Project 3: Adapt an Existing, Effective, Evidence-Based Intervention and Evaluate its Efficacy for People Aging with Long-Term Physical Disabilities in Community Settings

What is this project about?

Evidence-based programs to reduce environmental barriers are unproven among people aging with long-term physical disabilities (PAwLTPD) who may have changing home modification and community participation needs. There is evidence to show that building self-management skills enables people with disabilities to successfully identify and resolve barriers to participation. Project 3 consists of designing an intervention to reduce environmental barriers and teach self-management skills to promote participation for PAwLTPD.

Project Goals

  1. Determine what changes to make to an evidence-based program focused on self-management and removing environmental barriers for use with PAwLTPD. Conduct a series of focus groups with PAwLTPD and community long-term support service providers. Look at the results from Project 2 to see what else we should add to the intervention.
  2. Adapt the program for PAwLTPD. Pilot test the program with three PAwLTPD participants. Make more changes to the program based on the results.

What does this study involve?

We held key informant interviews and focus groups with PAwLTPD and professionals who work with aging and/or disability populations to ensure that the intervention will best meet the needs of people aging with disabilities. We used the findings from these interviews and focus groups as well as information from the following sources to inform the intervention:

      • The COMPASS, an evidence-based intervention designed to promote community participation and reduce environmental barriers to participation for individuals returning home following stroke
      • Our community-based research network (Project 1)
      • Our longitudinal cohort study (Project 2)


The resulting Removing Environmental Barriers to Independent Living (REBIL) intervention has two components: (1) home modifications from a trained occupational therapy interventionist to prevent falls and help PAwLTPD perform their daily activities, and (2) self-management strategies to help PAwLTPD problem-solve barriers to participation. The final phase of Project 3 is to pilot test the intervention with three PAwLTPD and refine the it based on their feedback.



We have designed the adapted intervention (REBIL) and tested it with two of our three pilot participants.