R3. Evaluating a Self-Management Intervention to Community Living, Participation and Employment after a Stroke
Joy Hammel, Ph.D, OT
An increasing body of evidence is pointing to the significant influence of the environment on health, health service use. Conceptually, the environment includes the built/physical environment, cognitive or learning contexts and supports, the social and community environments, and the system/policy level environmental factors. We are beginning to see the critical tie between these environmental factors and their influences on physical and emotional health, community living and mobility, community participation, employment and quality of life outcomes.
Another complimentary body of research has examined the effectiveness of “self-management” interventions that focus on increasing people’s ability to problem solve and strategize how to manage symptoms of conditions and impairments in everyday life across different environments (social, physical, system). In other words, these interventions focus on learning how to manage disability, including how to strategize environmental supports in order to remain healthy, stay in one’s home in the community, and pursue life goals, such as work. These interventions use a social learning approach in which small groups of peers with the same conditions share strategies with each other to problem solve individual and environmental barriers to everyday life, and in turn, via the group, increase their own individual self efficacy to problem solve future issues. Thus, they learn a problem solving approach they can use long term.
This project will develop, deliver and evaluate a Home, Community & Employment Self Management intervention program with people with stroke who are pursuing long term community living, participation and work goals following their stroke. The project will evaluate the impact and effectiveness of this intervention, as well as examine the individual and environmental factors most influencing these key life outcomes.