AgrAbility NTW McGill QOL
Lexington, KY
April 2, 2014
3:30-4:10 pm
By Robert J. Fetsch, Extension Specialist & Professor Emeritus
Director, Colorado AgrAbility Project,
Human Development & Family Studies
Colorado State University
& Robert Aherin,
Professor & Illinois AgrAbility Program Director
Department of Agricultural & Biological Engineering
University of Illinois Urbana Champaign
& NAP Evaluation Committee
AANTWMcGillQOL4.0214 (Rev. 3.2114)
What Can We learn from Our 493 New Clients with McGill QOL Pre-Survey Data?
By Robert J. Fetsch (CSU),
Robert Aherin (UIL),
Vicki Janisch (UW),
Sheila Simmons (KU),
Candy Leathers (CSU/Goodwill Denver),
Diana Sargent (OSU),
Kirk Ballin (ESVA),
Sharry Nielsen (UN),
Inetta Fluharty (WVU),
Rick Peterson (TAMU),
Leilani Carlson (UME),
Mary Hildebrand (ECU),
Toby Woodson (UAR),
& Danielle Jackman (CSU)
Our AgrAbility Mission
“The AgrAbility Mission is to enhance
and protect quality of life and preserve
livelihoods. It’s about supporting and
promoting growth and independence.
Ultimately it’s about hope.”
Source: National AgrAbility Project. (2011). It’s about hope [DVD]. Author: Purdue University.
NAPEC Produced Results
• Published two refereed journal articles and
submitted another.
– 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), 1-12.
– Jackman, D. M., Fetsch, R. J., & Collins, C. L. (2014). Quality of life
and independent living and working levels of farmers and ranchers
with disabilities. Manuscript submitted for publication.
– 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.
History of National AgrAbility
Project Evaluation Committee
• Early 2006—Kathryn Pereira, Evaluation Specialist
NAP U of WI, invited all SRAP’s to join in an
AgrAbility evaluation study.
• The National AgrAbility Evaluation Committee
(NAPEC) met approximately bi-monthly (2007Present) via teleconference/face-to-face (N = 6-25
participants/meeting).
How many SRAPs are collecting QOL and ILOS data from
their new clients?
History of National AgrAbility
Evaluation Committee
• As of 3/30/14, 16/24 SRAPs (66.7%) are on the
NAP Evaluation Committee (AR, CO, KS, ME, MN,
MO, NC, NE, OH, OK, PA, TX, UT, VA, WI, & WV).
History of National AgrAbility
Evaluation Committee
• 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.
Today Let’s Answer 5 Questions.
• 5 Questions:
– When they say “Yes” to AgrAbility, what are our clients’
QOL & ILW levels?
– How do QOL & ILW levels differ by primary disability?
– How do our QOL levels compare with Fetzer’s (2010)
non-intervention group?
– What’s ILW’s role in predicting QOL level?
– What implications can we draw from these results?
History of National AgrAbility
Evaluation Committee
• Eleven SRAP’s conducted a 6.5-year study
to answer the questions.
• McGill QOL—AR, CO, KS, ME, NE, NC, OK,
TX, VA, WI, & WV
• We collected 493 pre-surveys with a 60.4%
response rate.
Measures Used in 11-State Study
• McGill Quality of Life (QOL) Survey &
AgrAbility Independent Living & Working
Survey (ILW)
• NAP Demographic Data
McGill Quality of Life Scale
• Is short with only 17 items.
• Is a positive, strength-focused scale rather
than focused on lists of physical problems.
• Measures multiple domains—physical,
psychological well-being, support, and
experiential well-being domains.
• Fits well with our mission to give people
hope.
Protocol
• Procedure—11 SRAPs mailed each new
client the Pre-Survey, a cover letter, McGill
Pre-Survey, and a stamped, self-addressed
envelope with an invitation to complete
and return the Pre-Survey.
Protocol
• Participants were given the choice of
completing the survey themselves or of
having the items read aloud by the
AgrAbility team member. No one was
coerced to complete and return their
surveys.
We Have 3 Objectives Today
• To learn who our clients are when they say
“Yes” to AgrAbility.
• To learn which disabilities are associated
with the highest and lowest QOL and ILW
levels.
• To learn how your SRAP can join us in
determining AgrAbility’s effectiveness.
Who Were the Participants in the
Study (N = 493)?
• 75.1% were male; 20.1% were female; 4.9% N.R.
• 74.2% were Operators/Owners.
• 64.9% were Full-Time.
• M Age was 55.9 (SD = 13.8); M Age in U.S. was 57.1 in 2007.*
• Education level ?
• Ethnicity ?
• Total household income ?
• No. days off farm ?
• Veteran ?
