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People with disabilities in low and middle-income countries (LMICs) have access to less than 2.5 rehabilitation professionals per million. That means for more than 650 million people, access to rehabilitation is almost non-existent.

Toward an All-Inclusive Jordan was initiated with the objective of decreasing the access gap to rehabilitation in Jordan by providing means of direct services, education, and sustainability of services including occupational therapy, physical therapy, and speech and language pathology.

The project and subsequent research is led by Dr. Rawan AlHeresh, a professor of occupational therapy at the IHP.

toward an all inclusive jordan logo with standing and wheelchair stick people

 

 

Our Focus

Education
Teaching service delivery models of rehabilitation to graduate students in doctor of occupational therapy, physical therapy, speech and language pathology and nursing programs, who then train volunteers and parents in low-to-middle-income countries.
Advocacy
Increasing awareness about the rights of people of disabilities in Jordan. We use social media to combat negative stigma associated with disability.
 

 

Research
We're conducting several research projects tailored to inform service delivery in Jordan, funded by multiple sources, including funds awarded to our Director, Dr. AlHeresh, through MGH's Thomas S. Durant, MD Fellowship for Refugee Medicine. 

 

 

Our Team

Our team spans multiple roles and stretches across continents. It includes 20+ IHP graduate students in multiple disciplines, IHP faculty members, and 30+ contributors in Jordan, including a project manager, rehabilitation volunteers, and community-workers.

Our Stakeholders include: 

 

volunteer group stands for photo in front of building

 

Contact Us for more information or to get involved.

 

a little girl is examined by a volunteer
a little girl stands with help from a volunteer
a little girl uses an exercise ball with help from a volunteer
 

Education

Two main IHP courses are associated with the Toward an All-Inclusive Jordan project.

  • OH-784 Community Based Rehabilitation : This elective course introduces OT and non-OT students to Community Based Rehabilitation, an initiative developed by the World Health Organization to enhance the quality of people with disabilities, their families, communities, and ensure their inclusion and participation in developing countries.
  • OT-885 Advanced Doctoral Experience : A 16-week research intensive experience / sequence of courses which ends with a capstone.

As part of these experiences, students are connected with mothers and community health workers in Jordan who are located either within refugee camps or on the lower socioeconomic spectrum. When worldwide travel allows, students spend 3 months in Jordan working at stations set up to service those with disabilities. There is also a digital conferencing component, where they use Zoom to connect with families in Jordan - the most recent project completed rehabilitation for 8 families.

Dr. AlHeresh structures course activities so students can build training models to train the mothers, school teachers, etc., on what rehabilitation means, what to do, and how to address issues. For PhD students, research projects are built and executed year round to inform the direction of services delivered in the communities we work in. Students work in the field as rehabilitation experts in our year-round pro bono clinics in refugee camps in person and online. We work with numerous community stakeholders to make impactful change.

 

Research

Expanding Global Rehabilitation Services through International Academic-Community Partnerships

More than one billion people worldwide live with a disability, yet rehabilitation professionals are scarce in low- and middle-income countries. Attempts to expand access to rehabilitation services have encountered barriers on multiple levels: limited resources on the systemic level, hierarchies on the professional level, and cultural stigma on the community level. We sought to determine if an academic-community partnership could overcome multiple levels of barriers to expand services for people with disabilities.

Alheresh, R. and Cahn, P.S., 2020. Expanding Global Rehabilitation Services through International Academic-Community Partnerships. Annals of Global Health, 86(1), p.71. http://doi.org/10.5334/aogh.2876

Participation patterns and determinants of participation of young children with cerebral palsy

Understanding participation patterns of young children with cerebral palsy (CP) will enable occupational therapists to tailor family- and child-centred services. This study compares participation patterns and participation barriers of young children with CP with those of typically developing (TD) children. In addition, effect of age and gender on participation were examined as well as child-related determinants of participation for young children with CP.

