Evaluation of Project TEAM (Teens Making Environmental and Activity Modifications)

NCT02714868 | Completed Results

• 2 other identifiers: H133G12009190IF0032-01-00
• Study Type: interventional
• Target: 82
• Locations: 0 countries
• Sites: N/A

Brief Summary

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?.

Conditions

Transition-age Youth; Developmental Disabilities; Cerebral Palsy; Autism; Intellectual Disability

Keywords

repeated measures; matched comparison; manualized intervention; self-determination; participation; advocacy; problem-solving; commuinity participation; occupational therapy; environment

Outcome Measures

Primary Outcomes (4)

• Goal Attainment Scaling (GAS)

  All youth had four goals in the following areas: 1) a participation goal, 2) their ability to identify environmental barriers to their goal, 3) their ability to generate solutions to barriers, and 4) their ability to advocate for needed changes to achieve their goal. Each goal used a five-point goal attainment scale with baseline at -1. Goals levels were created at intake (initial assessment). For the knowledge application goals (goal 2-4), we created standardized goal levels to ensure content validity and reliability within and across youth. Goal attainment for all four goals was rated 12 weeks following intake (outcome) and transformed into a t-score. A t-score of 50 indicates all goals were achieved at the expected level; t-scores greater than 50 indicate individuals exceeded the expected level of goal attainment. Scores range from 0-100 (100 indicates greater than expected goal attainment).

  12 weeks following intake (outcome)

• Project TEAM Knowledge Test

  Part I: Knowledge of parts of the environment, modification strategies, and the "Game Plan." Higher scores indicate more correct responses. Part I responses were independently coded as correct/incorrect by the study facilitator and a trained graduate student; discrepancies were resolved by a third scorer (the PI). To establish unidimensionality, we applied a dichotomous Rasch model and removed 24% of the items with Outfit Mean Square \>2; values higher than 2 can indicate guessing. The resulting interval sum scores, in logits, were used for analysis; higher logit scores indicate more knowledge (Minimum: -4.05 to maximum 6.69). Higher scores indicate greater problem solving.

  intake, 12 weeks following intake (outcome), 18 weeks following intake (6 week follow up)

• AIR Self-Determination Scale (American Institutes on Research- AIR)

  The AIR measured the capacity and opportunity to act in a self-determined manner at home and school. Parallel youth and parent forms used a 5-point frequency scale (never-always), with higher scores reflecting more self-determination. Reported here are parent self-reported sum scores at outcome. Sum scores range from minimum 18- to maximum 90 (90/higher scores = more self determination)

  intake, 12 weeks following intake (outcome), 18 weeks following intake (6 week follow up)

• Generalized Self Efficacy Scale (GSES)

  We revised a disability self-efficacy scale for this study and created additional questions to assess self-efficacy for addressing environmental barriers. We used a modified three point response scale (Not like me, Sort of like me, Really like me) that incorporated visuals to support comprehension. Higher scores indicated higher self-efficacy. Sum scores range from minimum 11 to maximum 33.

  intake, 12 weeks following intake (outcome), 18 weeks following intake (6 week follow up)

Secondary Outcomes (2)

• Participation and Environment Measure for Children and Youth (PEM-CY)

  intake, 12 weeks following intake (outcome)

• Readiness for Advocacy

  intake, 12 weeks following intake (outcome)

Study Arms (2)

Project TEAM Intervention

EXPERIMENTAL

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.

Behavioral: Project TEAM

Matched comparison

ACTIVE COMPARATOR

Youth with disabilities who are matched controls will receive their typical educational or therapeutic services. Youth will receive a stipend to participate in a preferred activity in the community; youth will document what they did and with whom they participated. Attempts to control for the impact of resources on participation and goal achievement.

Behavioral: Matched Comparison

Interventions

Project TEAM BEHAVIORAL

Project TEAM is a manualized, group-based intervention designed to be co-facilitated by an experienced leader with a disability (disability advocate) and a licensed service provider (such as an occupational therapist, social worker, or educator). Project TEAM includes eight group sessions and two experiential learning field trips for each participant. Weekly phone calls with peer mentors with disabilities support achievement of each participant's personal activity goal.

