Jeremy Adderley & Teressa Brown

Teressa_Jeremy

Project Title: Testing the Hand Assessment for Multiple Sclerosis

Authors:  Jeremy Adderley, Teressa Brown, Susan Forwell and Sinead Hynes

Introduction: Up to 50% of people living with multiple sclerosis (MS) report physical limitations related to upper extremity function. The Hand Assessment for MS (HAMS) was created to assist clinicians in forming a multidimensional profile of hand function to facilitate development of individualized upper extremity interventions. The assessment includes a self report questionnaire, a goal setting interview, physical observations, and performance assessment.

Objective:
1. To determine the feasibility of administering the HAMS for clinicians and patients.
2. To characterize impaired hand function in a cohort of persons with MS.

Method: Ten people with MS and five occupational therapists will be recruited through MS clinics either in response to a recruitment poster or upon referral by the health care team. MS participants will be administered the HAMS by researchers, then will complete questionnaires related to time expenditure, comfort, and clarity. Participating clinicians will administer the HAMS with their own patients and will comment on its feasibility.  Results from the HAMS will be analyzed to form a profile of hand function within the cohort.

Practice Implications: This study will provide information as to whether the HAMS is an effective and feasible tool for characterizing hand function and guiding intervention in occupational therapy practice.

Conclusions: The HAMS is the first multidimensional performance-based hand assessment created for MS, and thus evaluating its acceptability and feasibility is integral in determining its clinical utility. The HAMS will enable therapists to efficiently form a profile of hand function that will guide client centered interventions.

Amy Pendergast & Andrea White

Amy_Andrea

Project Title: Exploring Well-being and Social Connectedness Through Community Gardening

Authors: Amy Pendergast, Andrea White, & Melinda J. Suto

Rationale: Individuals with Serious Mental Illness (SMI) often experience significant detriments in well-being, including reduced occupational functioning and participation across major life domains contributing to social exclusion.  Therapeutic gardening in mental illness is associated with improvements in well-being, sense of belonging, and participation in occupation; however, no study has explored how community gardening specifically impacts those with SMI living in subsidized housing.  The current study adds to the literature, exploring community gardening as a meaningful and accessible therapeutic occupation that has the potential to promote well-being and social connectedness.

Objective: To describe how the structure, process, and place of urban community gardening influences gardeners’ well-being and social connections.

Methods: This qualitative study forms the final part of a 3-year community-based participatory research project. Six to eight adults with SMI living in supported housing are engaged in a year-round community gardening program designed for this project.  Data collection includes: individual semi-structured interviews, participant observation, personal network maps, and participation mapping.  Thematic analysis of interviews and fieldnotes will contribute to the reflexive process and help to contextualize the findings.

Results: Expected findings include understanding community gardening as a meaningful occupation that promotes well-being and social connectedness through increased social inclusion, participation, and self-efficacy.

Conclusions: Occupational engagement in community gardening fosters a safe, socially inclusive environment for people marginalized by SMI to develop skills, expand interests, and experience belonging to help promote recovery.  As an Occupational Therapy intervention, the activity is inexpensive, open to all abilities, and provides tangible feedback.

Sarah Thompson & Alison Wright

Alison_Sarah

Project Title:  Occupational Therapy Practices for Weight-Shifting

Authors:  Sarah Thompson, Alison Wright, Dr. W. Ben Mortenson, Jeanette Boily, Sandy Leznoff, & Kevin Waldorf

Introduction: Pressure ulcers are a serious health concern for wheelchair users and create significant financial burden on health care systems (Stinson, Gillian, & Porter-Armstrong, 2013). Occupational therapists play an important role in providing clients with weight-shifting education and strategies to prevent pressure ulcers (Macens & Mackenzie, 2011). Although guidelines exist about the frequency with which weight-shifting should be performed, other important practice parameters such as techniques, patient education and self-management strategies are lacking.

Objective: The objective of this study is to explore occupational therapy weight-shifting practices and recommended educational strategies for clients, healthcare staff, and family/caregivers. These factors will be examined across a variety of health care settings including acute care, inpatient/outpatient rehabilitation, home and community care, and residential care.

Methods: Through a web survey of practicing occupational therapists, this study will examine frequency and duration of weight-shifting techniques, how education is conveyed to clients, health care staff and family/caregivers and what evidence is being used to guide occupational therapy practice.

Results/Practice Implications: The researchers will present a picture of current occupational therapy weight-shifting practices to inform future practice guidelines for pressure ulcer prevention.

Clarice Kwok

Clarice

Project Title:  Can developmental coordination disorder be reliably identified in very preterm infants at age 3 years?

Authors:  Clarice Kwok, Margot Mackay, Jennifer A. Agnew, Dr. Anne Synnes & Dr. Jill G. Zwicker

Rationale: Very preterm children (24-32 weeks gestational age) are at high risk for developmental coordination disorder (DCD), a motor disorder that significantly affects daily life and long-term outcomes. The Movement Assessment Battery for Children-2 (MABC-2) is commonly used to identify children with DCD, but the predictive validity of this assessment is unknown in very preterm children at age 3 years.

Objectives: The aims of this study are to determine: (1) if DCD can be reliably identified in preterm children at 3 years; and (2) if MABC-2 scores at age 3 years can predict DCD at 4.5 years of age.

