Enhancing Quality of Life: AgrAbility Latest Insights & Future Directions

1. 2018 AgrAbility NTW, Portland, MEMarch 21, 201811:10-11:55 am By Robert J. Fetsch, Extension Specialist & Professor Emeritus NAP Evaluation Committee Coordinator, Hamida Jinnah, Director Research & Evaluation Unit University of Georgia &NAP Evaluation Committee AANTWMcGillQOL3.2118 (Rev. 3.1618)

2. To “AgrAbility Quality of Life:Our Latest Findings and Future Directions”

3. AgrAbility Quality of Life:Our Latest Findings and Future Directions By Robert J. Fetsch (CSU) & Hamida Jinnah (UGA), Robert Aherin & Chip Petrea (UIL),Hannah Barthels, Vicki Janisch, & Abigail Jensen (UW), Sheila Simmons & Kerri Ebert (KU), Candiss Leathers & Danielle Jackman (CSU/Goodwill Denver), Nancy Frecks & Sharon Nielsen (UN), Linda Fetzer (PSU), Karen Funkenbusch (UMO), Rick Peterson (TAMU), Linda Jaco, Jan Johnston, & Diana Sargent (OSU), Toby Woodson (UAR),Richard Brzozowski & Leilani Carlson (UME), Inetta Fluharty (WVU), Kirk Ballin (ESVA), &Betty Rodriguez, Michele Proctor & Madeline McCauley (ECU).

4. Our AgrAbility Vision “The vision of AgrAbility is to enhance the quality of life for farmers, ranchers, and other agricultural workers with disabilities, so that they, their families, and their communities continue to succeed in rural America.” Source: Retrieved from www.agrability.org/about/program/#mission

5. What’s Our Agenda Today? Introduction. Summarize QOL Pretest-Posttest Results. Summarize QOL AgrAbility Intervention Group Versus No-Treatment Comparison Group Results. Report Current AgrAbility Demographic Results. Discuss Future Directions.

6. What’s Our Agenda Today? Introduction.

7. 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.

8. Measures Used in 12-State Study McGill Quality of Life (QOL) Survey AgrAbility Independent Living & Working Survey (ILW) Thank you, Carla Wilhite! NAP Demographic Data

9. What Has AgrAbility Achieved?What Can We Show for It? So far 15/20 currently funded SRAPs are working to collect data from AgrAbility clients with an on-site visit. 17 SRAPs used the same measures to assess QOL changes from before AgrAbility to after AgrAbility. 12 SRAPs collaborated to assess treatment no-treatment comparison group differences. 14 SRAPs collaborated to discover behavioral health improvements.

10. What’s Our Agenda Today? 2. Summarize QOL Pretest-Posttest Results.

11. What Has AgrAbility Achieved?What Can We Show for It? We compared pretest-posttest change scores with 191 AgrAbility participants in 10 states. Their ILW and QOL levels improved (p < .001) with large or larger than typical effect sizes. Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (in press). Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities. Disability and Health Journal. doi: http://dx.doi.org/10.1016/j.dhjo.2017.08.001

12. AgrAbility was effective at improving ILW & QOL levels regardless of…. Gender Owner/operator or Non owner/operator Full-time or Part-time Months with AgrAbility (M = 14.75; SD = 9.86; Range = 1-74) Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (in press). Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities. Disability and Health Journal. doi: http://dx.doi.org/10.1016/j.dhjo.2017.08.001

13. AgrAbility was effective. Middle-age adults’ improvement in ILW was almost twice the increase for younger and older adults combined (1.96 times). AgrAbility clients whose disabilities’ origins were incident related experienced gains in ILW almost twice that of those with chronic origins (1.82 times). Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (in press). Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities. Disability and Health Journal. doi: http://dx.doi.org/10.1016/j.dhjo.2017.08.001

16. AgrAbility was especially effective assisting those…. In the middle-age group (45-65). With AgrAbility clients whose origins of disability were incident related rather than chronic. Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (in press). Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities. Disability and Health Journal. doi: http://dx.doi.org/10.1016/j.dhjo.2017.08.001

17. AgrAbility can improve their effectiveness at serving clients…. Who are younger and older. Whose origins of disabilities were chronic. Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (in press). Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities. Disability and Health Journal. doi: http://dx.doi.org/10.1016/j.dhjo.2017.08.001

18. AgrAbility Teams are encouraged to…. Meet with DVR Counselors, Extension Agents, OTs, PTs, other professionals, and groups of clients. Come up with better strategies to assist folks whose disability origins are chronic. Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (in press). Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities. Disability and Health Journal. doi: http://dx.doi.org/10.1016/j.dhjo.2017.08.001

19. “Bad News” “However, this study did not determine whether other factors may have contributed to participants’ positive outcomes.” “No impact study.” Source: U.S. Government Accounting Office. (2012). Employment for people with disabilities; Little is known about the effectiveness of fragmented and overlapping programs (GAO Publication No. 12-677). Washington, DC. (pp. 27, 80).

