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

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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)

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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.

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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).

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History of National AgrAbility Evaluation Committee

• 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.

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History of National AgrAbility Evaluation Committee

• 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?

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History of National AgrAbility Evaluation Committee

• 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

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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).

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History of National AgrAbility Evaluation Committee

• 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.

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History of National AgrAbility Evaluation Committee

• 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.

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History of National AgrAbility Evaluation Committee

• 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.

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History of National AgrAbility Evaluation Committee

• 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

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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.

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

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

• Year original disability occurred ranged from 1937 to 2008.

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

• 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.

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

• 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.

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

• 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

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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

Pre-Survey Post-Survey

Support (N = 3)

Physical Symptoms (N= 3)

MQOL Total (N = 1)

McGill Pre- Post-Survey Changes

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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

Pre-Survey Post-Survey

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

Pre-Survey Post-Survey

Access workspaces (N= 2)

Live in home on farm(N = 3)

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

Ability to Remain in Agriculture Subscale

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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

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

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• 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.

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• 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.

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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.

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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).

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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?

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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!

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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?

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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.

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Won’t You Join Us?

1. Send an email to fetsch@cahs.colostate.edu.

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.

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Thank you very much!

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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?