Cerebral Palsy Clinical Trial
Official title:
Evaluation of Project TEAM (Teens Making Environmental and Activity Modifications) - Effectiveness, Social Validity and Feasibility
The purpose of this study is to determine the extent to which Project TEAM (Teens making Environment and Activity Modifications) is an effective, socially valid, and feasible intervention that prepares youth with developmental disabilities ages 14-21 to respond to environmental barriers and increases participation in school, work, and the community. Project TEAM is a manualized intervention co- facilitated by a disability advocate and a licensed professional. The intervention includes eight group sessions and two experiential learning field trips. In addition, young adults with disabilities serve as peer mentors on field trips and contact youth weekly to support attainment of goals. Project TEAM outcomes are to: increase youths' knowledge of environmental factors and modification strategies; reduce the impact of environmental barriers on participation; increase self-efficacy and self-determination; and increase participation in a personal activity goal in the area of education, employment, or community life. This project builds on a participatory action research partnership with disability community stakeholders to address the following research questions: (1) To what extent do youth with disabilities participating in Project TEAM achieve intervention outcomes? (2) What are the characteristics of youth with disabilities who most benefit from Project TEAM? (3) To what extent are goals, procedures, and outcomes of Project TEAM important and acceptable (socially valid) to youth with disabilities?.
Disparities in school, work, and community participation impact the 15% of youth in the
United States estimated to have a developmental disability. A growing body of literature
suggests disparities in participation are due to barriers in the physical and social
environment. Practitioners and advocates have developed skill and advocacy interventions in
an attempt to increase the participation of youth with disabilities. Yet none of these
interventions focus specifically on acquiring the problem-solving skills needed to identify
environmental barriers and generate modification strategies to resolve barriers to
participation. Research indicates that there is a vital need to develop manualized,
theory-based interventions that empower youth with developmental disabilities to identify and
advocate for environments that support their participation in school, work, and the
community.
The purpose of this study is to determine the extent to which Project TEAM is an effective,
socially valid, and feasible intervention that prepares youth with developmental disabilities
ages 14-21 to respond to environmental barriers and increases participation in school, work
and the community. Project TEAM is a manualized intervention co- facilitated by a disability
advocate and a licensed professional. The intervention includes eight group sessions and two
experiential learning field trips. In addition, young adults with disabilities serve as peer
mentors on field trips and contact youth weekly to support attainment of goals. Project TEAM
outcomes are to: increase youths' knowledge of environmental factors and modification
strategies; reduce the impact of environmental barriers on participation; increase
self-efficacy and self-determination; and increase participation in a personal activity goal
in the area of education, employment, or community life. Pilot research showed that Project
TEAM participants (N=20) had a significant increase in knowledge of environmental barriers
and modification strategies (t(19) = -6.37, p=.00), and 57% increased their participation in
one activity.
This project builds on a Participatory Action Research (PAR) partnership with disability
community stakeholders to address the following research questions: 1) To what extent do
youth with disabilities participating in Project TEAM achieve intervention outcomes? 2) What
are the characteristics of youth with disabilities who most benefit from Project TEAM? 3) To
what extent are goals, procedures, and outcomes of Project TEAM important and acceptable
(socially valid) to youth with disabilities? This project uses a multi-site,
quasi-experimental repeated measures design with matched controls to evaluate Project TEAM.
Sixty-four youth ages 14-21 with developmental disabilities will participate in Project TEAM
and complete outcome measures at three time points: 2 weeks pre-intervention, 2 weeks post-
intervention, and follow-up 6 weeks post-intervention. A control group of 64 youth, matched
to intervention participant characteristics using a three tiered approach, will complete
outcome measures at time points that correspond with the intervention group. Outcome measures
assess goal attainment (Goal Attainment Scaling), knowledge and application of skills
acquired during intervention (Project TEAM Knowledge Test), changes in participation and
impact of barriers on participation (Participation and Environment Measure- Child &Youth),
self-efficacy (Generalized Self Efficacy Scale), and self-determination (AIR
Self-Determination Scale). Characteristics that may influence the extent to which youth
benefit from Project TEAM will be assessed using a battery of descriptive measures. Outcomes
will be analyzed within and across groups to evaluate the effectiveness of Project TEAM.
Feasibility and adherence to the proposed design will be evaluated using a process
evaluation.
To evaluate social validity, a Youth Research Panel (YRP) of 6 youth with disabilities ages
14-21 and a Consumer Research Specialist will administer a satisfaction survey and focus
group interview to Project TEAM participants. Parents (n= 64) will also participate in
on-line focus groups to evaluate the feasibility and usefulness of Project TEAM. The YRP and
other members of the research team will use an action/reflection process to interpret data
and revise Project TEAM to maximize outcomes for future implementation. The YRP will
disseminate information about Project TEAM to local and national capacity- building
organizations targeted to youth with disabilities. The PI will also disseminate findings to
professionals and the disability community via a website, presentations, and peer- reviewed
journals.
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