2018 AgrAbility NTW, Portland, ME March 21, 2018 11:10-11:55 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) Pass out 40 copies of .ppt @ 6 slides per page.

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

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). Would all the members of the NAPEC please stand and be recognized?... Thank you! Thanks to each of you for your contributions of treatment group data to this program evaluation study. And special thanks to Chip Petrea for your contributions of no-treatment group data to this program evaluation study. This study would not have been possible without the ongoing dedication and good work of our colleagues—Sheila Simmons, Bob Meyer, Vicki Janisch, Vince Luke, Rick Peterson, Toby Woodson, Kirk Ballin, Bob Aherin, Inetta Fluharty, Sharry Nielsen, Diana Sargent, and Tina Little. Could we have a hand of appreciation for them? Several years ago during the previous administration, President Bush asked all the Secretaries, including the Secretary of Agriculture (who is Brad Rein’s and our Superior), to assess their success at increasing Quality of Life Levels. In 2007? we told Brad Rein that we could help him assess AgrAbility’s success at increasing new clients’ QOL levels. He asked us to provide him with recommendations (by 8/1/09). We formed the National AA Evaluation Committee. Would Committee members present please wave? We looked at 100 QOL tools and picked 2—SF-36 and the McGill QOL. We pilot tested the McGill QOL over the past four years as a pre- and post-survey in 9 states to see if it works with farmers and ranchers and to see if we observe increases in QOL levels. Currently, President Obama is asking, “What works?” as he decides which programs to fund and which to cut. We in AR, CO, KS, ME, MN, MO, NC, NE, OH, OK, TX, UT, VA, WI, and WV are working as a team to answer two questions for Brad:

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 4

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. 5

What’s Our Agenda Today? Introduction. 6

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.

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

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. “What Has AgrAbility Achieved? What Can We Show for It?” –Aida Balsano, 1/30/2017 But there are still 5 SRAPS who have not yet joined us in using our QOL surveys—please do! We welcome you! (CA, IL??[CHECK NAPEC]??, IN, KY, MI, & TN) 9

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

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 11

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

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

Source: SPSS Output—QOLPrePost6 Source: SPSS Output—QOLPrePost6.1217 Repeated measures ANOVA Client Age RR, p. 7. ILWATotalScore Middle Adult 18.09 “ “ Young & Older Adult Combined 16.50 ILWBTotalScore Middle Adult 23.09 “ “ Young & Older Adult Combined 19.05

Source: SPSS Output—QOLPrePost6 Source: SPSS Output—QOLPrePost6.1217 Repeated measures ANOVA Chronic And Incident, p. 7. ILWATotalScore 1.00 17.58 Chronic “ “ 2.00 15.88 Incident ILWBTotalScore 1.00 21.17 Chronic “ “ 2.00 22.42 Incident

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

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

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

“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). 19

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

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

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. 22

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! 23

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? 2/20/2007-1/20/2016 include the first entrya and the last exitb for the 225 included in the QOLTreNoT [QOLTrtCom] study. Note: According to QOLMss6.1813, 6.5 years = 1/26/2007-6/18/2013. QOLILWMss., pp. 8.5, 10.2 N = 476/788 (QOLILWMss., p. 10.2).

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 Source: Fetsch, R. J., & Turk, P. (2017, July 27). A quantitative assessment of the effectiveness of USDA’s AgrAbility Project. Manuscript in review 25

McGill QOL Pretest-Posttest Total Score Changes for Treatment & No-Treatment Comparison Groups Source: QOLTrtCom, p. 29, Table 2 7/27/17 QOL AA Treatment Group Pretest (M = 5.56, SD = 1.65, N = 216) QOL AA Treatment Group Posttest (M = 7.13, SD = 1.67, N = 207, p < .001) QOL Comparison Group Pretest (M = 5.10, SD = 0.75, N = 100) QOL Comparison Group Posttest (M = 4.91, SD = 0.70, N = 97, N.S.) Life-threatening experience—How many of us have experienced it either directly or via someone we care deeply about? In my experience and in the experience of many of my farm/ranch friends, when we face our own mortality, we raise deep questions about who we are and what life is all about. How many of us have experienced this too? Existential ~ Experiential. 4/27/15 Support (N=188)*** M=6.197.60 As of 4/27/15, the effect size was .72 which is large or larger than typical (Cohen, 1988; Morgan et al., 2004, p. 91; Morgan et al., 2011, p. 101.3) Existential/Experiential Well-Being (N=190)*** M=6.117.47 As of 4/27/15, the effect size was .74 which is large or larger than typical (Cohen, 1988; Morgan et al., 2004, p. 91; Morgan et al., 2011, p. 101.3) Psychological Well-Being (N=187)*** M=5.787.27 As of 4/27/15, the effect size was .66 which is large or larger than typical (Cohen, 1988; Morgan et al., 2004, p. 91; Morgan et al., 2011, p. 101.3) Note again—AgrAbility participants’ Quality of Life subscale scores rose from Pre-Survey to Post-Survey at a statistically significant amount. These results are real and are due to chance < 1 time out of 1,000. Experiential, existential, i.e. derived from experience or the experience of existence. Synonyms: experiential, existential Antonyms: theoretic, theoretical Retrieved September 4, 2011 from http://www.synonyms.net/synonym/existential 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