Saadi A, Al-Rousan T, AlHeresh R. Refugee Mental Health—An Urgent Call for Research and Action. JAMA Netw Open. 2021;4(3):e212543. doi:10.1001/jamanetworkopen.2021.2543

Sustainable support solutions for community-based rehabilitation workers in refugee camps: piloting telehealth acceptability and implementation

The lack of training and education of Community-Based Rehabilitation (CBR) workers poses one of the most significant barriers to receiving effective occupational, physical and speech therapy for individuals with disabilities in Low-to-Middle Income Countries (LMIC), especially in countries with significant refugee populations. The aim of this study was to successfully implement a telehealth support system for CBR workers, evaluate the feasibility and acceptability of this intervention’s implementation among CBR workers in the CBR setting, and further identify strategies to address the deficit of skilled rehabilitation workers in LMIC through technological intervention.

Bria Mitchell-Gillespie, B., Hashim, H., Griffin, M., and AlHeresh, R., 2020. Sustainable support solutions for community-based rehabilitation workers in refugee camps: piloting telehealth acceptability and implementation. Globalization and Health, 16:82 https://doi.org/10.3390/disabilities1040031

Predicting Depression among Jordanian Adults with Disabilities According to the International Classification of Functioning, Disability and Health: A Pilot Study

Individuals with disabilities face marginalization in society and are more likely to experience depression compared to the general population. Despite this, the health system in Jordan is not adequately equipped to screen for or manage depression as a comorbid condition. This study fills in gaps concerning the prevalence of depression and its correlates among Jordanian adults with a physical disability. Professionals in Jordan, including rehab specialists, have a role in both screening for and preventing depression, and this study acts as a point of reference for these professionals. 

Griffin M, Mitchell-Gillespie B, Hashim H, AlHeresh R. Predicting Depression among Jordanian Adults with Disabilities According to the International Classification of Functioning, Disability and Health: A Pilot Study. Disabilities. 2021; 1(4):450-458. https://doi.org/10.3390/disabilities1040031

Epidemiology of Cardiovascular Disease and its Risk Factors among Refugees and Asylum Seekers: Systematic Review and Meta-Analysis 

A social determinant of health, migration, if forced, impacts health negatively in refugees and asylum seekers for several disease outcomes. This is the first systematic review and meta-analysis assessing cardiovascular disease incidence and risk factors among refugees and asylum seekers. 

Al-Rousan, T., AlHeresh, R., Saadi, A., El-Sabrout, H., Young, M., Benmarhnia, T., Han, B. H., & Alshawabkeh, L. (2022). Epidemiology of cardiovascular disease and its risk factors among refugees and asylum seekers: Systematic review and meta-analysis. International Journal of Cardiology Cardiovascular Risk and Prevention,  12, 200126. https://doi.org/10.1016/j.ijcrp.2022.200126 

Community-based Mental Health for Refugees: A Qualitative Study to Inform Intervention Development 

Refugees face significantly worse mental health outcomes compared to the general population within their host country. While there is a strong need for refugee-specific mental health programs, very few exist within the United States. Utilizing Community-based Participatory Research methods, a community-based mental health intervention for refugees is under development. This study shared the in-development intervention with refugees, holding a series of three focus groups to gain feedback on the intervention content and determine acceptability. 

Hillegass, S. (OTD '22), & AlHeresh, R. (2022). Community-based mental health for refugees: A qualitative study to inform intervention development. 2022 North American Refugee Health Conference, Cleveland, Ohio.

Migration and Cognitive Health Disparities: The Arab American and Refugee Case

This study investigates whether year of arrival to the U.S. and birthplace relate to post-migration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life.

Al-Rousan, T., Kamalyan, L., Bernstein Sideman, A., Miller, B., AlHeresh, R., Moore, A., Marquine, M. J., Argeros, G., & Ajrouch, K. J. (2022). Migration and Cognitive Health Disparities: The Arab American and R efugee Case. The journals of gerontology. Series B, Psychological sciences and social sciences, gbac129. Advance online publication. https://doi.org/10.1093/geronb/gbac129