20 research outputs found
Evidence-Based Implementation Process for the Development of an Assistive Technology Self-Management Intervention
No full textAbstract
Date Presented 3/31/2017
We describe the use of a four-step systematic method to develop an evidence-based and theory-driven health intervention. Our results support the use of a systematic framework to guide occupational therapy researchers and practitioners through a comprehensive intervention development process.
Primary Author and Speaker: Elsa Orellano
Additional Authors and Speakers: Salim Pérez
Contributing Authors: Mailin Aquino, Andrea García, Jomaly Guilbe, Roxana López, Marta Rivero</jats:p
Occupational participation of older Puerto Rican adults
No full textFebruary 2008 A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy. Typescript Project Advisor : Max Ito Older adults may undergo changes in occupational participation patterns due to the process of aging, to institutionalization, or to illness. Measuring occupational participation of older adults using a client-centered approach has become a professional mandate for occupational therapists. The Activity Card Sort was developed to measure the level of client activity participation in instrumental, socio-cultural, and leisure activities. With the authors\u27 permission, a valid method of translation and cultural adaptation of the ACS was developed based on a sample of older Puerto Rican adults and occupations relevant to this population derived from a previous study. The final version used in this analysis included 82 picture cards of older adults participating in typical Puerto Rican occupations which clients were to sort into five categories. The purpose of this study was to determine the validity and reliability of the translated and culturally-adapted Puerto Rican Spanish version of the Activity Card Sort (PR-ACS) for older Spanish-speaking adults living in Puerto Rico. This study included 146 participants, two groups of 106 community-living, healthy older adults aged 60 or older and 40 adults with multiple sclerosis (MS) aged 50 or older. The study explored evidence of validity by examining the relationship of the PR-ACS current activity scores with other variables. Reliability evidence included test-retest and internal consistency. Results showed that the PR-ACS was able to discriminate between clients with different levels of functioning (t = 6.86; p = .00), and was positively associated with the Puerto Rican Version of the RAND 36-Short Form Health Survey (r = 0.66; p = .00). Good test-retest reliability (r = 0.82) and high internal consistency of the total scores of the combined sample (r = 0.91) and the sample of healthy older adults (.91) were demonstrated, as well as good internal consistency of these scores for the sample of individuals with MS (.77). The findings suggest the PR-ACS is a reliable and valid instrument to use with the Puerto Rican elderly population
Assistive Technology Needs and Measurement of the Psychosocial Impact of Assistive Technologies for Independent Living of Older Hispanics: Lessons Learned
No full text(1) Knowledge about the assistive technology (AT) needs and psychosocial impact of AT in different populations is needed because the adoption, retention, or abandonment of AT may be influenced by the psychosocial impact that AT has on its users. The aims of this study were to: (a) identify the AT needs of a sample of Hispanic older adults with functional limitations; (b) describe the psychosocial impact of these technologies on the sample’s quality of life; and (c) describe the methodological challenges in using the Puerto Rican version of the Psychosocial Impact of Assistive Device Scale (PR-PIADS) with a Hispanic sample; (2) Methods: This study used a cross-sectional design conducted with a sample of 60 participants. Data was collected using the Assistive Technology Card Assessment Questionnaire (ATCAQ) and the PR-PIADS. Data analyses included descriptive statistics and bivariate analysis; (3) Results: The sample’s most frequently reported needs for AT devices were in the areas of cooking, home tasks, and home safety activities. The sample reported a positive impact of AT use in their quality of life. Several methodological challenges of the PIADS were identified; (4) Conclusions: The sample has unmet needs for using AT devices to overcome difficulties in daily living activities
The Level of Central Bank Independence in Developed and Developing Countries