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 27

ILW Pretest-Posttest Total Score Changes for Treatment and No-Treatment Groups 6/9/16 ILW AA Treatment Group Pretest (M = 16.91, SD = 5.26, N = 197) or 7/27/17 (M = 2.86; SD = 0.91; N = 217) ILW AA Treatment Group Posttest (M = 22.21, SD = 5.75, N = 197, p < .001) or (M = 3.71; SD = 0.95; N = 201) ILW Comparison Group Pretest (M = 19.42, SD = 5.96, N = 100) or (M = 3.24; SD = 0.99; N = 100) ILW Comparison Group Posttest (M = 21.02, SD = 5.14, N = 100, p < .05) or (M = 3.50; SD = 0.86; N = 100) 4/27/15 ILW Total Score (N=168)*** M=16.9521.80 As of 4/27/15, the effect size is .84 which is large or larger than typical (Cohen, 1988; Morgan et al., 2004, p. 91; Morgan et al., 2011, p. 101.3) Finally, on the ILW Total Score, AgrAbility participants’ QOL total score rose from Pre-Survey to Post Survey. These results are statistically significant. They are real, worthy of note. Note that if any of the items are missing for a case, SPSS will not compute a total score. These results are real, not by chance. They are statistically significant. They need to be taken seriously. For those of you who are interested in more detail, there’s a language, a way of thinking, a set of conventions that researchers use that I can go into more detail later with those who are interested. P < .05 means that these results are real, are statistically significant, and are due to chance < 5 times out of 100. *indicates p <.05. P < .01 means that these results are statistically significant and are due to chance < 1 time out of 100. ** indicates p < .01. P < .001 means that these results are statistically significant and are due to chance < 1 time out of 1,000. *** indicates p < .001. (R.K. Yang, personal communication, September 15, 2009). 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

“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). 29

We now have data from a no-treatment comparison group. “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. 30

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

Figure 1. Number Client Reports Per Grant Year and Number New Clients Per Grant Year A team of us is working on a manuscript for review and possible publication on 25 years of AgrAbility demographic data—Bill Field, Chip Petrea, Paul Jones, Bob Aherin, and me. 2/12/18.

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)

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. Source: Fetsch, R. J., Petrea, R. E., Field, W. E., Jones, P. J., & Aherin, R. A. (2017, September 14). A 25-Year Overview of AgrAbility Demographics. Manuscript in preparation. 34

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). Source: Fetsch, R. J., Petrea, R. E., Field, W. E., Jones, P. J., & Aherin, R. A. (2017, September 14). A 25-Year Overview of AgrAbility Demographics. Manuscript in preparation. 35

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

Questions? & Answers

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

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? Source: Fetsch, R. J., Petrea, R. E., Field, W. E., Jones, P. J., & Aherin, R. A. (2017, September 14). A 25-Year Overview of AgrAbility Demographics. Manuscript in preparation. 39

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? 40

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

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. 42

Thank you very much! Now let’s go back to the Major Results of this study. Slide #21 McGill Total Score Changes Improve from 5.65 to 7.12***. Slide #27 AAILW Total Score Changes Improve from 16.95 to 21.80***. Now I want to hear from you. Let’s brainstorm implications and practical steps that AgrAbility teams can take.

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.

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.

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

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

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

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.

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.