20. How do we know these results are not due to something other than our AgrAbility information, education and service?

21. What’s Our Agenda Today? 3. Summarize QOL AgrAbility Intervention Group Versus No-Treatment Comparison Group Results.

22. What Our NAP Evaluation Committee Decided to Do Was… To compare two groups’ Pretest-Posttest QOL & ILW levels 225 AgrAbility Intervention Group participants who complete matched pretest- and posttest-surveys. 100 No-Treatment Comparison Group participants who complete matched pretest- and posttest-surveys.

23. Chip Petrea Worked Diligently with the No-Treatment Group. Chip provided us with 100 matched pretests and posttests. None of the No-Treatment Comparison Group participants ever received AgrAbility services currently or in the past. Thank you, Chip!

24. History of NAPEC Twelve SRAP’s conducted a 10-year (2/20/2007-1/20/2017) treatment no- treatment comparison, pretest-posttest study to answer two questions: Is AgrAbility effective for enhancing ILW & QOL levels? Is AgrAbility more effective than no treatment?

25. What Has AgrAbility Achieved?What Can We Show for It? In a 10-year AgrAbility treatment no-treatment comparison group study we found that AgrAbility participants (N = 225) reported statistically significantly pretest-posttest improvements in QOL levels (p < .001) while no-treatment group participants (N = 100) reported no change in QOL levels. Source: Fetsch, R. J. & Turk, P. (in press). A quantitative assessment of the effectiveness of USDA’s AgrAbility Project. Disability and Health Journal. https://doi.org/10.1016/j.dhjo.2017.10.004

26. McGill QOL Pretest-Posttest Total Score Changes for Treatment & No-Treatment Comparison Groups Source: Fetsch, R. J. & Turk, P. (in press). A quantitative assessment of the effectiveness of USDA’s AgrAbility Project. Disability and Health Journal. https://doi.org/10.1016/j.dhjo.2017.10.004

27. Results from 12 States Found that on Average… 196 AgrAbility intervention group participants’… QOL levels increased 28% (p < .001). ILW levels increased 30% (p < .001). 97-100 no-treatment comparison group participants’… QOL levels declined 4% (N.S.) ILW levels increased 8% (p < .05). Source: Fetsch, R. J. & Turk, P. (in press). A quantitative assessment of the effectiveness of USDA’s AgrAbility Project. Disability and Health Journal. https://doi.org/10.1016/j.dhjo.2017.10.004

28. ILW Pretest-Posttest Total Score Changes for Treatment and No-Treatment Groups Source: Fetsch, R. J. & Turk, P. (in press). A quantitative assessment of the effectiveness of USDA’s AgrAbility Project. Disability and Health Journal. https://doi.org/10.1016/j.dhjo.2017.10.004

29. “Good News” These matched pretest-posttest results suggest that 12 AgrAbility Projects may be more effective than a no-treatment comparison group at increasing QOL and ILW levels (AR, CO, KS, ME, NC, NE, OK, PA, TX, VA, WI, & WV).

30. “Good News” We now have data from a no-treatment comparison group. We now have some empirical evidence that suggests that the increases in QOL and ILW may be due to AgrAbility in 12 states/SRAPs.

31. What’s Our Agenda Today? 4. Report Current AgrAbility Demographic Results.

32. Figure 1. Number Client Reports Per Grant Year and Number New Clients Per Grant Year

33. Figure 4. Most Prevalent Origins of Disability in Total Sample Client Reports and in New Client Sample Total Sample Reports (N = 18,438) New Client Sample (N = 7,779)

34. From 25 years of Demographic Data We Learned that: AgrAbility provided information, education, and service to an estimated 11,754 new clients (1992-2015) with c. 490 new participants added each year. The average age was 52.12 years. 75.1% were male.