No full textThis LLM dissertation offers a comparative examination of varying levels of Central Bank Independence in pursuit of monetary policy in developed and developing countries, looking particularly at the situation in developing countries in the Caribbean (Belize, Barbados and Jamaica) as compared to developed countries such as the United Kingdom (UK). The author explains the range of factors that can be taken into consideration to measure the level of CBI. Chapter 1 focus on the functions of a CB with particular emphasis on monetary policy and price stability as the primary objective of a CB as well as financial stability and its regulatory role in the financial system. Chapter 2 gives an overview of CBI, its importance and discusses the different types of CBI and its relation with accountability. Chapter 3 measures the level of CBI in the selected Caribbean jurisdictions using their CB’s Acts. An analysis is done based on the four (4) legal indicators stipulated in the Cukierman, Webb and Neyapti (CWN) index. Chapter 4 further provides theoretical and empirical evidence illustrating how CBI is greater in developed countries than developing countries by looking at the CWN legal indicators as well as the actual turnover rate (TOR) of governors at the CB of Belize as compared to the Bank of England (BoE)
Occupational Participation of Older Adults: Reliability and Validity of the Activity Card Sort—Puerto Rican Version
No full textThe Activity Card Sort was developed to measure the level of participation of older adults in instrumental, social, and leisure activities. The purpose of this study was to determine the psychometric properties of the translated and culturally adapted Puerto Rican Spanish version of the Activity Card Sort (PR-ACS). This study included 106 community-dwelling older adults aged 60 years and older and 40 adults with multiple sclerosis aged 50 years and older. Results showed that the PR-ACS was able to discriminate between clients with different levels of functioning (t = 6.86; p \u3c .001), and was positively associated with the Puerto Rican version of the RAND-36 Short Form Health Survey (r = 0.66; p \u3c .001). Good test—retest reliability (intraclass correlation coefficient = 0.82) and high internal consistency (Cronbach\u27s alpha = 0.91) were demonstrated. Initial evidence of construct validity, concurrent validity, internal consistency, and test—retest reliability was found to support the use of the PR-ACS to assess occupational participation of Puerto Rican older adults living in the community
Achieving ecological validity of occupation-based interventions for healthy aging
No full textNoTo develop a culturally sensitive occupation-based health promotion
intervention for older Hispanic adults who live alone. Methods: We used a mixed
method design for the content validation of the intervention and the Ecological Validity
Model (EVM) to culturally center the intervention. In the quantitative phase, aging experts
as well as community members from two activity centers for the elderly in Puerto
Rico completed a content validity ratio exercise. In the qualitative phase, we conducted
three focus groups with these participants. Data analysis included content validity ratio
and a directed content analysis. Results: This resulted in a working version of the
intervention protocol addressing the eight dimensions of the EVM. Conclusions: The
EVM can be used to culturally center preventive interventions to other ethnic minority
groups to augment the external validity and cultural competence of interventions.
Future research must test the feasibility of this new intervention.This publication was supported by National Institute of Health (NIH), National Institute of Minority Health and Health Disparities (NIMHD), Clinical Research Education and Career Development (CRECD) [R25RR017589] in collaboration with Puerto Rico Clinical and Translational Research Consortium (PRCTRC) [8U54 MD 007587-03] and the National Center for Research Resources (NCRR) [8U54RR026139-01A1]. The second author was supported by the National Institute of Drug Abuse (NIDA) (1K02DA035122-01A1). Its content is solely the responsibility of the authors and do not necessarily represent the official views of the NIH, NIMHD, or NCRR
Assistive technology unmet needs of independent living older Hispanics with functional limitations
No full text88 Feasibility of a Home-based Physiotherapy Program to Increase Physical Activity Levels in Older Adults with Diabetes Mellitus