How Reliable Are the Subscales? A common measure of reliability is Cronbach’s alpha. Subscale (N = 325) Pre Post Physical Symptoms .50 .73 Psychological WB .82 .87 Existential WB .86 .90 Support .76 .74 MQOL Total .70 .84 ILW Total .74 .74 Updated as of 4/17/15. “Alphas should be positive and usually greater than .70 to provide good support for internal consistency reliability.” (Morgan, G. A., Leech, N. L., Gloeckner, G. W., & Barrett, K. C. (2004). SPSS for introductory statistics: Use and interpretation (2nd ed.). Mahwah, NY: Lawrence Erlbaum Associates. (p. 122.7). Sometimes 3-item subscales have lower Cronbach’s alphas. Ours is .59 which is marginal because it is (slightly) less than .70 (Morgan, Leech, Gloeckner, & Barrett, 2004, p. 124.2). The three-item physical symptoms subscale has at times had low Cronbach alphas in other studies ranging from .62 (Cohen et al., 1997) to .70 (Cohen, Mount, Strobel & Bui, 1995). The other 9 Cronbach alphas are .79-.93 which are quite acceptable because they are >.70. Cohen, R. S., Mount, B. M., Bruera, E., Provost, M., Rowe, J., & Tong, K. (1997). Validity of the McGill Quality of Life Questionnaire in the palliative care setting: A multi-centre Canadian study demonstrating the importance of the existential domain. Palliative Medicine, 11, 3-20. Cohen, R. S., Mount, B. M., Strobel, M. G., & Bui, F. (1995). The McGill Quality of Life Questionnaire: A measure of quality of life appropriate for people with advanced disease. A preliminary study of validity and acceptability. Palliative Medicine, 9, 207-219.

Aida Balsano & Brad Rein Asked Us to Help Respond. So far 17 SRAP’s are working to collect data from AgrAbility clients with an on-site visit (AR, CO, GA, KS, ME, MO, NC, NE, OH, OK, PA, TX, UT, VA, WI, & WV). AR, CO, GA, KS, ME, MO, NC, NE, OH, OK, PA, TX, UT, VA, WI, & WV ME = Maine MI = Michigan MN = Minnesota We invite you to join us, CA, IN, KY, MI, TN, & VT. 52

What Was the Average Length of Time with AgrAbility? The amount of time spent by treatment group participants with AgrAbility ranged from 1 to 74 months (M = 14.85; SD = 10.18; N = 225). The amount of time spent by no-treatment group participants ranged from 12 to 19 months (M = 13.76; SD = 0.98; N = 100).

Please Join Us! Treatment Group SRAPs Currently unfunded Com- parison Group SRAPs 3/5/18 To answer more sophisticated AgrAbility questions about what works best on the road to evidence-based programming, we need larger samples of QOL data from additional SRAPs to join us. 2/14/2017 20 SRAPS/20 States are currently funded (CA, CO, GA, IL, IN, KS, KY, ME, MI, MO, NC, NE, OH, PA, TN, TX, VA, UT, WI, and WV).?? Of these 20, 15 (75%) are using the QOL and ILW (CO, GA, IL, KS, ME, MO, NC, NE, OH, PA, TX, UT, VA, WI, & WV) plus 2 previously funded SRAPS (AR & OK) = 17 SRAPS are using QOL & ILW. (AgrAbility Green) 17 Treatment Group States (AR, CO, GA, IL, KS, ME, MO, NC, NE, OH, OK, PA, TX, UT, VA, WI, & WV (17 SRAPS). (Purple) 16 No-Treatment Group States + NAP (AL, AR, AZ, CA, FL, IA, IL, MN, MO, MT, MS, NAP, NY, OR, TX, WA, WY) 6 currently funded SRAPs are not yet with us using the QOL & ILW (Red)—Won’t You Join Us? (CA, IL, IN, KY, MI, & TN). [BOB, CHANGE IL (WEST OF IN) FROM AA GREEN TO RED.] 7 SRAPs are formerly funded SRAPs (Blue) (IA, LA, MN, MS, NH, VT, & WY). 2 of the 17 SRAPs are formerly funded (OK & ___??) 2 SRAPs are newly funded as of 10/14/15 (IL & MI). 3 SRAPs are newly funded as of 12/1/17 (OH, PA, TN). -Click on the State to change. -To change IL from red to AA green, Right click on IL Format Shape. -FillSolid FillColor -Go to Recent Color at bottom left and click on AA green OK??. -Olive Green, Accent 3? To change color to AgrAbility Green, use More Colors, Color Model RGB, Red = 118, Green = 202, Blue = 94, Transparency = 0%. -Close -Blue is in Standard Colors, 3rd from the right. -Purple is in Standard Colors, 1st from the right. -Red is in Standard Colors, 2nd from the left. -Yellow is in Standard Colors, 4th from the left. Please Join Us! Treatment Group SRAPs