*Source: Retrieved April 27, 2007 from http://nass.usda.gov/census/
Who Were the Participants in the
Study? (N = 474)
• Primary Agricultural Operation was…
– 32.9% dairy
– 25.5% livestock
– 22.6% field or grain
– 19.0% other
What Are Clients’ QOL Levels When
They Ask for AgrAbility Assistance?
• QOL levels M = 5.50 (SD = 1.63; N = 448;
Range = 0-10).
Results
• On QOL levels, males’ and females’ scores
were about the same.
• Middle-aged clients’ QOL levels were
significantly lower than those of younger
and elder clients.
QOL Levels by Age Group
What Were Clients’ Primary Disabilities (N = 493)?
• Back injury
83
16.8%
• Joint injury
69
14.0%
• Arthritis
48
9.7%
• Orthopedic injury
35
7.1%
• Visual impairment
20
4.1%
• Leg & foot amputation
19
3.9%
• Cardiovascular disease
19
3.9%
• Stroke
17
3.4%
• Spinal paraplegia & quadriplegia 16
3.2%
• Other
167 33.9%
QOL Levels by Disability
• On QOL levels by disability, what do you
think? Do you think they’re different by
disability? How?
Do QOL Levels Differ by Disability?
• On QOL levels by disability, there was no
difference by disability. Their QOL levels
were all about the same.
What Implications Can We Draw
from These QOL Results?
What Implications Can We Draw
from These QOL Results?
• Regardless of disability, our clients all begin
their work with us with about the same
QOL level.
• So we want to work hard with each of them
to assist them to modify their machinery,
home and workspaces to continue to live at
home.
How Do Our QOL Results Compare
with Fetzer’s (2010)?
Why Do You Think Fetzer’s average
QOL Level Was Higher than Ours?
What Implications Can We Draw
from These QOL Results?
How Do Our QOL Results Compare
with Fetzer’s (2010)?
• Maybe PA farmers and ranchers are happier and have
higher QOL levels.
• Maybe history intervened. Fetzer’s data was collected
prior to the Great Recession; ours was collected after the
Great Recession.
• Perhaps the breadth of the sample could account for the
difference—Fetzer’s was one state; NAP E. C.’s was 11
states.
• What else?
What Implications Can We Draw
from These QOL Results?
• Both samples rated support and experiential wellbeing highest.
• Given their high level of support, let’s encourage
our clients to continue to draw on family
members and agrifamily members for support.
• Families in tough times do better when they use
their support systems.
What Are Our Clients’ ILW Levels
When They Ask for AgrAbility?
• ILW levels M = 18.67 (SD = 5.34; N = 450;
Range = 0-30)
• With ILW levels, males’ ILW levels were
statistically significantly higher. Males’ M
= 19.26; Females’ M = 16.52.
What Are Our Clients’ ILW Levels
When They Ask for AgrAbility?
ILW Levels by Age Group
• ILW levels M = 18.67 (SD = 5.34; N = 450)
• With ILW levels, middle-age clients scored
significantly higher than the young group.
• Young (18-44) M = 17.37; Middle (45-65) M
= 19.32; Older (>65) M = 18.76
ILW Levels by Age Group
What Implications Can We Draw
from These ILW Results?
• We need to be sure with middle age group to
focus on providing AT, because it will help
improve their QOL levels.
• With female clients, let’s do a better job with
listening to their needs and goals and respond to
their AT needs well, because it will help improve
their QOL levels.
ILW Levels by Disability
• On ILW levels by disability, what do you
think? Do you think they’d be different by
disability? How?
Do ILW Levels Differ by Disability?
• On ILW levels by disability, there were
differences by disability.
Independent Living & Working Survey (ILW)
• I am able to…
– Complete chores on my farm/ranch.
– Operate machinery.
– Manage my farm/ranch.
– Access workspaces on my farm/ranch.
– Live in my home on the farm/ranch
– Change or modify my machinery in order to
accommodate my needs.
Do ILW Levels Differ by Disability?
•
•
•
•
•
•
•
•
•
•
Joint injury
Arthritis
Back injury
Orthopedic injury
Cardiovascular disease
Other infrequent disabilities
Stroke
Leg & foot amputation
Visual impairment
Spinal paraplegia & quadriplegia
21.06
19.96
19.48
19.29
18.78
17.90
17.29
15.95
15.30
15.06
67
45
77
34
18
137
17
19
20
16
13.6%
9.1%
15.6%
6.9%
3.7%
27.8%
13.4%
3.9%
4.1%
3.2%
What Implications Can We Draw
from These ILW Results?
ILW Levels Differ by Disability
• Those with spinal paraplegia and quadriplegia had ILW
total scores significantly lower than those with back
injury, arthritis, and joint injury.
• Those with visual impairments had significantly lower
ILW total scores than those with arthritis and joint injury.
• Those with leg and foot amputations had significantly
lower ILW total scores than those with joint injuries.
• What else?