Methods: In this retrospective study, 165 very preterm children (median gestational age: 26 weeks; median birth weight: 814 grams) were assessed at age 3 and 4.5 years with the MABC-2. Children with developmental delay, cerebral palsy, or intellectual impairment were excluded. Data analysis included descriptive statistics to identify significantly different characteristics between children with DCD and children without DCD, logistic regression to determine if the MABC-2 score at 3 years is predictive of DCD at 4.5 years, and cross-tabulations to determine the relationship between MABC-2 scores at 3 years and diagnosis of DCD at 4.5 years.

Results: Significant differences between children with DCD and children without DCD were identified. MABC-2 scores at 3 years of age in very preterm infants is a significant predictor for DCD outcome at 4.5 years with an overall odds ratio was 0.81. Cross-tabulation analysis showed that the MABC-2 has excellent sensitivity (90%) and moderate specificity (69%). The MABC-2 has small to moderate positive predictive value (38%) but high negative predictive value (97%).

Conclusions: The MABC-2 is highly sensitive to identifying very preterm children with DCD but also has many false positives at this age. However, MABC-2 scores reliably predict very preterm children who are NOT at risk for DCD.  Preterm children who score ≤ 5th percentile on the MABC-2 at age 3 are at risk for DCD may benefit from intervention and should be routinely followed to school-age.

Kirsten Ali & Kristi Moyls

Kristi_Kirsten

Project Title:  Cultivating Wellbeing: Community Gardening For People With Serious Mental Illness

Authors:  Kirsten T. Ali, Kristi C. Moyls, and Melinda J. Suto

Introduction: People with serious mental illness (SMI) face marginalization that contributes to isolation, decreased health status, and limited occupational engagement. Gardening is an effective way to address these issues, yet most research is specific to aging adults and lacks an occupational focus. The context of community gardening may naturally promote occupational engagement, participation, and wellbeing, but further investigation is warranted for people with SMI.

Objective: This qualitative study will describe how the structure, process and place of urban community gardening influence the wellbeing and social connections of gardeners living with SMI in supported housing and/or accessing a mental health resource centre.

Methods: Community-based participatory research guides this 3-year, occupation-based study. Six to eight gardeners who have been recruited by the principal investigator attend a weekly horticulturist-facilitated program. Participants engage in shared decision making, structured learning, and supported gardening activities. Data collection focuses on participants’ perspectives and will include semi-structured interviews, participant observation, personal network and participation mapping. Data will be analysed qualitatively, using thematic analysis.

Results: Preliminary research suggests community gardening facilitates wellbeing by creating a place that fosters social connections and a sense of belonging. Supporting community gardening initiatives leads to increased occupational participation amongst people with SMI.

Conclusions: Participation in community gardening is a feasible, sustainable and empowering occupation-based initiative for participants with SMI. Community gardening allows participants to engage in their community, wellbeing and recovery, and to acquire knowledge and skills required to participate in meaningful occupations.

Julie Deveau & Catharine Eckersley

Cat_Julie

Project Title:  Power mobility scooter education and training: Perspectives of scooter users

Authors:  Julie Deveau, Catharine Eckersley, Dr. W. Ben Mortenson, Richelle Emery & Linda Joyce

Introduction: Powered mobility scooters are popular among Canadians because of their affordability and social acceptability. However, scooter-related accidents and injuries are common and few users report receiving formal training (Jancey, Cooper, Howat, Meuleners, Sleet, & Baldwin, 2013). Currently, little research exists on the training experiences of scooter users and the kind of training that they would like to receive. This information could be invaluable in developing or modifying scooter training programs to meet the expressed needs of scooter users.

Objectives: To determine scooter users’ perspectives of their scooter training experience, and their recommendations for potential future training program content and delivery method.

Methods: Three one-hour focus groups were conducted, each with four to seven adult scooter users (fourteen participants total). Discussions focused on the participants’ preferences for training, their experience of learning new skills, and their training successes and challenges.

Results: Three themes were identified: the process of learning functional scooter use (‘learning to drive’), the experience of navigating the environment (‘life is a highway’), and recommendations for scooter training (‘let the good times roll’).

Conclusions: These findings can inform the development of scooter training interventions that are more meaningful to users, thereby possibly reducing scooter-related accidents, improving safe scooter use in the community, and subsequently maximizing scooter users’ community participation.

Larissa James & Janet Shing

Janet_Larissa

Project Title:  Exploring the outdoor hiking experiences using the TrailRider.

Authors:  Larissa James (B.Kin), Janet Shing (B.Kin), W. Ben Mortenson (PhD.), Johanne Mattie (MASc.), and Jaimie Borisoff (PhD.)

Introduction: Activities in outdoor environments are associated with positive effects on health and wellbeing. The TrailRider – a single wheeled chair propelled by two volunteers- enables individuals with mobility impairments to engage in hiking experiences. The TrailRider is used internationally in outdoor accessibility programs in North America, Australia and Japan.

Objectives: To explore the experiences of clients, volunteers and paid staff who are involved with a TrailRider program.

