1. R-4: Enhancing Community Participation Washington University in St. Louis David B. Gray, Ph.D. Holly H. Hollingsworth, Ph.D. Jessica L. Dashner, OTD OTR/L MICL Advisory Board Meeting November 18, 2009

2. Accomplishments Analyzed Data from CDPAS Outcome Measure Survey 100 Participants Analyzed Data from Consumer Training Program Pilot Study 7 Sessions At Paraquad 14 Participants Assisted with development and implementation of PA Training Program

3. CDPAS Outcomes Measure CDPAS Outcomes Measure Characteristics of Respondents (CORE): Demographics, health, and overall CDPAS quality Participation Survey (PARTS/PA): Choice, importance, satisfaction, pain and fatigue, difficulty level with and without CDPAS, unmet need, perceptions of safety (in ADLs and IADLs) Survey of Participation and Receptivity in Communities (SPARC): # of visits to specific places in the community

4. Consumer Training Program Supplement to Paraquads current program in- home orientation Created to expand the managerial and communication needs of consumers 4 hour, in-person training held at Paraquad Provided to interested consumers who have completed the CDPAS Outcome Measure Participants Compensated $30 to attend training and complete surveys $20 to complete follow up surveys

5. Consumer Training Program: Session Survey completion Consumer Training Survey Skills and Knowledge Test Presentation Slides Videos Group Activity Social Connectivity- Where do you go? Tour EMC Exercise Facility Assistive Technology Reutilization Program

6. Consumer Training Program CDPAS Program Specific Info Recruitment of PAs Interview Process Training New PAs Transfer Video CDPAS Program Specific Info Recruitment of PAs Interview Process Training New PAs Transfer Video Managing your PA Communication Video Clip Conflict Resolution Managing your PA Communication Video Clip Conflict Resolution Back-up Planning Emergency Planning Secondary Conditions Social Networking Activity Assistive Technology Paraquad Programs/Tour

7. Section 1: Consumer Training Content Recruitment Where to find? Where to advertise? Topics to cover when interviewing Job requirements, personal care tasks Tips for training new PA Describe the task step-by-step Demonstrate the task with a family member

8. Section 2: Consumer Training Content Managing PA Direct attendants- not the other way around Communication Appropriate boundaries for relationship Conflict resolution Feedback techniques Avoid playing the blame game

9. Section 3: Consumer Training Content Back up and Emergency Planning What to do if PA cannot come to work Secondary Conditions Respiratory problems, urinary tract infections, and pressure sores Assistive Technology Ex: Wheelchairs, walkers, shower bench, bedside commode

10. Training Program: Group Activity Social Connectivity Activity Social Networking Cognitive Mapping- where do you go? The goal is to share accessible community locations in hopes of increasing community participation

11. PA Training Program CDPAS Program Specific Info Person First Language Expectations/Professional Behaviors CDPAS Program Specific Info Person First Language Expectations/Professional Behaviors PA Skills, Participation and Health Hand Washing Personal Care Secondary Conditions Emergency Preparedness Range of Motion PA Skills, Participation and Health Hand Washing Personal Care Secondary Conditions Emergency Preparedness Range of Motion Assistive Technology Paraquad Programs/Tour Transfers Timesheet Training Multiple Choice Exam

12. Section 1: PA Training Content CDPAS Program Specific Who is the employer? Paraquad Role Contacts at Paraquad Background Checks Person First Language Expectations/Professional Behaviors Mandated Reporting HIPAA Medicaid Fraud Plan of care

13. Section 2: PA Training Content PA Skills, Participation and Health Hand washing Importance Characteristics of a good attendance and importance of job Personal Care Dressing Techniques Bowel/Bladder Care Secondary Conditions UTI/Bowel impaction Pressure sores

14. Section 3: PA Training Content Assistive Technology Mobility Devices-types and definition Cushions ADL Devices Paraquad Programs and Services/Tour Transfers Video/handouts Hands-on Hoyer lift Timesheets

15. Section 3 Cont.: PA Training Content Range of Motion Definition/purpose Types Techniques Emergency Preparedness Signs of medical emergencies/what to do Information PA needs to know Basic health history Medications Family contacts

16. Section 4: PA Training Content Multiple choice exam Training Content Must pass test to receive $.24/hour pay increase

17. Next Steps Minor modifications to improve and increase sensitivity of surveys (IRB) Continue with Data Analysis Resume Data Collection Train Paraquad staff to administer surveys and training sessions Survey Consumers whose PA receives training Schedule First Consumer/PA Training Session

18. Contact Information David Gray, Ph.D. graydb@wusm.wustl.edu Jessica Dashner, OTD OTR/L dashnerj@wusm.wustl.edu