What’s the Role of ILW in Predicting
QOL Levels?
• We used multiple linear regression to find a
model that best predicts QOL levels to see
whether age group and ILW scores improve the
prediction of QOL levels.
What’s the Role of ILW in Predicting
QOL Levels?
• The combination of age group and ILW levels
predicts 16.3% of QOL levels.
We Have 3 Objectives Today
• To learn who our clients are when they say
“Yes” to AgrAbility.
• To learn which disabilities are associated
with the highest and lowest QOL and ILW
levels.
• To learn how your SRAP can join us in
determining AgrAbility’s effectiveness.
Currently
unfunded
Control
SRAPs?
Please
join us!
Why Join Us?
1. Document your project’s effectiveness at
increasing QOL and ILOS.
2. Enhance your chances of receiving funding
next time with empirical evidence of your
SRAP’s quality and effectiveness.
3. Increase your chances for outside funding
by demonstrating your accountability.
4. Contribute to AgrAbility’s Mission.
Remember Our AgrAbility Mission
“The AgrAbility Mission is to enhance
and protect quality of life and preserve
livelihoods. It’s about supporting and
promoting growth and independence.
Ultimately it’s about hope.”
Source: National AgrAbility Project. (2011). It’s about hope [DVD]. Author: Purdue University.
Won’t You Join Us? Here’s how:
1. Send an email to
robert.fetsch@colostate.edu.
2. Seek IRB approval from your Land-Grant
University.
3. Study and use the same protocol.
4. Adapt CO to __ on pp. 1-2 & mail.
5. Enter your data into an Excel file that we
will provide, proof perfectly & email to
me.
McGill Pre- Post-Survey Changes
(Total Score)
10
9
8
7
6
5
4
3
2
1
0
MQOL Total Score
(N=104)***
Pre-Survey
Post-Survey
AgrAbility ILW Changes
(Total Score)
25
20
15
ILOS Total Score
(N=124)***
10
5
0
Pre-Survey
Post-Survey
These results look promising,
BUT…
How do we know these results
are not due to something other
than our AgrAbility services?
“Good News”
• AgrAbility is among the 45 federally
funded programs that supported
employment for people with
disabilities in fiscal year 2010.
• AgrAbility is among the 10/45
programs with a review or study to
evaluate the program’s effectiveness.
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. (p. i).
“Good News”
• “…The Department of Agriculture’s
AgrAbility program conducted a review
of its activities between 1991 and
2011 and found that 11,000 clients
had been served, and that 88 percent
of those clients continued to be
engaged in farm or ranch activities.”
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. (p. 27).
“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).
The Best Way to Know Is…
• To assign all of our new clients
randomly to
– Our Experimental Group that received onsite
visits and AgrAbility information, education,
and service OR to
– Our Control Group that does not.
Another More Practical Way to Know Is…
• To compare two groups’ PretestPosttest QOL & ILW levels
– 200 Experimental Group participants who
complete matched pretest- and posttestsurveys.
– 100 Control Group participants who complete
matched pretest- and posttest-surveys.
Here’s Where We Are Now…
• We now have our Experimental Group
with 135/200 matched pretestposttest surveys.
• What we need now is a Control Group
with 100 matched pretest-posttest
surveys.
NAP
UIUC
CSUE
Let’s Turn to Bob Aherin for an Update
on:
• Where he and Chip are with the
Control Group at UIUC and
• How we can assist their efforts with
collecting data for the Control Group.
Control Group (N = 100)
• Cannot be receiving any type of
AgrAbility program services or onsite
visits regardless of whether they are in
USDA funded or Affiliate States.
Where do we find 100 ranchers and
farmers for the Control Group?
1.
2.
Non-funded AgrAbility Affiliate States
previously funded, but not currently
funded to provide AgrAbility services,
e.g. IA, ID, IL, MI, MT, and PA.
Farmers and ranchers with disabilities
who call NAP’s 1-800-825-4264 for
information from non-funded states.
Where do we find 100 ranchers and
farmers for the Control Group?
3. Ranchers and farmers with disabilities who
call in to currently funded SRAP’s but
who decide not to become clients at this
time.
4. National Association of County Ag Agents
(N = c. 3,000 members).
5. Fingerlake, NY Goodwill?
6. Where else?
Currently
unfunded
Control
SRAPs?
Please
join us!
Chip Petrea
repetrea@illinois.edu
Bob Aherin
raherin@illinois.edu
Thank you
very much!
AgrAbility across the U.S.
(source: National AgrAbility Project)
How Reliable Are the Subscales?
• A common measure of reliability is
Cronbach’s alpha.
•
•
•
•
•
•
Subscale
Physical Symptoms
Psychological WB
Experiential WB
Support
MQOL Total
Pre
.59
.90
.92
.82
.79
Post
.85
.93
.93
.83
.87