Methods: This ethnographic study used a combination of participant observations and in-depth interviews as a means of data collection. Thematic analysis was ongoing through the data collection process. Participants were recruited from the British Columbia Mobility Opportunities Society (BCMOS) that operates adaptive outdoor programs for people living with disabilities.

Results: Researchers accompanied participants on five day-hikes; follow-up qualitative interviews were also completed. Analysis of observational and interview data indicated three themes: “A Tree-mendous Time” describes how TrailRider users report enjoying the opportunity to explore the great outdoors. “An Uphill Battle” acknowledges the perceived physical and psychological barriers to participation. “Clearing the Path” addresses the perceived areas for improvement to the TrailRider program; this includes increasing awareness, upgrading equipment and improving volunteer commitment.

Conclusion: Findings from this study will be used to help the TrailRider program to develop strategies to mitigate barriers, increase participation, and enhance user and volunteer enjoyment.

Kimberley Jung & Michelle Russell

Michelle_Kim

Project Title:  Innovative Gaming Technology to Promote Wheelchair Skills: Preferences of Older Adults

Authors: Michelle Russell, Kimberley Jung, Ed Giesbrecht, Ian Mitchell, and William Miller

Purpose: To explore the experiences and perceptions of older adults engaging with tablet-based wheelchair training games and inform the development of appealing, accessible, and motivating manual wheelchair skills training games for older adults.

Method: In this qualitative study, a convenience sample of 9 older adult (age 50+), inexperienced manual wheelchair users trialled three different prototype computer-tablet training games designed for in-wheelchair use. Following each five-minute game trial, participants completed the modified Player Experience of Needs Satisfaction (m-PENS) questionnaire. The session concluded with a semi-structured interview exploring player experience, usability of technology, game preferences, and factors affecting motivation. Themes and subthemes were derived from interview data through thematic analysis and further informed by frequency analysis of m-PENS responses.

Results: Two major themes, user experience and game recommendations, were identified. User experience was related to aspects of fun, motivation, frustration, engagement, and personal development. Game recommendations were provided regarding challenge, variety, feedback, graphic appeal, adjustability of settings, and instructions.

Conclusions: Understanding the preferences of older adults is key to developing age-appropriate games that engage users and promote wheelchair skills practice and proficiency. Tablet-based games designed for in-wheelchair use have potential to augment manual wheelchair training provided by occupational therapists.

Marina Khenson & Chelsey Tyler

Marina_Chelsey

Project Title:  Creation of 2nd edition of PleasureAble: A sexual device manual for people with disabilities

Authors: Marina Khenson, Chelsey Tyler, Leslie Houle, Dr. Stacy Elliott & Bill Miller

Introduction: Spinal cord injury (SCI) adversely affects sexual function and can impact one’s self-esteem, self-identity, and quality of life. People with SCI and their partners express a need for sexual rehabilitation and expect clinicians to initiate the conversation; however, clinicians report many barriers that prevent their engagement in this discussion. Consequently, conversations about sexual health seldom occur. In 2009 a resource called the PleasureAble manual was created, which catalogues a range of sexual devices relevant to the needs of people with SCI.

Objective: To revise the PleasureAble manual using feedback from people with SCI, their partners, and clinicians.

Methods: Semi-structured qualitative interviews were conducted with adults with SCI (n=6); partners of people with SCI (n=2); and clinicians with >1 year experience working with SCI (n=5). Participants read the original manual prior to the interview, filled out a questionnaire, and provided feedback about the manual in a semi-structured interview. Interviews were audio recorded and transcribed verbatim. Data were examined using thematic analysis, and themes were member checked with key informants.

Conclusions:  People with SCI and their partners requested additional information on managing psychosocial issues such as communication. Clinicians wanted the revised manual to provide examples on managing conversations around sexuality with clients. All participants reported that they would benefit from more educational resources. Future revisions of the PleasureAble manual would provide people with SCI, their partners, and clinicians with an educational resource which would support sexual rehabilitation and thereby promote enhanced quality of life.

Danelle Fuller & Hina Mahmood

Hina_Danella

Project Title:  Comparison of the standard joystick and JoyBar power wheelchair control

Authors:  Danelle Fuller, Hina Mahmood, Emma Smith & Bill Miller

Introduction: The JoyBar is a scooter-style tiller control for powered wheelchairs that separates speed and direction, requiring minimal fine motor control. Operating a power wheelchair with a standard joystick requires the user to control speed and direction simultaneously, making discrete maneuvers difficult. This pilot study evaluates driving maneuverability and task load associated with using these wheelchair control systems.

Objectives: To  compare the maneuverability of a powered wheelchair using the JoyBar versus a standard operating joystick. We hypothesize that the study procedures will be feasible to implement, and that participants using the JoyBar will score significantly better on maneuverability and report a lower task workload.

Approach: Using a randomized control trial, 24 ambulatory older adults (Age>60), who have minimal wheelchair use experience will be assigned to the intervention (tiller) or control group (joystick) using a randomized table. After 15 minutes of practice using the wheelchair in the assigned condition, both groups will complete two maneuverability tasks (three attempts at each task) using either the JoyBar tiller or standard joystick, as assigned. Scores will be calculated using mean completion time (nearest second) and mean number of errors across the three attempts. A questionnaire will be administered to measure task workload. Data will be analyzed using a T-Test.