35. From 25 years of Demographic Data We Learned that: Primary causes of disabilities were: Chronic nonincident related (41.7%); Non-agricultural incidents (32.2%); and Agricultural incidents (19.5%). Most clients worked with AgrAbility 2-7 years (M = 14.85 months).

36. We are building a road to Evidence-Based AgrAbility Programming over the next three years—Together!

37. Questions? & Answers

38. What’s Our Agenda Today? 5. Discuss Future Directions.

39. What Are Our Newest Directions? How do we get more matched pretest-posttest QOL data? Is AgrAbility more effective at enhancing the behavioral health levels of farmers and ranchers with disabilities than no treatment? What are we learning about who gains the most from AgrAbility in our qualitative case studies project?

40. Further Research Is Needed to Answer… What can we learn from AgrAbility demographics? How effective is AgrAbility at improving behavioral health levels of clients? What can we learn from those who improved the most or the least? What did they and their SRAPs do differently?

41. Future Directions for Our Qualitative Case Study by Hamida Jinnah & Paige Tidwell, University of Georgia Methods Key interview questions Preliminary themes from the data

42. To Answer These Questions… More SRAPs are encouraged to join us especially new SRAPs (OH & TN). SRAPs are encouraged to collect more matched pre-test and post-test data.

43. Thank you very much!

44. Why Join Us? Document your project’s effectiveness at increasing clients’ ILW and QOL levels. Enhance your chances of receiving funding next time with empirical evidence of your SRAP’s quality and effectiveness. (Cf. FY 2018 RFA, pp. 17, 18, and 25.) Increase your chances for outside funding by demonstrating your accountability. Contribute to AgrAbility’s Vision.

45. Won’t You Join Us? Here’s How: Send an email to robert.fetsch@colostate.edu. Seek IRB approval from your Land-Grant University. Study and use the same protocol. Adapt CO to __ on pp. 1-2 & mail. Enter your data into an Excel file that we will provide, proof perfectly & email to me.

46. National AgrAbility Project Evaluation Committee (NAPEC) Produced Results Published 5 refereed journal articles, 2 are in press, & 2 are in preparation. Christen, C. T., & Fetsch, R. J. (2008). Colorado AgrAbility: Enhancing the effectiveness of outreach efforts targeting farmers and ranchers with disabilities. Journal of Applied Communication, 92(1&2), 57-73. Fetsch, R. J., & Collins, C. L. (2018, February). The effects of AgrAbility on the mental/behavioral health of farmers and ranchers with functional limitations: A comparison study. Medical Research Archives, 6(2). doi: https://doi.org/10.18103/mra.v6i2

47. National AgrAbility Project Evaluation Committee (NAPEC) Produced Results Published 5 refereed journal articles, 2 are in press, & 2 are in preparation. Fetsch, R. J., & Jackman, D. M. (2015, December). Colorado’s AgrAbility Project’s effects in KASA and practice changes with agricultural producers and professionals. Journal of Extension, 53(6), Number 6, Article # 6FEA6. Available from http://www.joe.org/joe/2015december/a6.php

48. NAPEC Produced Results Published 5 refereed journal articles, 2 are in press, & 2 are in preparation. Fetsch, R. J., Jackman, D. M., & Collins, C. L. (in press). Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities. Disability and Health Journal.http://dx.doi.org/10.1016/j.dhjo.2017.08.001 Fetsch, R. J. & Turk, P. (in press). A quantitative assessment of the effectiveness of USDA’s AgrAbility Project. Disability and Health Journal. http://dx.doi.org/10.1016/;j.dhjo.2017.10.004

49. NAPEC Produced Results Published 5 refereed journal articles, 2 are in press, & 2 are in preparation. Jackman, D. M., Fetsch, R. J., & Collins, C. L. (2016). Quality of life and independent living and working levels of farmers and ranchers with disabilities. Disability and Health Journal, 9, 226-233. http://dx.doi.org/10.1016/j.dhjo.2015.09.002 Meyer, R. H. & Fetsch, R. J. (2006). National AgrAbility Project impact on farmers and ranchers with disabilities. Journal of Agricultural Safety and Health, 12(4), 275-291.

50. NAPEC Produced Results Published 5 refereed journal articles, 2 are in press, & 2 are in preparation. Fetsch, R. J., Petrea, R. E., Field, W. E., Jones, P. J., & Aherin, R. A. (2017, August 26). A 25-year overview of AgrAbility demographics. Manuscript in preparation.