No full textOBJECTIVES/GOALS: The objective of this study is to assess the feasibility and preliminary impact of a physiotherapy protocol for developing an individualized home-based physical activity program to increase physical activity (PA) levels in sedentary older adults with Type II Diabetes Mellitus (T2DM) living in Puerto Rico (PR). METHODS/STUDY POPULATION: This will be a pilot study with two phases. In phase 1, we will design a novel patient-centered home-based PA program protocol for adults ≥65 years with T2DM based on the Information-Motivation-Behavioral Skills model. Its content validity will be assessed through focus groups with 10 experts and 10 older adults and analyzed using a directed content analysis. Phase 2 we will be program implementation using a one-group, repeated measures design with 12 adults ≥65 years with T2DM. PA levels will be assessed by recording active minutes with a Fitbit. Risk of falls, balance, strength, and physical function will be assessed through standardized tests validated for this population. Statistical analysis will include descriptive statistics, comparisons via chi-square/Fisher’s exact test, and non-parametric tests. RESULTS/ANTICIPATED RESULTS: We expect to recruit a minimum of 12 participants and to administer the program for 12 weeks at a frequency of two visits per week. We anticipate that implementing and supervising the home-based PA protocol will be feasible as determined by recruitment and retention rates, patients’ satisfaction, and compliance with the program. We also expect that this protocol will increase physical activity levels, improve general strength, balance, physical function, and reduce the risk of falls in sedentary older adults with T2DM. DISCUSSION/SIGNIFICANCE: As the third cause of death in PR, T2DM represents a public health challenge. An effective home-based PA program may decrease morbidity and mortality rates in older adults by increasing PA and functional health. This study will provide data for planning a randomized controlled trial to assess its effectiveness in the outcomes of interest
Environmental Restrictors to Occupational Participation in Old Age: Exploring Differences across Gender in Puerto Rico
No full textMany older adults face challenges that prevent them from accomplishing common daily activities such as moving around, home maintenance, and leisure activities. There is still a need to examine and understand how environmental factors impact daily participation across gender. This study sought to make a qualitative comparison of gender differences regarding environmental barriers to participation in daily occupations from the perspectives of older adults who live alone in Puerto Rico. Twenty-six Hispanic older adults, 70 years or older participated in this study. We used a descriptive qualitative research design in which researchers administered an in-depth interview to each participant. The results elucidated that women were more likely than men to experience restricted participation due to lack of accessibility of the built environment and transportation systems. The findings could help with the development of tailored, occupation-based, preventive interventions that address gender specific environmental barriers and promote greater participation among both women and men. Further research is required to explore whether these environmental barriers to occupational participation remain consistent across living situations, socioeconomic status and ethnicity
193 Beyond Independence: The Empowering Potential of an Assistive Technology Web App to Enrich the Lives of Older Latinos with Functional Disabilities
No full textOBJECTIVES/GOALS: The use of assistive technology (AT) devices is known to improve older adults’ independence in daily activities. However, little is known about the impact of using an AT web app in older Latinos’ life. This study aims to evaluate the value and usefulness of the My Assistive Technology Guide web app among older Latinos with physical function disabilities. METHODS/STUDY POPULATION: We employed a convergent parallel mixed-method design with 12 community-living older Latinos from Puerto Rico. Researchers provided training in the use of My Assistive Technology Guide, a Spanish evidence-based web app with detailed information on 97 AT devices and videos of older people using them. Participants were encouraged to use it for 30 days. Afterward, we collected quantitative data using the subjective quality domain of the User Mobile Application Rating Scale (uMARS), followed by qualitative data through individual interviews. Quantitative data were analyzed with descriptive statistics and qualitative data with thematic content analysis. RESULTS/ANTICIPATED RESULTS: My Assistive Technology Guide web app received high ratings in the uMARS subjective quality domain (mean 4.5 [SD 0.5] out of 5), indicating that participants highly valued the usefulness of the web app. Qualitative data fell into four main categories: functional health, meaningful participation, autonomy, and personal growth. DISCUSSION/SIGNIFICANCE: The findings suggest that the AT knowledge provided by the My Assistive Technology Guide web app has the potential to enhance the quality of life of older Latinos in the face of the challenges posed by physical function disabilities as people age
