Document Type


Publication Date


Faculty Mentor

Cristina Smith


Many caregivers of children with disabilities experience chronic pain and related symptoms of cumulative physical trauma. This type of phenomenon is particularly prevalent in developing, low-income countries where environmental accommodations may not be as accessible. A quality improvement program, was conducted as a doctoral capstone project to create resources addressing the physical needs of caregivers of children with disabilities in Nicaragua. Program participants included teachers at a school for children with disabilities and special needs in Nicaragua. The primary project deliverable consisted of conducting an in-person workshop to train the teachers with evidence-based methods for preventing chronic pain and other symptoms of cumulative physical trauma with a focus on protective ergonomics. Program evaluation included a mixed methods design with pre and post intervention focus groups of teachers and school administrators. A post intervention survey was also conducted assessing teachers’ knowledge of content in their native language and with visual imagery to provide clarity. Results included reduction in teachers’ self-reported pain at least one week later as well as increased knowledge and self-efficacy in preventing chronic pain as a caregiver of children with disabilities. Additional video and written resources were developed and made publicly accessible online in Spanish, serving as supplementary educational and support resources for teachers and parents of children with disabilities. These were shared with the teachers incorporating feedback from the focus group and provided to similar schools in Central America via an app Juntos Podemos. This global health project demonstrates promising approaches to address the needs of caregivers for children with disabilities across borders in developing countries through collaborative communication and leveraging technology. Future programs should include increased opportunities for parent engagement in preventative training, further expansion of online and sustainable resources, and ongoing collaboration with in-country community partners to support caregivers of children with disabilities in developing countries.