1. Improving Access to Services and Information for People with Disabilities in Libraries an Archives

2. Collaboration to Create a Program for a Unique Community: The Therapeutic Volunteering Program Rachel Keiko Stark, MS Kaiser Permanente Preet Oza, PHD, DPT University of the Pacific

3. PRESENTATION OVERVIEW Vision The Program What is Stroke? Stroke by the numbers What is Traumatic Brain Injury? Traumatic Brain Injury by the numbers Why do this kind of program? The Project

4. VISION

5. Create a volunteer program designed to meet the needs of Stroke/TBI Survivors and encourage Stroke/TBI Survivors to volunteer at the Sacramento Public Libraries

6. WHAT IS STROKE?

7. Stroke Flow of blood in the brain is interrupted, causing brain cells to die due to lack of oxygen. (Ischemic) Sudden bleeding in the brain can also cause a stroke if it damages brain cells. (Hemorrhagic)

8. STROKE IN THE UNITED STATES

9. More than 795,000 people a year have a stroke Roughly 610,000 are first time strokes American Indians, Alaska Natives, and African Americans are more likely to have had a stroke than other groups 5 th leading cause of death Stroke chance increases with age Of people hospitalized in the USA for stroke were under the age of 65 in 2009 34%

10. WHAT IS TRAUMATIC BRAIN INJURY?

11. Traumatic Brain Injury (TBI) Caused by a bump/blow/jolt/strike to the head or a penetrating head injury that disrupts the normal function of the brain Not all bumps/blows/jolts/strikes to the head cause TBI

12. TRAUMATIC BRAIN INJURY IN THE UNITED STATES

13. 2.5 million TBI related emergency department visits, hospitalizations, or deaths in 2010 TBI rates are highest for persons 65 years of age and older Leading causes of (non-fatal) TBI by age in the USA (2006 – 2010) Falls 45+years 15 to 44 years 15 to 24 years 0 to 4 years Falls Assaults (Emergency Department Visits) Motor vehicle crashes (Hospitalizations)

14. THE PROGRAM

15. Stroke Survivors and people with TBI were interested in and participated in a volunteer program at a public library Arcade Library in the Sacramento region was the site of program Easy access to public transportation Volunteer Coordinator headed the program Staff buy-in

16. WHY DO THIS KIND OF PROGRAM?

17. Stroke survivors and people with TBI suffer from isolation and can benefit from volunteer work and structure. Libraries can be ideally suited for the kinds of work that people in recovery can benefit from. Stroke and Traumatic Brain Injury occurs in every community Stroke survivors and TBI survivors often have difficulty returning to a non-hospital setting Can be difficult to return to work Loss of skills Loss of social network

18. THE PROJECT

19. Groups Involved Individuals Involved Sacramento Public Library (SPL) Easter Seals (Sacramento) SPL Volunteer Coordinator Arcade Library Manager Hospital Librarian University Professor/DPT

20. Measures Survey for Staff after pilot project Survey for Volunteers after pilot project Physical Therapy Measures Berg Balance Scale Optimal Instrument The Activity Specific Balance Confidence Scale Timed Up and Go Montreal Cognitive Assessment

21. Participation Cohorts 3 Cohorts 10 Participants 9 male 1 female Data Points 6 Participants attended at least 2 data collection sessions 1 Participant attended 3 data collection session Drop Off 4 Participants left the program 1 participant had to stop mid way due to injury, but plans to return to volunteering when able

22. Benefits for Volunteers Concentration Balance Memory Confidence

23. Staff Benefits Staff enjoyed seeing the “positive effect it [the program] has on the volunteers first hand” Worked on projects library staff “couldn’t get around to” Reduced work load

24. What Volunteers Said “I think the more I do these tasks shall improve my memory; the more I do it the more confident I am at times I become which is very important to me” “There is nothing I don’t like [about the program]” “It keeps you interested”

25. What Staff Said “TV’s [Therapeutic Volunteers] took really no more than any other volunteers we have, or at least not more than the majority of volunteer” “They were some of the best volunteers I’ve worked with in the library system” “They [the volunteers] were so great to have and a pleasure to work with”

26. Barriers Transportation Library Staff Transfers Safety and Productivity Ensuring volunteers are tested for fall risk Sit only jobs can be limited Providing training to volunteers

27. Future Directions Expand program to other Sacramento Public Library Locations Recruit PT/OT/MD students to assist with testing volunteers at other Sacramento Public Library locations Revise Project Plan as needed and make available to other Libraries

28. Benefits of Collaboration Research opportunities for Faculty/Staff Increase diversity of volunteers and people who utilize the Sacramento Public Libraries SPL now has a program example for volunteers who are TBI/Stroke Survivors Connections! Connections! Connections!

29. References CDC. (2014) About Stroke. Retrieved from https://www.cdc.gov/stroke/about.htm https://www.cdc.gov/stroke/about.htm CDC. (2015) Stroke Facts. Retrieved from https://www.cdc.gov/stroke/facts.htm https://www.cdc.gov/stroke/facts.htm Silver, J. M., McAllister, T.W., & Yudofsky, S.C. (Eds.). (2011). Textbook of traumatic brain injury (2 nd ed.) Arlington, VA: American Psychiatric Publishing, Inc. Stein, J., Harvey, R. L., Macko, R. F., Winstein, C J. & Zorowitz, R. D. (Eds.). (2009) New York, NY: Demos Medical Publishing Zollman, F. S. (Ed.). (2011). Manual of traumatic brain injury. New York, NY: Demos Medical Publishing

30. Acknowledgements This program would not have been possible without the hard work of all the staff and volunteers who participated in the program Special thanks to Jamie Paiva, who started this program and whose hard work made it possible

31. Thank you Rachel Keiko Stark, MS rachelkstark@gmail.com Preeti Oza, PHD, DPT poza@pacific.edu