I Am Able: Population Based Rehabilitation in a Family Health Team

People who have long-term conditions such as heart disease, diabetes, arthritis etc. face challenges in staying active and able to participate in activities that are important to them. There is some research that suggests that a care model that focuses on physical functioning and helping patients to manage their own conditions will assist them to stay active and healthy longer. In this project, the investigators are testing whether physiotherapy and occupational therapy offered to groups of patients and information about rehabilitation offered to other members of the health care team can help people with chronic conditions to maintain their physical abilities.

Study Overview

• Status: Completed
• Conditions: Hypertension; Diabetes; Arthritis; Chronic Pain; Chronic Conditions
• Intervention / Treatment: Behavioral: Physiotherapy; Behavioral: Occupational Therapy; Behavioral: Capacity Building

Detailed Description

Participants older than 44, with at least one chronic disease, (n=60) will participate in a before-and-after study integrating a population based, rehabilitation-focused program targeting physical function into a Family Health Team. The program, delivered by a Physiotherapist and Occupational Therapist, will consist of comprehensive functional assessments and individualized self-management care plans; a rehabilitation based chronic disease self-management program; and on-line self-monitoring of physical function. Process and outcome measures will be administered at baseline and 4 months follow-up.

• Study Type: Interventional
• Enrollment (Actual): 124
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Hamilton, Ontario, Canada, L8W 3J6
      • McMaster Family Health Team (Stonechurch Family Health Centre and McMaster Family Practice)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 44 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 44 years and older
• 1 or more chronic conditions
• 3 visits to physician in the past year
• access or willingness to access email

Exclusion Criteria:

• none

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Group; Rehabilitation self-management group, on-line self monitoring of physical function, and organizational capacity building.	Behavioral: Physiotherapy; group self-management classes; Behavioral: Occupational Therapy; group self-management classes; Behavioral: Capacity Building; workshops and case reviews with primary health care team members
No Intervention: Case matched controls; Usual care in primary health care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical Functioning Inventory (PFI)	The PFI is used to assess physical functioning in older adults. It contains 21 tasks from 4 subscales: activities of daily living, instrumental activities of daily living, mobility, moderate activities. A series of questions is used to determine whether the person experiences difficulty in completing a task, the level of difficulty they experience, and any changes to the method and/or frequency of task performance. The PFI is sensitive to steps in the natural history of functional decline that are often not assessed clinically. Range of scores: 0 (most difficulty); 100 (least difficulty).	4 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Self-rated Health	4 months
Health Care Utilization	4 months
Self-efficacy for Chronic Disease Scale	4 months
Rapid Assessment of Physical Activity	4 months
Grip Strength	4 months
Two Minute Walk Test	4 months
Patient Assessment of Chronic Illness Care	4 months
Primary Care Resources and Supports	4 months
Balance Screen	4 months
Eight Foot Walk Test	4 months

Collaborators and Investigators

• Sponsor: Hamilton Health Sciences Corporation
• Collaborators: Ontario Neurotrauma Foundation
• Investigators: Principal Investigator: Julie Richardson, PhD, McMaster University

Publications and helpful links

General Publications

• Richardson J, Letts L, Chan D, Officer A, Wojkowski S, Oliver D, Moore A, McCarthy L, Price D, Kinzie S. Monitoring physical functioning as the sixth vital sign: evaluating patient and practice engagement in chronic illness care in a primary care setting--a quasi-experimental design. BMC Fam Pract. 2012 Apr 3;13:29. doi: 10.1186/1471-2296-13-29.

Study record dates

Study Major Dates

• Study Start: May 1, 2008
• Primary Completion (Actual): March 1, 2009
• Study Completion (Actual): April 1, 2009

Study Registration Dates

• First Submitted: March 10, 2009
• First Submitted That Met QC Criteria: March 10, 2009
• First Posted (Estimate): March 11, 2009

Study Record Updates

• Last Update Posted (Estimate): June 22, 2010
• Last Update Submitted That Met QC Criteria: June 17, 2010
• Last Verified: September 1, 2009

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Chronic Pain
• Other Study ID Numbers: 08-177; 2007-ORRAN-IIA-568