promoting independence in agriculture aantwmcgill qol11.1108 (rev. 11.0408b) agrability ntw mcgill...

Promoting Independence in Agriculture

AANTWMcGill QOL11.1108 (Rev. 11.0408b)

AgrAbility NTW McGill QOLWichita, KS

2008 National Training Workshop1:30-3:00 November 11, 2008

By Robert J. Fetsch, et al. Extension Specialist

& Director, Colorado AgrAbility Project,

Human Development & Family Studies

Colorado State University


Evaluating the Impact of Direct Client Services

By Robert J. Fetsch (CSU), Ron Schuler & Mary Beck (UW), Kirk Ballin (ESVA), Sheila Simmons (KU), Mary C. Little

(CSU), and Vincent Luke (ESC)


Brief Review of the Literature

• The literature includes a half dozen refereed journal articles with the McGill QOL with adults with Multiple Sclerosis.

• No studies reported using the McGill QOL with farmers/ranchers with disabilities.


History of National AgrAbility Evaluation Committee

• Early 2006—Kathryn Pereira, Evaluation Specialist NAP U of WI, invited all SRAP’s to join in evaluation study.

• The National AgrAbility Evaluation Committee (NAEC) met approximately monthly via teleconference/face-to-face (N = 10-25 participants/meeting).



• Who is an AgrAbility Client? An AgrAbility client is an individual with a disability engaged in production agriculture as an owner/operator, family member, or employee who has received professional services from AgrAbility project staff during an on-site visit.



• 4 Questions:– Do our AgrAbility clients increase their QOL?– Are our AgrAbility clients able to remain in

production agriculture or to continue living on their farm/ranch if they choose?

– Are our group mean scores the same as those from the population groups’ mean scores?

– Are both QOL measures sensitive to the effects of AgrAbility involvement?



• Five SRAP’s decided to conduct a 16-month pilot study to answer the 4 questions (June 2007-September 2008).

• McGill QOL—CO, KS, VA, & WI

• SF-36—DE-MD


Measures Used in CO, KS, VA, & WI Pilot Study

• McGill Quality of Life Questionnaire• Ability to Remain in Agriculture Subscale• NAP Demographic Data• Chronic pain, stress, anger, depression, self-

esteem, and perception of financial situation (CO only).



• CO, KS, VA, & WI obtained IRB approval from their Land-Grant Universities.

• Procedure—Each state was first to mail out to each new client a cover letter, McGill Pre-Survey, and stamped, self-addressed envelope prior to the on-site visit.



• During the visit we either thanked them for returning their survey or mentioned that we had not yet received it—need another copy? No coercion was used.



• A McGill Post-Survey was mailed out either when the client’s case was closed or at the end of the current study using a modified Dillman method with 10-day intervals: 1) cover letter, post-survey, and stamped return envelope; 2) thank you postcard/reminder; and 3) follow-up cover letter, post-survey, and stamped return envelope.



• By October 1, 2008 CO, KS, VA, & WI entered the data into an Excel File and emailed it to CO for entering and analyzing.– CO 21 Pre + 0 Post = 21 Total– KS 9 Pre + 0 Post = 9 Total– VA 4 Pre + 2 Post = 6 Total – WI 44 Pre + 5 Post = 49 Total– Total 78 Pre + 7 Post = 85 Total


Who Were the Participants in the Pilot Study? (N = 78)

• 57 (73%) were male; 15 (19%) were female; 6 (8%) were missing.

• 39 (50%) were new; 23 (30%) were on-going; 8 (10%) were re-opened; 3 (4%) were closed in current grant year; and 5 (6%) were missing.



• Ages ranged from 35 to 86. M = 58; SD = 12.

• Year original disability occurred ranged from 1937 to 2008.



• 56 (72%) were owners/operators; 15 (19%) were spouses/partners; 1 (1%) was planning new ag career; 1 (1%) was other family member; and 5 (6%) were missing.



• Regarding work status, 46 (59%) were full time, 15 (19%) were part time, 9 (12%) were occasional, 3 (4%) were none, and 5 (6%) were missing.



• Regarding agricultural operation, 24 (31%) were dairy, 20 (26%) were livestock, 16 (21%) were field/grain, 7 (9%) were hay, 3 (4%) were other animal, 2 (3%) were poultry, 1 (1%) was other, and 5 (6%) were missing.

