Living Well With a Disability Curriculum Adaptation Evaluation Plan
Phase: NA
Conditions: Health Education, Community Health Services, Health Services for Persons With Disabilities, Developmental Disabilities
Sponsor: Georgia Southern University

 
 
 
LIVING WELL WITH A DISABILITY CURRICULUM ADAPTATION EVALUATION PLAN 
 
 
H18234 
 
2-13-18 
 
IRB Approval Date: 2-5-18 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Objectives 
1. Adapt the Living Well in the Community peer led health promotion program to address the 
needs of families caring for adolescents living with a disability in rural, southeast Georgia.  
2. Implement the adapted Living Well in the Community program in southeast Georgia.  
3. Evaluate the adapted Living Well in the Community program.  
 
Investigators will provide technical assistance to local Peer Facilitators and develop a Parent 
Facilitator Guide to accompany the Living Well in the Community program. A local community 
partner will recruit 20 families to participate in the pilot of the adapted program. Four members 
of the Navigator Team will serve as Parent Mentors and lead 5 families through adapted Living 
Well in the Community program. Investigators will 1) matching parent facilitators with families, 
2) scheduling and confirming weekly meetings, 3) scheduling and confirming bi-weekly 
workshops and 4) leading bi-weekly workshops that will include extended programming for 
parents and children.  
 
Hypothesis 
 
We hypothesize that families in participating in the program will experience increases in health-
related quality of life, mental health, and physical activity.  
 
Design  
 
Investigators will conduct a mixed-methods evaluation of the adapted curriculum including both 
children and youth participants to measure changes in outcomes and consumer satisfaction 
with the program. 
 
Methods 
 
First, parent facilitators will be recruited and matched with their peers. Parent facilitators will be 
community members with a child with a disability. The peer matching resembles the community 
lay health worker model. The community lay health worker model will reduce the amount of time 
needed to meet face to face with families. To begin adapting the facilitator training and 
curriculum, the program directors will work with investigators to review and update training 
materials. Parent facilitators will undergo an online, intensive facilitator training. The facilitator 
training is approximately 15 hours long. The training includes three major components: peer 
training, facilitator training, and Master “Train the Trainer” training. Five parent facilitators will 
work together with investigators to deliver the adapted curriculum to participating families. With 
bi-weekly meetings for 10 weeks between parent facilitators and family participants in the home 
or another desired location. The investigators have already participated in the facilitator training 
and will serve as mentors to newly trained facilitators. At the end of the online training session, 
the parent facilitators will be equipped to successfully implement the Living Well curriculum. The 
investigators will schedule a working meeting before and after the facilitator training to discuss 
curriculum changes. Changes in readability are anticipated since the target audience includes 
adolescents. Curriculum delivery methods will need tailoring to match a family-based approach 
including activities to be completed at the home at the family and individual levels for parents, 
siblings, and children. Both investigators and parent facilitators will lead monthly summary 
meetings to review the adapted content. These meetings will take place at a convenient location 
in the community. Pre and post focus groups will take place before and after these monthly 
meetings at a convenient locale in the community.  
 
 
 
 
 
 

Instrumentation 
 
Quantitative. The Patient Reported Outcomes Measurement Information System (PROMIS; 
see attached) will be used to examine mental health and physical activity. PROMIS has 4 
unique features: comparability, reliability/validity, flexibility, and inclusiveness. Its measures 
have been standardized, allowing comparisons across subpopulations and with the general 
population. Recently, pediatric versions have been adapted for proxy reporting in the areas of 
mental, physical, and social health. 
 
Qualitative. The project directors will conduct face to face interviews with the children living with 
disability participants and focus groups with the parent/caregiver participants to explore program 
effects and collect feedback on the adapted program. The project directors will aim to recruit 8- 
10 participants for the face-to-face interviews and 8-10 focus group participants from the 
families who participated in the curriculum. Both interviews and focus groups will last 
approximately 60 minutes. Interview and focus group guides will be developed and used to 
guide each interview and focus group. Interviews and focus groups will be recorded. Audio 
recordings will be transcribed verbatim. Transcripts will be analyzed using content analysis to 
identify codes and emergent themes. 
 
The evaluation team will collect questionnaires pre and post implementation. Each facilitator will 
have an envelope to return to the evaluation team. The evaluation team will enter the data into a 
SPSS database and analyze the results. A Multivariate analysis of variance (MANOVA) will be 
conducted for each survey with appropriate post hoc tests. Interview and focus group guides will 
be developed and used to guide each interview and focus group. Interviews and focus groups 
will be recorded. Audio recordings will be transcribed verbatim. Transcripts will be analyzed 
using content analysis to identify codes and emergent themes. 
 
Only data will only be presented in aggregate post analysis. 
 
Statistical Analyses  
 
All data will be analyzed by paired t-tests/Friedman’s test. To accommodate multiple comparisons, 
all p-values will be adjusted using Hochberg’s adjustment. 
 
Statistical Analysis Overview  
 
The evaluation team will collect questionnaires pre and post implementation. Each facilitator will 
have an envelope to return to the evaluation team. The evaluation team will enter the data into 
SAS database and analyze the results. We will evaluate differences between pre and post 
measures using a paired t-test for normally distributed data and Friedman’s test for non-normally 
distributed scales. 
 
Comparison Group Selection 
 
Each subject will serve as their own control. 
 
Comments  
 
A 5% increase in subscales are considered meaningful. With a 5% increase with a standard 
deviation of 0.1 and alpha = 0.007 (to account for multiple tests) power at N = 20 ranges from a 
low of 0.84 to a high of 0.99 calculated using SAS proc power. 
 
Type of Statistical Test  
 
Superiority 

Statistical Test of Hypothesis  
 
Null: There is no differences in scale and subscale measures between pre and post outcome 
measures. 
 
Alternative: There are differences in scale and subscale measures between pre and post outcome 
measures. 
 
All data will be analyzed by paired t-tests/Friedman’s test. To accommodate multiple comparisons, 
all p-values will be adjusted using Hochberg’s adjustment. 
 
P-Value  
 
p = .05  
 
Comments  
 
Hochberg’s adjustment 
 
Method 
 
t-Test, 2-Sided 
 
Other 
 
Other Method Name  
 
Friedman’s test 
 
Estimation Parameter 
 
Mean Difference (Final Values) 
 
Median Difference (Final Values) 
 
Parameter Dispersion Type  
 
Standard Error of the Mean