Evaluation of Project TEAM (Teens Making Environmental and Activity Modifications)
Condition: Transition-age Youth; Developmental Disabilities; Cerebral Palsy; Autism; Intellectual Disability
MeSH terms: Cerebral Palsy; Intellectual Disability; Developmental Disabilities
Study type: Interventional

Summary: 
      The purpose of this study is to determine the extent to which Project TEAM (Teens making
      Environment and Activity Modifications) is an effective, socially valid, and feasible
      intervention that prepares youth with developmental disabilities ages 14-21 to respond to
      environmental barriers and increases participation in school, work, and the community.
      Project TEAM is a manualized intervention co- facilitated by a disability advocate and a
      licensed professional. The intervention includes eight group sessions and two experiential
      learning field trips. In addition, young adults with disabilities serve as peer mentors on
      field trips and contact youth weekly to support attainment of goals. Project TEAM outcomes
      are to: increase youths' knowledge of environmental factors and modification strategies;
      reduce the impact of environmental barriers on participation; increase self-efficacy and
      self-determination; and increase participation in a personal activity goal in the area of
      education, employment, or community life. This project builds on a participatory action
      research partnership with disability community stakeholders to address the following research
      questions: (1) To what extent do youth with disabilities participating in Project TEAM
      achieve intervention outcomes? (2) What are the characteristics of youth with disabilities
      who most benefit from Project TEAM? (3) To what extent are goals, procedures, and outcomes of
      Project TEAM important and acceptable (socially valid) to youth with disabilities?.
    

Detailed description: 
      Disparities in school, work, and community participation impact the 15% of youth in the
      United States estimated to have a developmental disability. A growing body of literature
      suggests disparities in participation are due to barriers in the physical and social
      environment. Practitioners and advocates have developed skill and advocacy interventions in
      an attempt to increase the participation of youth with disabilities. Yet none of these
      interventions focus specifically on acquiring the problem-solving skills needed to identify
      environmental barriers and generate modification strategies to resolve barriers to
      participation. Research indicates that there is a vital need to develop manualized,
      theory-based interventions that empower youth with developmental disabilities to identify and
      advocate for environments that support their participation in school, work, and the
      community.

      The purpose of this study is to determine the extent to which Project TEAM is an effective,
      socially valid, and feasible intervention that prepares youth with developmental disabilities
      ages 14-21 to respond to environmental barriers and increases participation in school, work
      and the community. Project TEAM is a manualized intervention co- facilitated by a disability
      advocate and a licensed professional. The intervention includes eight group sessions and two
      experiential learning field trips. In addition, young adults with disabilities serve as peer
      mentors on field trips and contact youth weekly to support attainment of goals. Project TEAM
      outcomes are to: increase youths' knowledge of environmental factors and modification
      strategies; reduce the impact of environmental barriers on participation; increase
      self-efficacy and self-determination; and increase participation in a personal activity goal
      in the area of education, employment, or community life. Pilot research showed that Project
      TEAM participants (N=20) had a significant increase in knowledge of environmental barriers
      and modification strategies (t(19) = -6.37, p=.00), and 57% increased their participation in
      one activity.

      This project builds on a Participatory Action Research (PAR) partnership with disability
      community stakeholders to address the following research questions: 1) To what extent do
      youth with disabilities participating in Project TEAM achieve intervention outcomes? 2) What
      are the characteristics of youth with disabilities who most benefit from Project TEAM? 3) To
      what extent are goals, procedures, and outcomes of Project TEAM important and acceptable
      (socially valid) to youth with disabilities? This project uses a multi-site,
      quasi-experimental repeated measures design with matched controls to evaluate Project TEAM.
      Sixty-four youth ages 14-21 with developmental disabilities will participate in Project TEAM
      and complete outcome measures at three time points: 2 weeks pre-intervention, 2 weeks post-
      intervention, and follow-up 6 weeks post-intervention. A control group of 64 youth, matched
      to intervention participant characteristics using a three tiered approach, will complete
      outcome measures at time points that correspond with the intervention group. Outcome measures
      assess goal attainment (Goal Attainment Scaling), knowledge and application of skills
      acquired during intervention (Project TEAM Knowledge Test), changes in participation and
      impact of barriers on participation (Participation and Environment Measure- Child &Youth),
      self-efficacy (Generalized Self Efficacy Scale), and self-determination (AIR
      Self-Determination Scale). Characteristics that may influence the extent to which youth
      benefit from Project TEAM will be assessed using a battery of descriptive measures. Outcomes
      will be analyzed within and across groups to evaluate the effectiveness of Project TEAM.
      Feasibility and adherence to the proposed design will be evaluated using a process
      evaluation.

      To evaluate social validity, a Youth Research Panel (YRP) of 6 youth with disabilities ages
      14-21 and a Consumer Research Specialist will administer a satisfaction survey and focus
      group interview to Project TEAM participants. Parents (n= 64) will also participate in
      on-line focus groups to evaluate the feasibility and usefulness of Project TEAM. The YRP and
      other members of the research team will use an action/reflection process to interpret data
      and revise Project TEAM to maximize outcomes for future implementation. The YRP will
      disseminate information about Project TEAM to local and national capacity- building
      organizations targeted to youth with disabilities. The PI will also disseminate findings to
      professionals and the disability community via a website, presentations, and peer- reviewed
      journals.
    

Intervention name(s): Project TEAM; Matched Comparison
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Project TEAM is a manualized, group-based intervention designed to be co-facilitated by an experienced leader with a disability (disability advocate) and a licensed service provider (such as an occupational therapist, social worker, or educator). Project TEAM includes eight group sessions and two experiential learning field trips for each participant. Weekly phone calls with peer mentors with disabilities support achievement of each participant's personal activity goal.; Participants set goal to try a new activity in the community
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: repeated measures; matched comparison; manualized intervention; self-determination; participation; advocacy; problem-solving; commuinity participation; occupational therapy; environment