Abstract
Background: Child and youth engagement in paediatric rehabilitation is crucial for achieving health outcomes and sustaining the child’s interest and motivation. To date, limited evidence exists regarding rider engagement within therapeutic horse riding (THR), an intervention that incorporates horses to support the wellbeing of individuals experiencing disability. Therefore, it is necessary to explore engagement within the THR context to understand factors and processes that enable optimal rider engagement.
Aim: To explore how rider engagement within the therapeutic horse-riding landscape at the New Zealand Riding for the Disabled Association (NZRDA) can be optimised. However, the research focus evolved toward facilitating staff awareness and understanding of rider engagement and engagement strategies, enabling staff to optimise rider engagement through their practice. Therefore, a range of educational resources for coaches and volunteers was co-developed to support engagement-promoting behaviours.
Methodology: Three Participatory Action Research (PAR) cycles, employing a range of participatory, qualitative research methods, were undertaken within a transformative research paradigm in partnership with a Core Research Group comprising NZRDA leadership.
Methods: During PAR Cycle 1, staff interviews, surveys with staff, caregivers, and riders, and an online discussion with the Core Research Group occurred. In PAR Cycle 2, data included fieldnotes from THR sessions, a staff brainstorming task, surveys administered to staff, caregivers, and riders, and two online discussions. A coach workshop and re-coding of Cycle 1 data also took place. Cycle 3 involved staff surveys, a staff focus group, two online discussions, and another coach workshop. Data across all cycles were analysed using content analysis.
Results: PAR Cycle 1 data revealed insights to enhance how staff foster rider engagement and focused on themes of the THR environment, offering the appropriate level of challenge, fostering relationships, and supporting riders’ emotional and physical wellbeing. Based on these findings, PAR Cycle 2 aimed to raise staff members’ awareness and understanding of rider engagement. Therefore, within PAR Cycle 2, various engagement tools and resources for staff members were developed in alignment with the Behaviour Change Wheel, to offer learning, discussion and reflection opportunities. Another key finding of PAR Cycle 2 was the importance of an individualised, relationship- and context-based approach to rider engagement and engagement strategies, with the facilitation of rider ownership as a crucial element. PAR Cycle 3 results suggested that the developed resources did change staff members’ behaviours and attitudes and made them more aware of rider engagement and how to support it. Staff members also noted the importance of incorporating real-life examples and reminders to enhance their awareness and understanding, and to foster discussion opportunities and knowledge sharing among team members. Since there is no one-size-fits-all approach to rider engagement and engagement education, staff training and organisational change processes are needed to ensure context, relationships and preferences are considered.
Conclusion: This thesis explored how rider engagement can be optimised, with the transformative PAR process centring on staff members’ awareness, understanding, mindset shifts, and behaviours that promote engagement to effectively enhance rider engagement. It concludes that supporting rider engagement required a multi-level approach, involving a dynamic process across different NZRDA levels, i.e., organisational, group, and ultimately staff member–rider levels. This thesis’s findings provide a basis for future THR staff training and highlight the importance of considering the collective wellbeing of all stakeholders involved in addressing rider engagement. It also prompts reflection on the challenges and facilitators of fostering ownership among children and youth with disabilities. Findings may be of value to a range of THR providers, offering a starting point for considering their own learning, discussion and reflection opportunities leading to optimised rider engagement processes.