How Do We Define QOL? QOL is a multidimensional construct of a person’s overall physical, emotional, social, financial, and spiritual well-being. Sources: Bogue P, Phelan J. Exploring the quality of life of farm families in Ireland: implications for extension. J Int Agri Ext Educ. 2005;12(1):79-90. Cummins RA. Assessing quality of life for people with disabilities. In: Brown RJ., ed. Quality of Life for Handicapped People. Cheltenham, UK: Stanley Thomas, 1997:116-150. Fetsch, R. J., & Turk, P. (2016, December 13). A quantitative assessment of the effectiveness of USDA’s AgrAbility Project. Manuscript in review. Hagerty MA, Cummins RA, Ferriss AL. et al. Quality of life indexes for national policy: review and agenda for research. Soc Indic Res. 2001;55(1):1-96.

How Do We Measure Quality of Life (QOL) Levels? The McGill QOL scale is a 17-item scale (0-10) with five subscales… Physical well-being. Physical symptoms. Psychological well-being. Existential well-being. Support.

How Many SRAPs Are Collecting ILW and QOL data?

“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). 59

82.4% of Treatment Group Improved Their 7.11 Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (2017, August 9—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.] As of 3/29/16 the Treatment Group Pre 5.577.15 (N = 199): -81.9% (163/199) improved on QOL; -18.1% (36/199) decreased on QOL; and -0% (0/199) remained the same on QOL. The No-Treatment Group Pre 5.09Post 4.91 (N = 97): -44.3% (43/97) improved on QOL: -54.6% (53/97) decreased on QOL; and -1.0% (1/97) remained the same on QOL. Fetsch, R. J., Jackman, D. M., & Collins, C. L. (2015, July 23). Pretest-posttest quality of life and independent living and working levels among farmers and ranchers with disabilities. Manuscript in preparation. Psychological Well-Being Pretest = 5.78 (SD = 2.41; N = 187) & Posttest = 7.27 (SD = 2.10; N = 187), t = -8.80, df = 186, p = .000, p < .001, d = .66, which is large or larger than typical (Cohen, 1988). (Cf. p. 40.7.) Cohen, J. (1988). Statistical power and analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates. 82.4% of Treatment Group Improved Their Quality of Life Levels (N = 136/165; Range = 0-10) 5.63

Improved Their Independent Living and Working Levels 16.95 21.80 Source: Fetsch, R. J., Jackman, D. M., & Collins, C. L. (2017, August 9—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.] As of 3/29/16 the Treatment Group Pre 17.0021.91 (N = 200): -83% (166/200) improved on ILW; -12% (24/200) decreased on ILW; and -5% (10/200) remained the same on ILW. The No-Treatment Group Pre 19.42Post 21.02 (N = 100): -58% (58/100) improved on ILW: -38% (38/100) decreased on ILW; and -4% (4/100) remained the same on ILW. Fetsch, R. J., Jackman, D. M., & Collins, C. L. (2015, July 23). Pretest-posttest quality of life and independent living and working levels among farmers and ranchers with disabilities. Manuscript in preparation. Psychological Well-Being Pretest = 5.78 (SD = 2.41; N = 187) & Posttest = 7.27 (SD = 2.10; N = 187), t = -8.80, df = 186, p = .000, p < .001, d = .66, which is large or larger than typical (Cohen, 1988). (Cf. p. 40.7.) Cohen, J. (1988). Statistical power and analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates. 83.3% of Treatment Group Improved Their Independent Living and Working Levels (N = 140/168; Range = 0-30) 16.95

From 25 years of Demographic Data We Learned that: Counting both new and repeat clients, AgrAbility served 27,201 clients over 24 years (1992-2015) which on average was 1,133 clients served each year. Source: Fetsch, R. J., Petrea, R. E., Field, W. E., Jones, P. J., & Aherin, R. A. (2017, September 14). A 25-Year Overview of AgrAbility Demographics. Manuscript in preparation. 62

Source: SPSS Output—QOLPrePost6 Source: SPSS Output—QOLPrePost6.1217 Repeated measures ANOVA Client Age RR, p. 7. ILWATotalScore Middle Adult 18.09 “ “ Young & Older Adult Combined 16.50 ILWBTotalScore Middle Adult 23.09 “ “ Young & Older Adult Combined 19.05

Source: SPSS Output—QOLPrePost6 Source: SPSS Output—QOLPrePost6.1217 Repeated measures ANOVA Chronic And Incident, p. 7. ILWATotalScore 1.00 17.58 Chronic “ “ 2.00 15.88 Incident ILWBTotalScore 1.00 21.17 Chronic “ “ 2.00 22.42 Incident