Practice Implications: The JoyBar tiller presents as an interesting alternative form of power wheelchair control which may provide better maneuverability for new users.

Conclusion: The results of this study will suggest whether confirmatory studies of effectiveness of the JoyBar tiller are worth pursuing.

Jodie McCormick & Erin Rissling

Erin_Jodi

Project Title:  Teaching methods that promote university students’ mental health and wellbeing

Authors:  Jodie McCormick, Erin Rissling, Michael Lee, Dr. Melinda Suto, Kathleen Lane, & Mineko Wada

Introduction: Diminished mental health among post-secondary students has been linked to high levels of academic stress and affects their ability to succeed in academic occupations. While it is known that teaching methods affect learning, and learning affects academic performance, little is known about which teaching methods support undergraduate student mental health and wellbeing.

Objectives: To identify what teaching methods instructors at UBC use to promote student mental health and wellbeing and reasons underlying those methods.

Methods: Participants for this qualitative study were nominated by undergraduate students as being supportive of student mental health and wellbeing, through completion of a campus-wide survey. Researchers administered semi-structured interviews with nine instructors of the Faculties of Arts and Science. Instructors were interviewed on which teaching methods they use to provide this support, and data was transcribed and coded using conventional content analysis.

Results: Three main categories emerged from the data, including instructors demonstrating attitudes towards students that encompass caring, compassion, and belief in wellness; reaching out to students to promote wellbeing; and enacting learning strategies to address students’ learning and social needs. Additionally, they identified barriers that hinder the use of teaching practices that promote students’ wellbeing.

Conclusions: Teaching methods constitute a part of students’ learning environment and impact mental health and wellbeing. Our understanding of which teaching methods promote this allows us to positively impact student’s participation in the occupation of learning. Occupational therapists can play an advisory role for universities to help implement strategies for mitigating mental health and wellbeing, enabling students’ occupation of learning, and facilitate undergraduate student’s achieving academic success.

Kirsty Cameron

Kirsty

Project Title:  Recovery-oriented practice: Are Occupational Therapists in British Columbia ready?

Authors:  Kirsty Cameron, Dr. Skye Barbic, Dr. Regina Casey, & Michael Lee

Introduction: In June of 2015 the Mental Health Commission of Canada (MHCC) released their Guidelines for Recovery-Oriented Practice, the first Canadian document of its kind.  With the release of this document, the Commission aims to promote “a consistent application of recovery principles across the country at [the] policy, program and practice level” (Mental Health Commission of Canada [MHCC], 2015) for patients, their families and healthcare professionals, including occupational therapists (OTs).

Objectives: To gain an understanding of British Columbian OTs current enactment of recovery principles as articulated by the MHCC Guidelines and to determine readiness to implement these principles in practice.

Approach/Methods: In March, 2016 data was collected through an online cross-sectional survey, distributed to all OTs practicing in British Columbia, with additional recruitment efforts targeting those working in a mental health setting. The survey, based upon the MHCC Guidelines, asked questions about the frequency in which specific recovery behaviours, skills and attitudes were enacted while inviting participants to comment on how they incorporated individual recovery principles into their practice.

Results: Survey results identified areas of current OT practice strengths; suggested areas for further individual skill development; and identified several structural challenges influencing the enactment of recovery-oriented practice.

Practice Implications: As recovery-oriented practice is now a target for clinical outcomes and system reform, an increased understanding of OTs’ strengths and needs in the area will be critical to inform continuing education, curriculum development and the identification of competencies for therapists delivering mental health care across the country.

Conclusion:  Survey results show that OTs in British Columbia currently report broad strengths in conveying hope, highlighting the individual nature of recovery and maintaining client-centeredness. Increasing the inclusion of family and loved ones in care, developing stronger ties to the community and engaging the peer led workforce will help OTs attain the goal of delivering high-quality, recovery-oriented care.

References:
Mental Health Commission of Canada. (2015). Guidelines for Recovery-Oriented Practice. . Retrieved August 3, 2015, from www.mentalhealthcommission.ca/English/initiatives/RecoveryGuidelines

Aja Hann & Jennifer Querques

Aja_Jen

Project Title:  Hearing Voices Groups & Recovery: A Quantitative Approach

Authors:  Aja Hann, Jennifer Querques, Dr. Regina Casey, Gill Walker & Michael Lee

Introduction:  Auditory hallucinations can be a distressing experience for individuals and can lead to social distress and decreased participation in activities of their daily lives (McCarthy-Jones et al., 2014). The hearing voices network, a new movement, encourages individuals with auditory hallucinations to acknowledge and talk about their experience of hearing voices (Ruddle, Mason, & Wykes, 2011). Hearing Voices Groups (HVG) provide individuals the opportunity to create connections through shared encouragement, allowing members to share coping strategies, and create a paradigm shift of thinking in regards to their voices (Ruddle, et al., 2011). HVG strive to raise awareness of the experience of hearing voices and shift the societal perspective that this experience is a definitive sign of mental illness. HVG support the following notions: hearing voices is a common variation in individuals, it is not a symptom of an illness, and individuals can make meaning of their voices and come to value them (Escher & Romme, 2012).

