R-1: Evolution of Measures of Participation and Environmental Facilitators and Barriers to Participation

Washington University in St. LouisDavid B. Gray, Ph.D.Holly H. Hollingsworth, Ph.D.Jessica L. Dashner, OTD OTR/L

MICL Advisory MeetingNovember 18, 2009

Post Policy Change

Pre Policy

Change

Hypothesized Change In SocialParticipation by People With Disabilities:

Pre and Post Social Policy

Change in Social PolicyUSA - ADA

UN - Convention on the Rights of

People with Disabilities People

with Disabilities

People without Disabilities

Measures

Objective

Environment CRI pending

Environment CHEC

Subjective

General Demographics CORE

Participation PARTSM, PARTS/G

Environment - FABS/M

Participation & Environment SPARC

Measures

Objective

Environment CRIPending

Environment CHEC

MeasuresObjective

Environment CRI

PendingEnvironment CHEC

MobilityGeneral Buildings

Restaurants

Doctor’s Offices

Exercise Facilities

Houses of Worship

Grocery StoresPending

VisionGeneral

Buildings

Restaurants

Doctor’s Offices

HearingGeneral

Buildings

Restaurants

Doctor’s Offices

Developed with MICL Funds H133B060018 MICL, University of Kansas, Glen White, Ph.D., PI

CHEC: Assessment Approach Do people with a

mobility limitation get in, do what they need to do and get out without much difficulty?

Currently being expanded to people with low vision and hard of hearing.Expansion made possible with MICL Funds H133B060018 MICL, University of Kansas, Glen White, Ph.D., PI

CHEC – Restaurant: Feature & Item Development

◦ In three separate focus groups, a total of 42 impairment-specific features were described 14 Mobility 15 Vision 13 Hearing

◦ To assess restaurants for the presence or absence of these features, a total of 53 test items were developed 17 Mobility 20 Vision 16 Hearing

Developed with MICL Funds H133B060018 MICL, University of Kansas, Glen White, Ph.D., PI

CHEC-R Utility StudyOccupational Therapy Student Group (n = 4)

Community Disability Consultant Group (n = 4)

CHEC-R Training Establish inter-rater

reliability (r ≥ 0.90) Assess 10 restaurants

Send CHEC-R report Reassess after 3

months

CHEC-R Training Establish inter-rater

reliability (r ≥ 0.90) Assess 10 restaurants Advocate for change:

speak with manager, write a letter, etc.

Send CHEC-R report Reassess after 3

months

Developed with MICL Funds H133A060089 University of Missouri, James de Jong, PI

MeasuresSubjective

General Demographi

cs CORE

Participation PARTS/M & PARTS/G

Environment FABS/M

Evolution of Participation MeasuresPARTS/M

Mobility Impaired & LimitedCDC Funded 1998 – 2000Components Temporal, Evaluative, Health and

SupportPaper and Pencil

Psychometrics Published

PARTS/G Expansion of PARTS/M to Low Vision & Hard of Hearing

Added – Directed by, Control over, Difficult of, Time in Participation and more

NIDRR Funded 2007 - 2011 Planned sample size 1200, Psychometrics & Utility Studies

PARTS/MNIH Funded 2003 – 2007

Computer Navigated Item Sequencing Web Based

MeasuresSubjectiveParticipatio

n PARTS/G

Dressing 1Bathing 1

Bladder Care 1Bowel Care 1

Meals 1

Move Inside Home 1Leave Home 1

Vacations

Work Inside Home 1Exterior Maintenance 1

Parenting 1Intimacy

Employment 1Volunteering 1

Money Management 1

Community Activities 1Religious Activities 1

SocializingLeisure Activities 1Active Recreation

Education 1Exercising 1

Communication: Receptive 1

Communication: Expressive 1

Mobility Vision Hearin

gGroups

Personal Care Domain Mobility Domain Domestic Domain

Major Life Area DomainInterpersonal Domain

Community Domain

Changes to PARTS/G – ADDEDDirected Participation 1 Participation areas Evaluation – Control Communication ExpressiveImpairments and limitations of Communication Receptive Low Vision & Hard of Hearing ExercisePain & Fatigue Questions Education Paid & Unpaid Help Frequency of HelpDeveloped with Funds from

H133B060018 MICL, University of Kansas, Glen White, Ph.D., PI; NCMRR/NIH -1R21HD045855 Washington University, David B. Gray, Ph.D., PI; H133A060089 University of Missouri, James de Jong, PI

PARTS-G: Internal Consistency and Test Retest

Reliability

Measures

Subjective

Environment SPARCHomeGrocery Store

Pharmacy

House of Worship

Restaurants Homes of Family/FriendsLarge Stores

Gas Stations

Doctor's Office

Museums/ Landmarks

Public Parks

Beauty Salon/ Barber Shop

DMESports Arenas

Movie Theaters

Shopping Malls

Transportation

Exercise Facilities

Mobility Vision Hearin

g

Work, Volunteer or Education

Participation HIGH

Groups

Participation

MODERATE

Participation LOW

Developed with Funds from H133B060018 MICL, University of Kansas, Glen White, Ph.D., PI; NCMRR/NIH -1R21HD045855 Washington University, David B. Gray, Ph.D., PI; H133A060089 University of Missouri, James de Jong, PI

Next Steps Use CHECs to objectively assess influence of

community interventions CIL and other advocacy groups

Use SPARC to subjectively assess influence of community interventions CIL and other advocacy groups

Use PARTS/G to survey consumers who receive individual services

Use CHECs, SPARC, PARTS/M and FABS/M to assess social policy changes