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

What is this project about?

Home modification programs have been used to help older adults and individuals returning home following illness or injury safely do the activities that they want and need to do. However, such evidence-based programs have not been explored for people aging with long-term physical disabilities, who may have changing home modification and participation needs over time. Research has shown that building self-management skills can help people with disabilities successfully identify and resolve barriers to participation. Project 3 consists of designing a program to reduce environmental barriers and teach self-management skills to promote participation for people aging with long-term physical disabilities.

Project goals

  1. Use feedback from focus groups and interviews to decide what changes to make to COMPASS, an evidence-based program focused on self-management and home modification to remove environmental barriers, for use with people aging with long-term physical disabilities. Get feedback from members of our community-based research network. Look at results from Project 2 to see what else we should add to the program.
  2. Adapt the program for people aging with long-term physical disabilities. Pilot test it with three participants. Make more changes to the program based on the results. 

What does this study involve?

We developed a program to teach self-management strategies and remove barriers to participation for people aging with long-term physical disabilities. We used COMPASS, an evidence-based program designed to promote community participation for people returning home after stroke, to inform the program. We held focus groups and key informant interviews with people aging with long-term physical disabilities and professionals who work with older adults and/or people with disabilities to find out what changes need to be made to COMPASS to meet the needs of people aging with long-term physical disabilities. We also got feedback from our community-based research network (see Project 1) and used findings from our cohort study (see Project 2) to develop the new program.

Through the focus groups/interviews and the results of our cohort study, we learned that falls and fall prevention are important topics to address for people aging with long-term physical disabilities. As all people age, we are at greater risk for falls, and falls are also a risk for people with mobility and/or balance impairments. However, falls can be preventable. With all of this in mind, we incorporated elements of HARP, a program that teaches older adults about fall hazards and makes changes to the home environment to reduce those hazards (e.g., improving lighting, securing rugs, installing grab bars in bathrooms), into the new program.

REBIL

The resulting Removing Environmental Barriers to Independent Living (REBIL) program has two main parts: (1) home modifications from a trained occupational therapist to prevent falls and help people aging with long-term physical disabilities perform their daily activities, and (2) teaching self-management strategies to help people aging with long-term physical disabilities problem-solve barriers to participation. 

REBILComponents

Status

Project 3 is complete; the REBIL program has been developed and tested with our initial participants. Project 4 involves testing REBIL with a larger number of people so we can see how feasible it would be for community organizations to use the program. If you are interested in testing REBIL, please contact us at 314-287-4118 or cedarmidwest@paraquad.org.