ICF-Based Interdisciplinary Case Management for Individuals With Disabilities

Application of the International Classification of Functioning, Disability, and Health (ICF) on Interdisciplinary Case Management for Healthcare Service Delivery for Individuals With Disabilities

This study evaluates whether an interdisciplinary case management approach based on the International Classification of Functioning, Disability and Health (ICF) and the Rehab-Cycle® framework can improve rehabilitation outcomes for adults with intellectual disabilities receiving community-based rehabilitation services.

A total of 120 adults with mild to moderate intellectual disabilities will be recruited from community rehabilitation services and randomly assigned to either an ICF-based interdisciplinary case management group or a conventional care management group. Participants in the ICF-based group will receive coordinated assessments, goal-setting, intervention planning, and outcome evaluation conducted by an interdisciplinary rehabilitation team. Participants in the control group will continue to receive standard services delivered through conventional care management practices.

The study will assess changes in functioning, activity participation, quality of life, life satisfaction, and rehabilitation team effectiveness. The findings will help determine whether ICF-based interdisciplinary case management can provide more personalized, coordinated, and effective community rehabilitation services for individuals with intellectual disabilities.

The International Classification of Functioning, Disability and Health (ICF), developed by the World Health Organization, provides a biopsychosocial framework for understanding functioning and disability by integrating body functions, activities, participation, environmental factors, and personal factors. Although the ICF framework has been increasingly promoted for rehabilitation and social service planning, its application in community-based disability services remains limited. This study aims to evaluate the effectiveness of implementing an ICF-based interdisciplinary case management model inspired by the Rehab-Cycle® framework in community rehabilitation services for individuals with intellectual disabilities.

The study will employ a randomized controlled trial with pre-intervention and post-intervention assessments. One hundred and twenty adults aged 18 to 60 years with medically confirmed mild or moderate intellectual disabilities will be recruited from community-based rehabilitation facilities operated by participating non-governmental organizations. Participants will be randomly allocated to either an ICF-based interdisciplinary case management group (n=60) or a conventional care management group (n=60). In addition, approximately fifteen rehabilitation professionals, including social workers, occupational therapists, physiotherapists, speech therapists, nurses, and clinical psychologists, will participate in the interdisciplinary service delivery process.

The intervention will be developed according to the Rehab-Cycle® process. First, a Neurodevelopment Core Set for Intellectual Condition will be established through an expert consensus process using relevant ICF core sets and the Delphi method. The selected ICF categories will guide interdisciplinary assessment and rehabilitation planning. Participants in the intervention group will undergo ICF-based assessment, development of individualized functioning profiles, interdisciplinary goal setting, coordinated intervention planning, and ongoing case review. Participants in the control group will receive conventional rehabilitation services, with assessments and interventions provided independently by different professionals without formal interdisciplinary ICF-based planning.

The primary purpose of the intervention is to improve functioning and participation through coordinated interdisciplinary rehabilitation management. By identifying participants' strengths, limitations, environmental barriers, and facilitators, the interdisciplinary team will establish mutually agreed rehabilitation goals and implement individualized interventions tailored to each participant's needs. Regular interdisciplinary meetings will be conducted to review progress and modify intervention plans as needed.

Outcome measures will evaluate functioning using selected ICF Core Set items covering body functions, activities and participation, and environmental factors. Additional outcomes will include life satisfaction as measured by the Satisfaction With Life Scale (SWLS), quality of life as measured by the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and interdisciplinary team effectiveness as measured by the Provider-Perceptions of Team Effectiveness (Provider-PTE) scale. Outcomes will be assessed before and after the intervention period.

The study hypothesizes that participants receiving ICF-based interdisciplinary case management will demonstrate greater improvements in functioning, participation, life satisfaction, and quality of life than those receiving conventional care management. It is also expected that healthcare professionals implementing the ICF-based approach will report enhanced interdisciplinary team effectiveness. The results will contribute evidence regarding the feasibility and effectiveness of integrating the ICF and Rehab-Cycle® frameworks into community-based rehabilitation services and may inform future disability and rehabilitation service planning in Hong Kong and other settings.

Inclusion Criteria:

1. between the age of 18 and 60 years old,
2. intellectual disability with mild grade (IQ 50-69) or moderate grade (IQ 35-49) as confirmed by medical doctors,
3. ability to communicate verbally in Cantonese or English.

Exclusion Criteria:

1. acute and unstable medical conditions (such as seizures),
2. Current or recent diagnosis of severe psychiatric disorders (e.g., active psychosis, major depressive episode within the past 12 months, or other conditions that significantly impair participation)

Their caregivers will provide proxy consent if the participants with intellectual disability were unable to give the informed consent.