Arthritis17%

Back injury15%

Joint injury13%

Orthopedic injury

9%

Multiple Sclerosis

5%

Leg amp above knee

5%

Spinal praplegia5%

Cardiovascular3%

Finger amp3%

Cerebral vascular

accident stroke3%

Other22%

Primary Disabilities


Do Our AgrAbility Clients Increase Their QOL?

0

1

2

3

4

5

6

7

8

9

Pre-Survey Post-Survey

Existential WellBeing (N = 3)

McGill SIS (N = 3)

Physical Well Being(N = 3)

Psychological WellBeing (N = 1)

McGill Pre- Post-Survey Changes

0

1

2

3

4

5

6

7

8


Support (N = 3)

Physical Symptoms (N= 3)

MQOL Total (N = 1)

McGill Pre- Post-Survey Changes


Are Our AgrAbility Clients Able to Remain in Production

Agriculture or to Continue Living on Their Farm/Ranch if

They Choose?

00.5

11.5

22.5

33.5

44.5

5


Complete chores (N =3, p = .074)

Operate machinery (N= 3, p = .057)

Manage farm (N = 2)

Ability to Remain in Agriculture Subscale

00.5

11.5

22.5

33.5

44.5

5


Access workspaces (N= 2)

Live in home on farm(N = 3)

Modify machinery (N= 3, p = .074)

Ability to Remain in Agriculture Subscale


Are Our Group Mean Scores the Same as Those from the Population Groups’ Mean

Scores?• How similar/different was our

sample from population mean scores?

Comparison of 4-State Pilot Study (N = 73-78) with Non-Agricultural Populations (N = 143) and CO Sample (N = 6-7)

0

2

4

6

8

10

McGill QOL SIS Physical Well-Being

Physical Symptoms

Pilot

Norms

CO Sample

Comparison of 4-State Pilot Study (N = 73-78) with Non-Agricultural Populations (N = 143) and CO Sample (N = 6-7)

0123456789

Psychological Well-Being (p =

.069)

Existential Well-Being (p < .05)

Support (p < .01) McGill QOL Total

Pilot

Norms

CO Sample


Are Both QOL Measures Sensitive to the Effects of AgrAbility Involvement?


• I cannot say about the SF-36.• The data show that all of the McGill

QOL group mean scores increased from pre- to post-survey.

• We need more data.


• When we get more matching pre- and post-survey data from the present 4 states and from you, I think it is likely that we will see statistically significant improvements in QOL levels.


Results

• Yes, at least 3 AgrAbility clients did increase their QOL, although the group mean scores were not statistically significant—probably due to the small sample size.

• Yes, our 3 AgrAbility clients were able to remain in their homes on their farms/ranches if they chose to do so.


Results

• Our group mean scores, for the most part were the same as those for the population group mean scores (MQOL SIS, Physical Well Being, Physical Symptoms, and MQOL Total Score).

• However, on the Psychological Well Being Subscale our sample of 78 on the pre-survey scored higher (p = .069).


Results

• Our group mean scores on the pre-survey were statistically significantly lower than the norms on Existential Well Being (p < .05) and on Support (p < .001).

• Is this an opportunity to encourage effective, science-based peer support training?


Conclusions

• Does the AgrAbility Program work?• What do you conclude from the present

study’s findings?• We conclude with the caveat that we did

not have a large sample, I am very hopeful that as more of you join us and as we collect more data, it looks very promising!


Challenges

• Getting 100 new clients’ pre-surveys and matching post-survey data with complete responses is a challenge, but we already have 78 pre-surveys!

• Who of you are interested in helping us with the goal of 100 matching pre- and post-surveys with complete data?


Recommendations

• That the NAEC continue the Pilot Study through September 2009 and collect more data and present at 2009 NTW.

• That more SRAP’s join us ASAP.


Won’t You Join Us?

1. Send an email to [email protected].

2. Check with your IRB.

3. Study and use the procedure.

4. Adapt CO to __ on pp. 1-2 & mail.

5. Enter your data, proof perfect & send.


Thank you very much!


Panel Discussion• What did you like about collecting the

McGill QOL data in our pilot study? • What did you not like about the process

& what are your recommendations?• How can new SRAP’s get involved?• What new information about your

clients has the McGill provided you?

promoting independence in agriculture aantwmcgill qol11.1108 (rev. 11.0408b) agrability ntw mcgill...

Documents

evaluation study

agrability clients able

colorado agrability

agrability project staff

mcgill presurvey

mcgill qolco

stamped return envelope

onsite visit