Transcript Slide 1

Research on Assistive Technology Reuse
Outcomes and Effectiveness
Lindsey Bean-Kampwerth, OTD, OTR/L, Joy Kniskern, Principal Investigator, Pass It On Center
Contributors: Kerri Morgan, Carla Walker, Kim Walker, Aimee Duplantis, Melissa Najarian
BACKGROUND
QUANITATIVE AT REUSE RESEARCH EXAMPLE
QUALITATIVE RESEARCH EXAMPLE
BEYOND OUTPUTS TO OUTCOMES
Outputs are raw data, such as numbers of device distributed or received.
Outcome is a level of performance, or achievement. For example, how did
the device affect the persons participation in daily activities?
BACKGROUND
The framework of this project was the Institute of Medicine’s Enabling-Disabling Process. When a person does
not have an impairment there is a good interaction between the person and their physical, social and work
environment. When the person has an impairment, the environment does not interact as well with the person and
the person can not fully do their occupations. To improve the interaction between the person and environment
there are two options that can be done together or individually. Option 1 is functional restoration. Functional
restoration focuses on improving the person, such as increasing endurance, strength, or ROM. Option 2 is
changing the environment by adding personal assistance, changing the physical environment or adding assistive
technology, which is the focus of Assistive Technology Reuse.
PURPOSE & AIMS
The purpose of this project was to develop and implement an outcome measure to evaluate the effectiveness of
Paraquad’s Assistive Technology Reutilization Program on personal care, participation, and satisfaction with AT
and services. The specific aims were to develop an outcome measure to track the effectiveness of Paraquad’s AT
Reutilization Program and to pilot the outcome measure with recipients of the program to examine if the
consumer is using the AT they received from the program, if they are participating using the AT in Personal care
and Community activities, and to finally examine the services of the program by finding gaps in the program and
the satisfaction of the clients with the program. To do this the study had 3 phases.
METHOD
Phase one included item development for the AT reutilization survey. This included an extensive literature review
and reviewing prior assessments. Phase two included qualitative research using focus groups. These groups
were held to establish content validity of the survey items and how Paraquad’s participant reviewed the overall
program. Phase three included a retrospective quantitative study using the AT reutilization survey.
RESULTS
The final survey consisted of The Characteristics of Respondents (CORE) which is used to collect demographic,
such as income & benefits; The Participation Survey (PARTS/G) is used to measure the participation of people
who use assistive technology. It has 20 activities that stand on their own because each has established internal
consistency and test-retest reliability. (Gray, Hollingsworth, Stark, & Morgan, 2006); and The Quebec User of
Evaluation of Satisfaction with Assistive Technology (QUEST) is a measurement of satisfaction with the AT device
and services. (Demers, L., Monetti, M., Lapierre, Y., Arnold, D.L., & Wolfson, C., 2002)
The focus group recommendations were to include items related to falling, specify questions are only about their
AT reuse device, clarify the activity definitions and select activities that were relevant to AT use. The suggestions
were used to improve the survey.
The results of the final retrospective surveys included 34% of the 338 surveys being returned. The demographics
are below. Approximately 80% were satisfied or highly satisfied with their AT reuse device and device services.
Thirty five respondents said they have fallen in the past month. Of that, 35 people 34.3% and 20% said that falls
limited their participation a moderate amount and a great deal. Then 26.5% of participants said that the AT
prevented them from falling most of the time and 35.3% said all of the time. One question in the survey asked,
“With the device you received from the program, the activity is____” then they could rank it on a likert scale,
impossible to very easy. There was the same question except it asked “without the device you received from the
program”. Taking the results from these two questions the means where measured, using a repeated measures t
test to do this. There was statistical significance with AT and without AT for the 3 activities. See the graph below.
BACKGROUND
The International Classification of Functioning, Disability, and Health (ICF) is formatted
into two parts – functioning & disability and contextual factors.
Functioning and disability are further separated into components called body functions
and structures (this takes into account a person's strength or mobility). Activities and
participation deal with the involvement in a life situation. Please see the diagram
below.
PURPOSE & AIMS
The purpose of this study was to gather more information about people’s use & nonuse of reused devices.
METHODS
Forty participants were contacted by telephone. Each participant had took part in a
previous AT reuse study. While they were on the phone a semi-structured interview
was completed. They were asked initial questions and then the remaining questions
were open-ended. All of the interviews were transcribed and sorted into two groups;
one group used their AT reuse device and the other had stopped using their reuse
device. Transcription example is below.
RESULTS
[My chair] doesn’t just help me. It makes it possible for me to do tasks.”
Power wheelchair user
D4: Mobility, D6: Domestic life
TYPES OF RESEARCH
Qualitative research is concerned with subjective, narrative information,
which typically is obtained under less structured conditions.
Quantitative research involves measurement of outcomes using numerical
data under standardized conditions.
Case Study, or case series, may consist of a description of one or several
patients, to document unusual conditions or the effect of innovative
interventions.
Surveys or Questionnaires are often used to collect descriptive information
from small and large groups.
MEASUREMENT
Reliability - the extent to which a measurement is consistent and free from
error
Validity - ensures that a test is measuring what it is intended to measure.
PHASE V
Communication
Report findings
Suggestions for
further study
PHASE I
Identify the Research
Question
Identify the
research problem
Review of literature:
theoretical framework
PHASE IV
Data Analysis
Identify variables
Interpret
findings
Analyze Data
PHASE II
Design the
Study
Design the
protocol
Choose a
sample
State Hypotheses
Specify purpose
PHASE III
Methods
Difficulty Average
Foundations of Clinical Research: Application to Practice, Portney & Watkins
Least Difficult
Gender
Without AT
Income
Female 72.6%
Research is important to assistive technology reuse for a number
of reasons. First, research directly influences the program and
services, then in return the program and services directly influence
the direction of the research. Second, research is helpful in getting
funding and showing exactly how an Assistive Technology Reuse
program helps a person. Third, research increases awareness and
promotes the idea of Assistive Technology Reuse. Lastly, he
research can also show how Reuse programs support the “Green
Initiative”, which could be another possible funding store.
International Classification of Functioning, Disability, and Health (IFC)
Functioning
& Disability
Body
Functions and
Structures
Activities and
Participation
Contextual
Factors
Environmental
Factors
Personal
Factors
Most Difficult
Collect Data:
Reduce data
WHY IS RESEARCH SIGNIFICANT TO
AT REUSE?
Well it’s the only way I can bathe, so [the shower bench] is vital.”
Transfer bench user
D5: Self-care
Race
Black
White
Impairment
Mobility
Visual
Mental Health
Cognitive
Hearing
$0-$14,999
56.4%
Benefits
47.9%
47.0%
93.2%
35.0%
29.9%
17.1%
13.7%
Social Security
84.6%
Medicaid
58.1%
Medicare
54.7%
Age
28-93 Mean 56.0
Currently Use
Yes
79.5%
Moving Around Your Home
With AT
Leaving Your Home
Leisure Activities
D4: MOBILITY
d465 moving around
using equipment
Moving the whole body
from place to place, or
on any surface or space,
by using specific devices
designed to facilitate
movement or create
other ways of moving
around… or moving
down the street in a
wheelchair or walker
Codes
d410 changing basic body position
d415 maintaining a body position
d420 transferring oneself
d430 lifting and carrying objects
d435 moving objects with lower
extremities
d440 hand and arm use
d450 walking
d455 moving around
d465 moving around using equipment
d470 using transportation
d475 driving
printed by
www.postersession.com