Objectives:
1. To gain insight and knowledge into the recovery perspectives of individuals attending the hearing voices groups, and the diversity of those who participate.
2. To determine if there are any correlations between recovery levels, and number of HVG groups attended.

Methods:  Quantitative data has been collected through distributing a survey to members attending the HVG in the Lower Mainland. Included in the survey package is a demographics form and the Stages of Recovery Instrument. This will allow the researchers to determine the various levels of recovery of those attending the groups, and whether there are correlative trends between recovery levels and demographic data.

Conclusion: We anticipate there will be a diversity of recovery levels supported by the HVG. As well, that higher recovery levels will correlate to more attendance to HVG groups.

Tara Loewen & Alysha Paiaro

Tara_Alysha

Project Title:  Experiences from participants attending a “Hearing voices group” – a qualitative approach

Authors:  Tara Loewen, Alysha Paiaro, Gill Walker, Dr. Regina Casey & Michael Lee

Introduction: Literature has shown that quality of life, perceived health, well-being, self-mastery and social interaction among people with psychiatric disabilities are closely linked with participation in meaningful occupaitons. (Eklund, Bjerhorlm & Leufstadius, 2009; Goldberg, Britnell & Goldberg, 2002). By contrast, the experience of hearing voices and sounds not heard by others, can cause distress and negatively impact an individual’s engagement in meaningful occupations (Ruddle, Mason & Wykes, 2011). In other words due to stigmatization people may be marginalized in their communities. Hearing Voices Groups (HVG) aim to support those in search of a deeper understanding, acceptance and control over their voice hearing experiences.  Despite HVG gaining popularity, existing research has not examined how HVG influences an individual’s experience of participation in meaningful occupations.

Objectives: This research aims to examine the subjective experience of occupational engagement of HVG members, to advance the existing body of literature and to inform future mental health service provision.

Approach: Participants have been recruited from a HVG and in-depth, semi-structured interviews were conducted.  Interpretive phenomenological analysis was used to explore meaning from the raw data and generate several common themes (Smith, Flower & Larkin, 2009).

Practice Implications: Understanding HVG members experiences of occupational engagement will inform current practice and future research to more effectively support confident engagement in meaningful occupations.

Conclusions: This study will better illuminate the experience of engaging in HVG groups and will therefore advance our knowledge of meaningful occupation participation for people who may otherwise be marginalized.

Taku Kawai & Andrea Smith

Andrea_Taku

Project Title:  A Closer Look: Occupational Opportunities for Adults with Blindness

Authors:  Taku Kawai, Andrea Smith, Laura Bulk & Tal Jarus

Rationale: Canadian adults with blindness experience higher rates of unemployment, social isolation, and lower incomes than adults with vision (CNIB, 2005). Addressing these negative impacts on health and well-being through occupation-based interventions and social policies requires sound evidence. However, few studies exist that explore the lived experiences of working aged adults with blindness from an occupation-based perspective.

Objectives: To explore experiences of adults with blindness, and highlight the political, social, and economic factors that influence their opportunities for occupational participation and engagement.

Method: This critically-informed study will explore the lived experiences of occupational participation and engagement amongst adults with blindness. Data will be collected through in-depth, semi-structured interviews with four legally blind participants (visual acuity of 20/200 or below), aged 19-65. Researchers will employ narrative analysis to interpret the data, and subsequent themes will be subject to member-checking for validity.

Practice Implications:  It is imperative that a closer look is given to how adults with blindness experience participation and engagement in the occupations that they want and need to do, so both practitioners and policy makers can enable adults with blindness to reach their peak occupational potential.

Conclusions: Understanding the experiences of Canadians with blindness can provide a foundation for both occupational therapy and social policy to better support these individuals to participate in – and master- the occupations of everyday life.

References:
Canadian National Institute for the Blind. (2005). An unequal playing field executive summary. Retrieved from http://www.cnib.ca/en/about/Publications/research/pages/needs-study-executive-summary.aspx

Chelsey Murdock & Fiona Stevenson

Chelsey_Fiona

Project title: DREAM: A Blended Learning Module for Students with Disabilities

Authors: Chelsey Murdock, Fiona Stevenson, Tal Jarus, and Michael Lee

Introduction: Over the last decade, there has been a steady increase of post-secondary students who identify as having a disability (Howlin, Halligan & O’Toole, 2014). Despite legislation, many students with disabilities (SWD) still experience barriers and stigma that cause difficulty engaging in education-related occupations. University students in health and human service (HHS) disciplines may have additional challenges, as they also have to navigate a practical component. The DREAM (Disclosure, Rights and Responsibilities, Advocacy and Accommodations) blended learning module aims to combat some of the challenges SWD face, and act as a stepping stone in providing equity to SWD.

Objectives: To develop and evaluate a blended learning module titled DREAM. The project has three distinct phases. The First Phase of the DREAM project focuses on the development of DREAM, while the Second Phase focuses on the evaluation of the online content of DREAM. The Third Phase will trial the module and involve ongoing evaluation of DREAM’s effectiveness for students with disabilities in HHS disciplines, and will occur from July 2016 to July 2017. The ultimate goal of DREAM is to educate and provide skills to students with disabilities in HHS disciplines in a barrier-reduced learning environment.

