Optimizing life success through residential immersive life skills programs for youth with disabilities: study protocol of a mixed-methods, prospective, comparative cohort study

Amy C McPherson, Gillian King, Alanna Rudzik, Shauna Kingsnorth, Jan Willem Gorter, Ontario Independence Program Research (OIPR) team, Amy C McPherson, Gillian King, Alanna Rudzik, Shauna Kingsnorth, Jan Willem Gorter, Ontario Independence Program Research (OIPR) team

Abstract

Background: Young people with disabilities often lag behind their typically developing peers in the achievement of adult roles, which has been attributed to a lack of opportunities to develop critical life skills. Residential Immersive Life Skills (RILS) programs provide situated learning opportunities to develop life skills alongside peers and away from home in real-world settings. Retrospective research suggests that attending RILS programs is a transformative experience that empowers youth, provides parental hope, and increases service provider expertise. However, prospective, comparative research is needed to determine longer term benefits of these programs on youth life trajectories, in addition to exploring the program features and participant experiences that optimize program success. This protocol describes a 5-year, multi-site prospective study examining the effects of RILS programs for youth with disabilities.

Methods: The study involves RILS programs at three sites in Ontario, Canada. Cohorts of treatment and control groups will receive the study protocol over 3 successive years. Thirty English-speaking participants aged 14-21 years with a child-onset disability and the cognitive capacity to engage in goal setting will be recruited every year for 3 years in the following groups: youth attending a RILS program (Group A); a deferred RILS control group of youth (Group B); a control group of youth attending a non-residential life skills program (Group C); and a control group matched on age, diagnoses, and cognitive capacity not receiving any life skills intervention (Group D). All participants will complete measures of self-determination and self-efficacy at four time points. Program opportunities and experiences will also be assessed in-the-moment at the RILS programs. Qualitative interviews pre-program and at 3- and 12-months post-program will be undertaken with a sub-sample of youth and parents to explore their expectations and experiences.

Discussion: This study will address key gaps in the literature pertaining to the long-term impact of RILS programs and the role of immersive environments in shaping youth outcomes and experiences. Our research program aims to uncover transferable processes and essential features by which RILS programs have their effects on attitudes, cognitions, and behaviour.

Trial registration: The trial registration number on clinicaltrials.gov is NCT02753452 (retrospectively registered 26 April 2016). Trial sponsor: Holland Bloorview Kids Rehabilitation Hospital.

Keywords: Adulthood; Disabilities; Environment; Life skills; Protocol; Qualitative research; Self-determination; Self-efficacy; Therapy; Transitions; Youth.

