruited until thematic saturation was achieved (i.e., no new themes were identified from subsequent interviews). Interviews were recorded and transcribed verbatim. Recurring themes were identified using thematic content analysis.



Eight CBR community partners and 11 program participants completed interviews. Key strengths of the program included engaging CBR program participants as partners in the decision-making process and raising disability awareness. Key weaknesses of the program included lack of a vocational training program and lack of a systematic approach to identify people with disabilities (PWD) or risk factors for disease and disability.



This participatory evaluation provided PWD, their families, and the community the opportunity to express their needs and priorities regarding CBR. Key recommendations included: (1) developing vocational training programs for PWD; (2) expanding collaborations with craftspeople and other community partners throughout Toledo District; (3) continuing the disability awareness program in schools and the broader community; and (4) strengthening community outreach and data collection. Implications for Rehabilitation Persons with disabilities, their families, and community partners should play an active role in the development, implementation, and evaluation of CBR programs to ensure program goals align with community priorities. The CBR evaluation process should strive to include diverse perspectives that represent the most marginalized populations (e.g., individuals with significant disabilities living in geographically remote areas). The CBR matrix can provide a comprehensive and flexible framework with which to examine community perspectives regarding the strengths, weaknesses, opportunities, and threats of CBR programs.
a Department of Orthopedics and Rehabilitation , University of Wisconsin-Madison, School of Medicine and Public Health , Madison , WI , USA.|b Department of Pediatrics , Johns Hopkins, School of Medicine , Baltimore , MD , USA.
Dawn
D
Magnusson
c SERRC: Alaska's Education Resource Center , Juneau , AK , USA.
Monica
M
Roe
d Department of Physical Therapy and Human Movement Sciences , Northwestern University , Chicago , IL , USA.
Jeff
J
Hartman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001531:Belize; D003153:Community Health Services / Q000458:organization & administration*; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012047:Rehabilitation Centers / Q000458:organization & administration*; D020377:Self Efficacy; D058992:Social Participation; D055815:Young Adult
Disability; empowerment; vocational rehabilitation