Methods: In the Second Phase of DREAM, 10 evaluators knowledgeable in the area of disability, will offer both quantitative and qualitative feedback on the efficacy, usability and validity of the online content of the DREAM module. Participant feedback is guided by the evaluation rubric which assesses four criteria: module organization and layout, module content and delivery, online student interaction, and online learner support. Data analysis will identify areas of strength and weakness of the module that will allow for improvement prior to the Third Phase of DREAM.

Conclusions: Findings from this study will be used to further develop DREAM for Phase Three, when students with disabilities in health and human service disciplines will participate and evaluate DREAM.

Brooke Fenn & Elyse Stokely

Brooke_Elyse

Project Title:   Virtual Reality Intervention for Children with Autism: Client Centered Design

Authors:  Brooke Fenn, Elyse Stokely, Parisa Ghanouni & Tal Jarus

Rationale: Autism Spectrum Disorder (ASD)’s prevalence is on the rise, affecting 1 in every 68 Canadian children. These children face challenges in social interactions impacting participation in everyday activities. Research demonstrated Virtual Reality (VR) technologies, such as video and computer games, to be an effective low-cost intervention targeting social challenges in individuals with ASD. This project explores two notions: first, motion-based VR have the potential to increase user’s engagement, however limited research has investigated its use as an intervention for social participation. Second, the valued voices of end-users have never been incorporated in the development of VR games.

Objectives: This project aims to design and trial a Kinect motion-based video game to address social participation, incorporating the perspectives of end-users.

Method: 9 parents of children with ASD, 4 multidisciplinary clinicians working with children with ASD and 2 youth with ASD were recruited. In our preliminary research, stakeholders identified priority issues surrounding social participation. This research involved interviews to solicit input of the stakeholders regarding the design and development of a VR motion-based game.

Practice Implications: Developing a motion based game informed by the voices of the end-users will ensure that the needs and issues identified are addressed.

Conclusion: The proposed development of this motion-based game may serve as an affordable, creative and engaging tool to complement the Occupational Therapy intervention when overcoming social participation difficulties in everyday lives of individuals with ASD.

 

Jordana Hutchinson & Anna Nguyen

Jordana_Anna

Project Title:  The Step-Wise Approach for Treating Intention Tremor 2: The Community Application

Authors:  Jordana Hutchinson, Anna Nguyen, Susan Forwell & Sinead Hynes

Introduction: Intention tremor (IT) is a debilitating symptom affecting up to 1/3 of individuals diagnosed with multiple sclerosis (MS) (Heenan, Scheidt, Woo, & Beardsley, 2014). IT affects all occupations that require a goal-directed movement from eating to playing the guitar (Feys et al., 2004). Currently there is little research on non-invasive and occupation focused treatments for IT.

Objective: Researchers tested the feasibility of the Stepwise Approach to Treatment of Intention Tremor (SWAT-IT2), which includes a protocol of 12 interventions categorized into cognitive psychoeducational, behavioral and positioning techniques, and assistive devices. The protocol includes coupling of techniques to increase success.

Methods: The researchers administered the SWAT-IT2 protocol to 4 participants with IT due to MS. The protocol was applied to the occupations of eating, handwriting, or another occupation of the participant’s choice. Data collected included demographic and medical questionnaires, the Multidimensional Assessment of Tremor and daily evaluation of techniques in the week following administration of the SWAT-IT2 protocol. Verbal feedback from participants was collected and a feasibility questionnaire was administered at one-month follow-up. Practice Implications: Information gained during this study credibly augments evidence for the use of non-invasive treatments for IT and began the process of providing occupational therapists with a useful new intervention.

Conclusion: This feasibility study provides the first steps towards testing the efficacy and utilization of the SWAT-IT2 intervention.

References:
1) Heenan, M., Scheidt, R. A., Woo, D., & Beardsley, S. A. (2014). Intention tremor and deficits of sensory feedback control in multiple sclerosis: A pilot study. Journal of Neuroengineering and Rehabilitation, 11(1), 170.
2) Feys, P., Romberg, A., Ruutiainen, J., & Ketelaer, P. (2004). Interference of upper limb tremor on daily life activities in people with multiple sclerosis. Occupational Therapy in Health

Samantha Jenkins & Jennifer Mathieson

Sam_Jenn

Project Title:  Testing an Occupational Therapy Comprehensive Battery of Measures for clients post TBI

Authors:  Samantha Jenkins, Jennifer Mathieson, Giovanna Boniface, Jeff Boniface, Skye P. Barbic, & Susan Forwell

Introduction: Occupational therapists (OTs) use measurement tools to assess areas of need, guide intervention planning, and evaluate intervention outcomes. While many assessments are available to OTs, there is currently no standard measure available for OTs working with clients with traumatic brain injuries (TBI) in community settings. To address this gap, the Comprehensive Battery of Measures (CBOM-TBI) was developed based on consultations with community-based clinicians and an extensive literature review. The CBOM-TBI is a self-report or administered measure designed to provide a comprehensive profile of a client’s strengths and challenges.

Objectives:
a) To determine the appropriateness of the CBOM-TBI for clinical use through a second round of clinician feedback and initial round of feedback from persons with TBI, and
b) To characterize issues for persons with TBI based on completed CBOM-TBIs.

