Purpose. To explore the interactions between child and parents psychosocial factors and team integration variables that may explain improvements in physical dimensions of the PEDS QL quality of life of children with complex needs after 2 years. Methods. In this 2-year study, parents were identified by the Children's Treatment Network. Families were eligible if the child was aged 0–19 years, had physical limitations, resided in either Simcoe County or the Region of York, Ontario, and there were multiple other family needs. Regression analysis used to explore associations and interactions; . Results. A child's physical quality of life was affected by interacting factors including child's behavior, parenting, and integrated care. Statistically significant interactions between team integration, processes of care, and child/parent variables highlight the complexity of the rehabilitation approach in real-life situations. Conclusions. Rehabilitation providers working with children with complex needs and their families should also address child and parent problematic behaviors. When this was the case in high integrated teams, the child's physical quality of life improved after two years. 1. Introduction Integration is the goal of many human service organizations, policymakers, theorists, and professionals. Integrated health services hold the promise of improved efficiency, capacity, performance/quality, cost-effectiveness, and enhanced working environment with improved communication and cooperation [1, 2]. The Canadian Council on Health Services Accreditation (2006) offers a definition of integration which encapsulates the many definitions found in the limited health literature “…services, providers, and organizations from across the continuum working together so that services are complementary, coordinated, in a seamless unified system, with continuity for the client” [3]. In Ontario, there are increasing efforts to promote health services integration especially in Local Health Integration Networks (LHINs). In a synthesis of reviews of effective, efficient human services for school-aged youth, Browne et al. [4] concluded that comprehensive interventions address multiple risk and protective factors, operate across multiple environments such as school, home, and community, and provide a mix of universal, targeted, and clinical services that are often proactive. This can be achieved by providing integrated care coordination (adjusting one provider’s care because of what other providers do) or collaboration (jointly planning the type of care, provided how and by
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