References

    1. Canadian Institutes of Child Health . The health of Canada’s children: A CICH profile. Children and youth with disabilities. Ottawa: Canadian Institute of Child Health; 2010.
    1. McDougall J, King G, De Wit D, Miller L, Hong S, Offord D, Meyer K. Chronic physical health conditions and disability among Canadian school-aged children: A national profile. Disabil Rehabil. 2004;26(1):35–45. doi: 10.1080/09638280410001645076.
    1. Cussen A, Howie L, Imms C. Looking to the future: Adolescents with cerebral palsy talk about their aspirations-a narrative study. Disabil Rehabil. 2012;34(24):2103–2110. doi: 10.3109/09638288.2012.672540.
    1. King G, Cathers T, Miller Polgar J, MacKinnon E, Havens L. Success in life for older adolescents with cerebral palsy. Qual Health Res. 2000;10:734–749. doi: 10.1177/104973200129118796.
    1. Gorter J, Stewart D, Woodbury-Smith M, King G, Wright M, Nguyen T, Swinton M. Pathways toward positive psychosocial outcomes and mental health for youth with disabilities: A knowledge synthesis of developmental trajectories. Can J Commun Ment Health. 2014;33(1):45–61. doi: 10.7870/cjcmh-2014-005.
    1. King G, Baldwin P, Currie M, Evans J. Planning successful transitions from school to adult roles for youth with disabilities. Child Health Care. 2005;34(3):193–216. doi: 10.1207/s15326888chc3403_3.
    1. Tuffrey C. Adolescents with physical disability: Seeing the individual in context. Arch Dis Child. 2013;98(5):373–377. doi: 10.1136/archdischild-2012-302839.
    1. Stewart D, Law M, Rosenbaum P, Willms D. A qualitative study of the transition to adulthood for youth with physical disabilities. Phys Occup Ther Pediatr. 2001;21(4):3–21. doi: 10.1080/J006v21n04_02.
    1. World Health Organization, Skills-based health education including life-skills: An important component of a child-friendly/health-promoting school. Geneva: World Health Organization; 2003.
    1. Ankeny EM, Lehmann JP. Journey toward self-determination: Voices of students with disabilities who participated in a secondary transition program on a community college campus. Remedial Spec Educ. 2011;32(4):279–289. doi: 10.1177/0741932510362215.
    1. Carter E, Lane K, Pierson M, Glaeser B. Self-determination skills and opportunities of transition-age youth with emotional disturbance and learning disabilities. Except Child. 2006;72(3):333–346. doi: 10.1177/001440290607200305.
    1. Burstein K, Bryan T, Chao P-C. Promoting self-determination skills among youth with special health needs using participatory action research. J Dev Phys Disabil. 2005;17(2):185–201. doi: 10.1007/s10882-005-3688-1.
    1. Wehmeyer M, Palmer S. Adult outcomes for students with cognitive disabilities three-years after high school: The impact of self-determination. Educ Train Dev Disabil. 2003;38(2):131–144.
    1. McDougall J, Evans J, Baldwin P. The importance of self-determination to perceived quality of life for youth and young adults with chronic conditions and disabilities. Remedial Spec Educ. 2010;31(4):252–260. doi: 10.1177/0741932509355989.
    1. Bandura A. Self-efficacy. In: Ramachaudran V, editor. Encyclopedia of human behavior. New York: Academic Press; 1994. pp. 71–81.
    1. Cramm J, Strating M, Roebroeck ME, Nieboer A. The importance of general self-efficacy for the quality of life of adolescents with chronic conditions. Soc Indic Res. 2013;113:551–561. doi: 10.1007/s11205-012-0110-0.
    1. Shapiro D, Martin J. Athletic identity, affect, and peer relations in young athletes with physical disabilities. Disabil Health J. 2010;3:79–85. doi: 10.1016/j.dhjo.2009.08.004.
    1. Behle A, Pinquart M. Perceived attainment of developmental tasks in adolescents with and without physical disabilities. J Dev Phys Disabil. 2015;27(6):773–787. doi: 10.1007/s10882-015-9454-0.
    1. Holmbeck G, Johnson S, Wills K, McKernon W, Rose B, Erklin S, Kemper T. Observed and perceived parental overprotection in relation to psychosocial adjustment in preadolescents with a physical disability: The mediational role of behavioral autonomy. Clin Adolesc Psychol. 2002;70(1):96–110.
    1. Sanders K. Overprotection and lowered expectations of persons with disabilities: The unforeseen consequences. Work. 2006;27(2):181–188.
    1. Larson R, Angus R. Adolescents’ development of skills for agency in youth programs: Learning to think strategically. Child Dev. 2011;82(1):277–294. doi: 10.1111/j.1467-8624.2010.01555.x.
    1. Kingsnorth S, Healy H, MacArthur C. Preparing for adulthood: A systematic review of life skill programs for youth with physical disabilities. J Adolesc Health. 2007;41:323–332. doi: 10.1016/j.jadohealth.2007.06.007.
    1. Griffin M. You can’t get there from here: Situated learning, transfer and map skills. Contemp Educ Psychol. 1995;20:65–87. doi: 10.1006/ceps.1995.1004.
    1. King G, McPherson A, Kingsnorth S, Stewart D, Glencross-Eimantas T, Jones-Galley K, Gorter J. Residential immersive life skills programs for youth with disabilities: Service providers’ perceptions of change processes. Disabil Rehabil. 2015;37(26):2418–2428. doi: 10.3109/09638288.2015.1031285.