Methods: Community-based OTs, from across British Columbia will administer the CBOM-TBI with at least two clients then complete questionnaires to provide feedback on its appropriateness for clinical practice related to content, timing, format and process of administration. Client feedback will also be obtained by questionnaire and their responses to the CBOM-TBI will be analyzed.

Practice implications: With the CBOM-TBI determined to be appropriate for community practice; this tool will facilitate a systematic, evidence-based and efficient process for OTs to ascertain a comprehensive understanding of the needs, successes and challenges of their clients with TBI.

Conclusion: This study will establish the CBOM-TBI as a useful assessment for community practice and will position future research to evaluate the credibility of the CBOM-TBI, through psychometric testing.

Joseph Romanyk & Todd Young

Joe_Todd

Project Title:  Transition from an occupational perspective: Defining and presenting a model of life transition unrelated to health

Authors:  Joe Romanyk, Todd Young, Katie Lee Bunting, and Dr. Susan Forwell

Rationale: There continues to be significant attention in the occupation literature on life transitions where numerous factors, processes, barriers and facilitators are described and associations brought to light. Despite this, there remains no definition or model of life transitions from an occupation perspective with often the dominant perspectives of psychology and social-psychology seized to fill this void. Therefore this research aims to answer the following questions: Given the growth of knowledge in the occupation literature related to life transitions, How does recent occupational research in transition align with previous work? What definition for life transition emerges from an occupation perspective that is unrelated to health? What model of life transition emerges from an occupation perspective that is unrelated to health?

Methods: This research expands on previous research carried out by Crider, Calder, Lee Bunting, & Forwell (2015), which highlighted the need to further explore transition from an occupational perspective and called for a definition of transition from an occupation perspective. By following the established integrative review method (Whittemore and Knafl, 2005), a diversity of primary literature was surveyed, including empirical and theoretical findings. This method is ideally suited to allow for a rigorous review of data to guide the formulation of both a definition and model. It was established a priori that the definition must account for factors and processes of life transitions and provide an occupational perspective. The model must account for constructs, concepts, relationships, and processes that further articulate the occupational perspective related to life transition.

Results: Initial results suggest that both a definition and model of life transition unrelated to health from an occupation perspective can be developed and address the considerable gap identified by Crider et al. (2015). The synthesis of the definition pulls together a breadth of characteristics and iterative stages while the model offers testable points and processes for further research.

Implications: The results of this paper serve to expand the transition literature as well as fill the void within the occupation literature by offering a definition and model that positions occupation as salient to transition and creating a much-needed foundation for occupational science and research. This will also ensure we have the theoretical groundwork required to support balance as people navigate the potentially unbalanced seas of transition.

Liv Brekke & Nicole Matichuk

Nicole_Liv

Project Title:  Evaluating a Homemaking Assessment for Broader Application to Practice

Authors:  Liv Brekke, Nicole Matichuk, Hilary Drummond, & Susan Forwell

Introduction: In response to needs of third party payers, a homemaking assessment was developed to provide a fair, objective, and consistent approach to quantifying the assistance an individual requires with housekeeping tasks as a result of accident or disability.  While this measure has been used for more than a decade in an occupational therapy private practice, there has been no systematic evaluation of its validity and reliability.

Objectives: To evaluate psychometric properties (validity and reliability) of this homemaking assessment for use with community-dwelling adults with injury or disability.

Methods: This study uses a retrospective chart review of approximately 100 cases to examine internal consistency, and a prospective design to test interrater reliability.  Data will be analyzed and reported using descriptive statistics, factor analysis, Cronbach’s alpha, and Cohen’s kappa coefficient.

Results: This study helps demonstrate the validity and reliability of a novel measure of homemaking ability. Results will guide the development of materials to support education and dissemination of the assessment.

Conclusions: This study provides evidence for the psychometric integrity of a homemaking assessment that has been accepted among clinicians and stakeholders as providing credible support for funding decisions related to housekeeping services.  This study also provides the foundation for broader use of this assessment in community practice.

Kendra Nimmo & Jennifer Turnbull

Jen_Kendra

Project Title:  Assessing the quality of fieldwork learning environments

Authors:  Kendra Nimmo, Jennifer Turnbull, Dr. Leanne Currie, Dr. Angela Wolff, & Donna Drynan

Introduction: Fieldwork is a fundamental feature of occupational therapy education, priming students to become competent entry-level practitioners (Hall, MacFarlane, and Mulholland, 2012). There are critical shortages in fieldwork placements, making it more important than ever to optimize the quality of the learning environment (Thomas et al., 2007). However, little is known about the current quality of fieldwork learning environments available to occupational therapy students in British Columbia.

Objective: The purpose of this study is to evaluate the quality of the fieldwork learning environment from the perspective of occupational therapists working in British Columbia.

Methods: Through the creation and distribution of a web survey tool, the Quality of Occupational Therapy Fieldwork (QOTFE), this study will determine current fieldwork experience quality according to occupational therapists practicing across British Columbia. Domains covered by the survey include: (1) Role of Fieldwork Educator in Student Learning (2) Role of the Practice Environment and Team in Student Learning (3) Manager’s Contribution to Student Learning (4) Readiness to Support Student Learning

Results/practice implications: This research will present a picture of the current quality of fieldwork experiences available to occupational therapy students and will inform factors that may contribute to improving the learning experience for educators and students alike.