Project TEAM Intervention

Matched Comparison BEHAVIORAL

Participants set goal to try a new activity in the community

Matched comparison

Eligibility Criteria

• Age: 14 Years - 21 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• \) A developmental disability as defined by the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (Public Law No.106-402) 9(example diagnoses include autism, intellectual disability, and cerebral palsy), 2) Age 14 to 21 years at time of enrollment, 3) Communicate in English verbally or using other means as needed, 4) Able to attend to a task for 10 minutes and follow a two-step direction with support, 5) Able to categorize objects and concepts, and 6) Self-identify as a youth with a disability as reported on a modified functional strengths and challenges questionnaire

You may not qualify if:

• Learning disabilities without any other co-occuring diagnosis.
• living outside of the university recruitment regions

Sponsors & Collaborators

• Boston University Charles River Campus: lead
• Wayne State University: collaborator

Related Publications (5)

• Levin MR, Kramer JM. Key elements supporting goal attainment for transition-age young adults: A case illustration from Project TEAM. Inclusion 3: 145-161, 2015

  BACKGROUND

• Kramer J, Hwang I, Helfrich C, Samuel P, Carralles A, YELL Youth Research Team. Evaluating the social validity of Project TEAM: A problem-solving intervention to teach transition age youth with developmental disabilities to resolve environmental barriers. International Journal of Disability, Development, & Education 65(1): 57-75, 2018

  RESULT

• Schwartz AE, Kramer JM. "I just had to be flexible and show good patience": management of interactional approaches to enact mentoring roles by peer mentors with developmental disabilities. Disabil Rehabil. 2018 Oct;40(20):2364-2371. doi: 10.1080/09638288.2017.1334835. Epub 2017 Jun 8.

  PMID: 28592154 RESULT

• Kramer JM, Ryan CT, Moore R, Schwartz A. Feasibility of electronic peer mentoring for transition-age youth and young adults with intellectual and developmental disabilities: Project Teens making Environment and Activity Modifications. J Appl Res Intellect Disabil. 2018 Jan;31(1):e118-e129. doi: 10.1111/jar.12346. Epub 2017 Mar 1.

  PMID: 28247558 RESULT

• Ryan CT, Kramer JM, Cohn ES. Exploring the Self-Disclosure Process in Peer Mentoring Relationships for Transition-Age Youth With Developmental Disabilities. Intellect Dev Disabil. 2016 Aug;54(4):245-59. doi: 10.1352/1934-9556-54.4.245.

  PMID: 27494124 RESULT

Related Links

• Youth and Young Adult Empowerment, Leadership, and Learning (YELL) Lab Website
• Project TEAM Website

MeSH Terms

Conditions

Developmental Disabilities; Cerebral Palsy; Autistic Disorder; Intellectual Disability

Interventions

Matched-Pair Analysis

Condition Hierarchy (Ancestors)

Neurodevelopmental Disorders; Mental Disorders; Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Autism Spectrum Disorder; Child Development Disorders, Pervasive; Neurobehavioral Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Statistics as Topic; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Limitations and Caveats

Missing responses to 1-3 items, we imputed a response using the median of responses to that item at that time period. We then obtained sum scores for each outcome measure (except GAS) for each participant.

Results Point of Contact

• Title: Dr. Jessica Kramer, Assistant Professor, PI
• Organization: Department of Occupational Therapy, Boston University

kramerj@bu.edu

617-353-2702

Study Officials

• Jessica Kramer, PhD

  Assistant Professor

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Jessica Kramer, PhD, OTR/L, Director, Youth and Young Adult Empowerment, Leadership & Learning Lab

Study Record Dates

• First Submitted: March 11, 2016
• First Posted: March 22, 2016
• Study Start: October 1, 2012
• Primary Completion: September 1, 2016
• Study Completion: July 31, 2017
• Last Updated: November 25, 2019
• Results First Posted: November 25, 2019

Record last verified: 2019-11

Data Sharing

• IPD Sharing: Will not share