Increasing the Winter Community Participation of Older Adult Wheelchair Users

Study Overview
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Brief Summary
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The purpose of this study is to examine whether intervention strategies targeted at the level of the environment (e.g. improving access to community based leisure groups, transportation) can successfully promote the community participation experiences of community-dwelling older adult Manitobans who use wheelchairs in the winter.

Detailed Description
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There is strong evidence to support that community-dwelling older adults who are able to maintain their involvement in social, recreational, spiritual and physical activities experience positive effects on their health and quality of life. While winter creates challenges to community participation for many Manitobans, these difficulties are magnified for older adults and particularly for older adults who use wheelchairs. The aim of this study is to explore ways to improve or maintain community participation of community-dwelling older adults who use wheelchairs in the winter. Using a single-subject design, five older adult Manitobans who are wheelchair users will each select three community-based participation goals to work on throughout the winter months. Each older adult participant will work with an occupational therapist to receive individually-focused interventions aimed at increasing his or her community participation. The investigators will use a client-centered outcome measure designed to detect changes in performance and satisfaction in the goals that the individual has self-identified as being important to him or her, yet difficult to perform. The findings of this study will help determine the feasibility of conducting a larger scale study that would include a greater number of older adult Manitobans. Older adult wheelchair users in Manitoba bear a disproportionate burden in the winter when aging, mobility limitations, and weather coincide to create conditions that make community participation exceedingly difficult. It is important to the health and well-being of older adult Manitobans to find effective ways to promote community engagement throughout the winter months.

Official Title
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Increasing the Winter Community Participation of Older Adult Wheelchair Users

Conditions
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Frail Elderly

Intervention / Treatment
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* Behavioral: Participant-identified community based activity


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 70 or older, user of a manual or power wheelchair or scooter for outdoor mobility Self-identifies a reduction in community participation throughout the winter months Community-dwelling Lives within the perimeter of Winnipeg. Exclusion Criteria: Geriatric Depression Scale-SF score of 6 or more Montreal Cognitive Assessment score of 25 or less

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Behavioural<br>Participant-identified community based activity | Behavioral: Participant-identified community based activity<br>* The Canadian Occupational Performance Measure (COPM) is a client-centered outcome measure designed to detect changes in performance and satisfaction in occupations that the individual has self-identified as being important and difficult to perform. The COPM will be used to set self-identified, community-based activities as treatment goals.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Occupational Performance Using the The Canadian Occupational Performance Measure (COPM) at 5 Months | The Canadian Occupational Performance Measure (COPM) is a client-centered outcome measure designed to detect changes in performance and satisfaction in occupations that the individual has self-identified as being important and difficult to perform. The COPM has well-established psychometric properties and will be used as the primary outcome measure and will be used to set treatment goals, determine baseline stability, and detect change in performance of, and satisfaction with, the goals. | Initial and 5 month follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS2) | The WHO-DAS 2.0 is a generic self-report health status measure, linked to the concepts of health and disability outlined in the International Classification of Functioning, Disability and Health and is intended to identify limitations in six domains with 36 items, including self-care, and community and social functioning experienced over the past 30 days. The WHO-DAS 2.0 is responsive to change, has excellent internal consistency, established content validity, and high convergent validity. The WHO-DAS 2.0 will be used to identify changes in overall health status that occur through the study. Uses a scale of 1-5 - 1=no difficulty and 5=extreme difficulty or cannot do. Sum of items within each domain are then summed across the 6 domains to result in a general disability summary score, converted to a metric from 0-100 with higher score indicating more disability. | Initial and 5 month follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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wheelchairs, social participation