Sophia Bobovski & Marieka Gerding

Sophia_Marieka

Project Title:  What are the needs of people with mental illness living in metro Vancouver?

Authors: Sophia Bobovski, Marieka Gerding, Dr. Skye Barbic, & Dr. Catherine Backman

Introduction: Personal recovery is an overarching goal for mental health services in Canada. Surprisingly, little research has been published about what the personal recovery needs are of community-dwelling individuals with serious mental illness. Planning and evaluation of community-based mental health rehabilitation services can be better informed by direct input from clients indicating their recovery priorities and goals.

Objective: To provide a systematic summary of the recovery needs of urban-dwelling adults living with serious mental illness.

Methods: Researchers are completing a multisite cross-sectional survey of adults over 19 years, who access community-based, outpatient mental health services in a metropolitan region. Participants completed five questionnaires about personal recovery and three questionnaires about hope, mental health status, and quality of life. Researchers used descriptive and correlational analyses to summarize the data according to an evidence-based theoretical conceptualization of recovery (Leamy et al., 2011).

Results: The study reports the demographics and recovery needs of 224 participants in five pre-specified domains: connectedness, hope, identity, meaning in life, and empowerment. Analyses demonstrate relationships among these domains and demographic characteristics. Findings summarize the extent to which the demographic and functional profile of the sample impacts personal recovery.

Conclusions: The findings support occupational therapists practicing in psychosocial rehabilitation settings, particularly with regard to collaborating with clients on strategies to set relevant goals and maintain or improve quality of life, as well as support clients with engaging in meaningful activities. Careful assessment of the needs and goals of individuals with mental illness is essential to guide meaningful, client-centered interventions.

Mandeep Manku & Sherry Yu

Mandeep_Sherry

Project Title:  Occupational balance, health, and perceived stress in Canadian adults

Authors:  Mandeep Manku, Sherry Yu, & Catherine Backman

Introduction: A philosophical assumption underpinning occupational therapy is that occupational balance promotes health and well-being. Empirical studies support an association between occupational balance and health in clinical populations. Presently, there is no study investigating occupational balance in a Canadian general population.

Objectives: 1) to examine test-retest reliability of the Occupational Balance Questionnaire (OBQ); 2) to describe the relationship between occupational balance and perceived health and stress, as measured by the OBQ, Short Form Health Survey – 36 version 2.0 (SF-36v2) and Perceived Stress Scale-10 (PSS-10), respectively; and 3) to investigate if these relationships differ based on age or gender.

Methods: To estimate test-retest reliability a convenience sample of 10 adults completing the OBQ twice, 10 to 14 days apart, using intraclass correlation coefficients for data analysis. For the relationships among occupational balance, perceived health, and stress, fifty adults will complete a cross-sectional survey comprised of  OBQ, SF-36v2, PSS-10, and demographic questions. Data will be analyzed using descriptive statistics, including correlation coefficients.

Results: Researchers anticipate 1) that the OBQ will demonstrate moderate to high test-retest reliability; 2) a positive, moderate correlation between the OBQ and SF-36v2, and a negative, moderate correlation between the OBQ and PSS-10; and 3) statistically significant differences in the relationship between occupational balance and health and stress (respectively) between men and women, and with age.

Conclusion: An informed understanding of the interplay between occupational balance and health-related concepts will enable occupational therapists to coach clients to identify satisfying patterns of occupational engagement that promote well-being.

Lisa Allyn & Lisa Zoller

Lisa_Lisa

Project Title:  Analysis of Ergonomic Assessments in a Work Loss Prevention Trial

Authors:  Lisa Allyn, Lisa Zoller, Diane Lacaille, & Dr. Catherine Backman

Introduction: Work cessation and at-work productivity loss are common and early outcomes of inflammatory arthritis (IA). Ergonomic accommodations contribute to successful management of arthritis symptoms in the workplace. The Ergonomic Assessment Tool for Arthritis (EATA) is an interview-based tool developed as part of a self-management program to prevent work loss for people with IA. The self-assessment and interview format of the EATA mitigates concerns about disclosing diagnoses to employers. However, evaluation of its utility and feasibility is needed.

Objectives: To describe: 1) how participants and occupational therapists use the EATA; 2) the kinds of ergonomic issues experienced by working adults with IA and the potential solutions proposed by the occupational therapist; 3) the occupational therapists’ perspectives and impressions on the usability of the EATA.

Methods: This descriptive study is nested within a larger randomized clinical trial. A descriptive content analysis of 67 EATA client self-assessments and therapist interviews is underway. Interviews will be conducted with the trial’s occupational therapists to understand their perspectives on the utility of the EATA and potential for use in clinical practice.

Practice Implications: Findings are anticipated to provide information to further understand the patterns and prevalence of ergonomic issues experienced in working adults with IA. This study will contribute to understanding whether an interview-based approach can identify ergonomic problems and provide reasonable solutions to promote self-management of IA.

Conclusions: Evaluation of the EATA will document the utility and feasibility of this tool, and inform potential applications to practice.