    1. Kolb D, Boyatzis R, Mainemelis C. Experiential learning theory: Previous research and new directions. Perspect Thinking Learn Cogn Styles. 2001;1:227–247.
    1. Standal Ø, Jespersen E. Peers as resources for learning: A situated learning approach to adapted physical activity in rehabilitation. Adapt Phys Activ Q. 2008;25:208–227. doi: 10.1123/apaq.25.3.208.
    1. McPherson A, Rudzik A, Kingsnorth S, King G, Gorter J, Morrison A. “Ready to take on the world”: Experiences and understandings of independence after attending residential immersive life skills programs for youth with physical disabilities. Dev Neurorehabil. 2016
    1. King G, McPherson A, Kingsnorth S, Stewart DG-ET, Gorter J, Jones-Galley K, Isihi A. Residential immersive life skills programs for youth with disabilities: Service providers’ perceptions of experiential benefits and key program features. Disabil Rehabil. 2015;37(11):971–980. doi: 10.3109/09638288.2014.949353.
    1. King G, Kingsnorth S, McPherson A, Jones-Galley K, Pinto M, Fellin M, Savage D. Residential immersive life skills programs for youth with physical disabilities: A pilot study of program opportunities, intervention strategies, and youth experiences. Research in Developmental Disabilities. 2016;55:242–55.
    1. Evans J, McDougall J, Baldwin P. An evaluation of the “youth en route” program. Phys Occup Ther Pediatr. 2006;26(4):63–87. doi: 10.1080/J006v26n04_05.
    1. O’Cathain A, Murphy E, Nicholl J. The quality of mixed methods studies in health services research. J Health Serv Res Policy. 2008;13(2):92–98. doi: 10.1258/jhsrp.2007.007074.
    1. Fife-Schaw C. Quasi-experimental designs. In: Breakwell G, Smith J, Wright D, editors. Research methods in psychology. London: Sage; 2012. pp. 75–92.
    1. Wehmeyer M. The Arc’s self-determination scale: Procedural guidelines. 1995.
    1. Wehmeyer M, Kelchner K. Measuring the autonomy of adolescents and adults with mental retardation: A self-report form of the autonomous functioning checklist. Career Dev Except Individ. 1995;18(1):3–20. doi: 10.1177/088572889501800102.
    1. Scholz U, Dona B, Sud S, Schwarzer R. Is general self-efficacy a universal construct? Psychometric findings from 25 countries. Eur J Psychol Assess. 2002;18(3):242–251. doi: 10.1027//1015-5759.18.3.242.
    1. King G, Rigby P, Avery L. Revised measure of environmental qualities of activity settings (MEQAS) for youth leisure and life skills activity settings. Disabil Rehabil. 2015;38(15):1509–1520. doi: 10.3109/09638288.2015.1103792.
    1. McDougall J, King G, Malloy-Miller T, Gritzan J, Tucker M, Evans J. A checklist to determine the methods of intervention used in school-based therapy: Development and pilot testing. Phys Occup Ther Pediatr. 1999;19(2):53–77.
    1. King G, Batorowicz B, Rigby P, McMain-Klein M, Thompson L, Pinto M. Development of a measure to assess youth self-reported experiences of activity settings (SEAS) Int J Disabil Dev Educ. 2014;61(1):44–66. doi: 10.1080/1034912X.2014.878542.
    1. Cohen J. Statistical power analysis for the behavioral science. Hillsdale: Lawrence Erlbaum; 1988.
    1. Lincoln Y, Guba E. Naturalistic enquiry. Newbury Park: Sage; 1986.
    1. Kingsnorth S, Rudzik A, King G, McPherson A. Residential immersive life skills programs for youth with disabilities: A pilot study of youth and parent trajectories of personal growth Manuscript in preparation. 2016.
    1. Rosnow R, Rosenthal R. Computing contrasts, effect sizes, and counternulls on other people’s published data: General procedures for research consumers. Pyschol Methods. 1996;1:331–340. doi: 10.1037/1082-989X.1.4.331.
    1. Dierckx B, Gastmans C, Bryon E, Denier Y. Quagol: A guide for qualitative analysis. Int J Nurs Stud. 2012;49:260–371.
    1. Avis M. Is there an epistemology for qualitative research? In: Holloway I, editor. Qualitative research. Maidenhead: Open University Press; 2005. pp. 3–16.
    1. Shenton A. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22:63–75.
    1. Cresswell J. Qualitative inquiry and research design: Choosing among the five traditions. Thousand Oaks: Sage; 1998.
    1. Fade S, Swift J. Qualitative research in nutrition and dietetics: Data analysis issues. J Hum Nutr Diet. 2011;24(2):106–114. doi: 10.1111/j.1365-277X.2010.01118.x.
    1. Rolfe G. Validity, trustworthiness and rigour: Quality and the idea of qualitative research. J Adv Nurs. 2006;53(3):304–310. doi: 10.1111/j.1365-2648.2006.03727.x.
    1. Johnson R, Onwuegbuzie A, Turner L. Toward a definition of mixed methods research. J Mixed Methods Res. 2007;1(2):112–133. doi: 10.1177/1558689806298224.
    1. Wisdom J, Cavaleri M, Onwuegbuzie A, Green C. Methodological reporting in qualitative, quantitative, and mixed methods health services research articles. Health Serv Res. 2012;47(2):721–745. doi: 10.1111/j.1475-6773.2011.01344.x.
    1. Canadian Institutes of Health Research. Guide to knowledge translation planning at CIHR: Integrated and end-of-grant approaches, 2012: Ottawa.
    1. Barwick M. Knowledge translation planning template- r. 2011.

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