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R-7: Developing a Health Promotion Assistance Tool

Methods, Sample, Measurement, Implementation and Data Collection, 
Data Analysis

We will conduct the Health Promotion Assistance Tool Development Project in two phases.

Phase 1: Design Needs Assessment

We will conduct a national needs assessment survey to determine the type of information and format for delivery that will be most useful for staff. The needs assessment requires two steps: 

  • Step 1 will involve qualitative interviews with leaders in the field, including our Consumer Empowered Team (CET), to develop parameters of both content and format.
  • In Step 2 we will survey approximately 200 staff in CILs and ADRCs with an online survey to guide us in developing the most sustainable format and prioritizing content of material to include in the Health Promotion Tool.

Based on these findings, the remainder of the year will be spent in designing and populating a Health Promotion Tool to enable staff to generate individualized, targeted health information for consumers Design: We will develop a computerized database that links to the wide array of existing health promotion materials. Our intent is to make these materials more accessible and meaningful to consumers. Our tentative topic areas (to be changed subsequent to our needs assessment) include:

1. Knowledge-based modules for CIL and ADRC staff:

a) What is a health disparity? What are health disparities among people with disabilities?
b) What are the barriers contributing to these disparities?
c) What can IL/ADRC staff do to address health disparities?
d) What should I know about the types of chronic diseases consumers may have?
e) What should I know about the health care system?
f) What should I know about preventive care? 
g) How do I use the Health Promotion Assistance Tool?
h) Add or revise modules specific to aging 
i) Add or revise modules based on feedback

2. Health Promotion Assistance Tool (a database tool):

a) Uses a decision tree to produce recommended actions for individual consumers based on (a) primary disability, (b) health conditions, and (c) other distinguishing factors. The database will contain links to existing sites/materials providing supports, (e.g., questions to ask the doctor, schedules for check-ups, etc). 

b) Provides individualized planning tool for consumer to support preventive care and wellness goals. The tool will provide a rubric for the staff member and consumer to develop short-term goals for health promotion (i.e., about 3 months), and to create a Goal Attainment Scale to enable the consumer and staff member to have an evidence-based tool for measuring achievement of health goals. The rationale for a short-term goal is to provide opportunities for visible progress and thus to develop a sense of accomplishment in consumers.

Phase 2: Development 
A key element in design research is the iterative testing process, in which users of our product will test and provide feedback over a series of trials and revisions of the product. Our goal is to create a Health Promotions Assistance Tool that is (a) useful and relevant to needs of both consumers and staff who are supporting them; (b) efficient in terms of its ease of incorporation into the existing routines and interactions of staff and consumers; (c) easy to implement with fidelity; and (d) effective in terms of showing promise of beneficial outcomes for consumers.

We will recruit six programs over a two year period and will work with two programs as a time in iterative trials, for a total of three trials. Each program pair will consist of one CIL and one ADRC. Within each program, we will recruit a minimum of 2 staff members to receive training on the use of the Health Promotions Tool. These staff members in turn will recruit five consumers each, purposively sampled to achieve diversity. (N for each trial: 2 programs x 2 staff members x 5 consumers = 20). Thus, the total N across the three trials of the development phase will be 60.

Each trial will require six months in total, with a two month period between each trial for revision of the model and data analysis. Following are the tasks for this trial/revision sequence:

Trial 1 timeline – 6 months total 
a) Recruit staff and provide training (1 month) 
b) Recruit consumers and conduct pre-intervention measures; set personal goals for Goal Attainment Scale (2 months)
c) Conduct intervention trial, use fidelity checklists to monitor completion (3 months) 
d) Conduct evaluation (ratings of GAS scores), post-intervention measures (1 month) 

Iteration 1 revision – 2 months – utilize results, confer with CET, and select SCAP members; revise materials 

Trial 2 timeline – 6 months total 
[Repeat Trial 1 timeline]

Trial 2 revision – 2 months 

Trial 3 timeline – 6 months total 
[Repeat Trial 1 timeline] 

Knowledge Translation and Dissemination 
Following completion of the final trial, we will: a) Complete analyses and make final revisions of the intervention package (including facilitator’s guide, fidelity/feasibility measures, outcome measures); b) Develop reports of preliminary results, submit manuscripts; and c) Prepare a proposal for further large-scale research to test the efficacy of the intervention.

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