An exploration of the effectiveness of positive behaviour support in unstructured community settings: A systematic review of quantitative literature

Author: Narelle McCaffrey

McCaffrey, Narelle, 2021 An exploration of the effectiveness of positive behaviour support in unstructured community settings: A systematic review of quantitative literature, Flinders University, College of Nursing and Health Sciences

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Background: There are a high occurrence of behaviours of concern among individuals with disabilities. These can manifest in a variety of ways (e.g. aggressive behaviours, property destruction, sexual behaviours, reduced initiation and symptoms of mood disorders), can have a significant impact on an individual’s quality of life, and may pose risk of harm to themselves or others. Positive behaviour support (PBS) is an evidence-based framework for improving quality of life of individuals, through determining the purpose of behaviours of concern, which inform the implementation of databased strategies that improve the environment, teach functionally meaningful skills, and reinforce desired behaviours.

Aim: To examine the evidence base of community- based PBS interventions in enhancing quality of life and reducing behaviours of concern for individuals with disabilities.

Method: A systematic review of literature reporting on quantitative outcomes. Six electronic databases relevant to disability and behavior support were searched between 1980 and 2018. Citation indexes and hand searches of identified articles were also screened for relevance, and articles selected for full-text review were independently considered by two reviewers. Papers included in this review were analysed using the McMasters critical appraisal tool for quantitative studies.

Results: Sixty-six articles were identified and after duplicates were removed and fifty-one were assessed for relevance, twenty were included for review. A majority of studies were weak in design, however critical appraisal determined that the articles were of good quality.

Conclusion: Due to limited research and high evidence studies, no conclusions can be drawn regarding the efficacy of community-based PBS interventions in unstructured community settings. It is suggested that effective interventions are those where comprehensive assessments were conducted to understand the purpose of BOC. This understanding informed person-centered PBS plans that were mindful of cultural differences and values held by the individuals and their families.

Keywords: Positive Behaviour Support, behaviours of concern, disability, community

Subject: Disability and Rehabilitation Studies thesis

Thesis type: Masters
Completed: 2021
School: College of Nursing and Health Sciences
Supervisor: Dr Alinka Fisher