1. Promoting Independence in Agriculture AANTWMcGill QOL11.1108 (Rev. 11.0408b) AgrAbility NTW McGill QOL Wichita, KS 2008 National Training Workshop 1:30-3:00 November 11, 2008 By Robert J. Fetsch, et al. Extension Specialist & Director, Colorado AgrAbility Project, Human Development & Family Studies Colorado State University

2. Promoting Independence in Agriculture Evaluating the Impact of Direct Client Services By Robert J. Fetsch (CSU), Ron Schuler & Mary Beck (UW), Kirk Ballin (ESVA), Sheila Simmons (KU), Mary C. Little (CSU), and Vincent Luke (ESC)

3. Promoting Independence in Agriculture Brief Review of the Literature The literature includes a half dozen refereed journal articles with the McGill QOL with adults with Multiple Sclerosis. No studies reported using the McGill QOL with farmers/ranchers with disabilities.

4. Promoting Independence in Agriculture History of National AgrAbility Evaluation Committee Early 2006—Kathryn Pereira, Evaluation Specialist NAP U of WI, invited all SRAP’s to join in evaluation study. The National AgrAbility Evaluation Committee (NAEC) met approximately monthly via teleconference/face-to-face (N = 10-25 participants/meeting).

5. Promoting Independence in Agriculture 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.

6. Promoting Independence in Agriculture History of National AgrAbility Evaluation Committee 4 Questions: –Do our AgrAbility clients increase their QOL? –Are our AgrAbility clients able to remain in production agriculture or to continue living on their farm/ranch if they choose? –Are our group mean scores the same as those from the population groups’ mean scores? –Are both QOL measures sensitive to the effects of AgrAbility involvement?

7. Promoting Independence in Agriculture History of National AgrAbility Evaluation Committee Five SRAP’s decided to conduct a 16- month pilot study to answer the 4 questions (June 2007-September 2008). McGill QOL—CO, KS, VA, & WI SF-36—DE-MD

8. Promoting Independence in Agriculture Measures Used in CO, KS, VA, & WI Pilot Study McGill Quality of Life Questionnaire Ability to Remain in Agriculture Subscale NAP Demographic Data Chronic pain, stress, anger, depression, self- esteem, and perception of financial situation (CO only).

9. Promoting Independence in Agriculture History of National AgrAbility Evaluation Committee CO, KS, VA, & WI obtained IRB approval from their Land-Grant Universities. Procedure—Each state was first to mail out to each new client a cover letter, McGill Pre-Survey, and stamped, self- addressed envelope prior to the on-site visit.

10. Promoting Independence in Agriculture History of National AgrAbility Evaluation Committee During the visit we either thanked them for returning their survey or mentioned that we had not yet received it—need another copy? No coercion was used.

11. Promoting Independence in Agriculture History of National AgrAbility Evaluation Committee A McGill Post-Survey was mailed out either when the client’s case was closed or at the end of the current study using a modified Dillman method with 10-day intervals: 1) cover letter, post-survey, and stamped return envelope; 2) thank you postcard/reminder; and 3) follow-up cover letter, post-survey, and stamped return envelope.

12. Promoting Independence in Agriculture History of National AgrAbility Evaluation Committee By October 1, 2008 CO, KS, VA, & WI entered the data into an Excel File and emailed it to CO for entering and analyzing. –CO21 Pre + 0 Post = 21 Total –KS9 Pre + 0 Post = 9 Total –VA4 Pre + 2 Post = 6 Total –WI44 Pre + 5 Post = 49 Total –Total78 Pre + 7 Post = 85 Total

13. Promoting Independence in Agriculture Who Were the Participants in the Pilot Study? (N = 78) 57 (73%) were male; 15 (19%) were female; 6 (8%) were missing. 39 (50%) were new; 23 (30%) were on- going; 8 (10%) were re-opened; 3 (4%) were closed in current grant year; and 5 (6%) were missing.

14. Promoting Independence in Agriculture Who Were the Participants in the Pilot Study? (N = 78) Ages ranged from 35 to 86. M = 58; SD = 12. Year original disability occurred ranged from 1937 to 2008.

15. Promoting Independence in Agriculture Who Were the Participants in the Pilot Study? (N = 78) 56 (72%) were owners/operators; 15 (19%) were spouses/partners; 1 (1%) was planning new ag career; 1 (1%) was other family member; and 5 (6%) were missing.

16. Promoting Independence in Agriculture Who Were the Participants in the Pilot Study? (N = 78) Regarding work status, 46 (59%) were full time, 15 (19%) were part time, 9 (12%) were occasional, 3 (4%) were none, and 5 (6%) were missing.

17. Promoting Independence in Agriculture Who Were the Participants in the Pilot Study? (N = 78) Regarding agricultural operation, 24 (31%) were dairy, 20 (26%) were livestock, 16 (21%) were field/grain, 7 (9%) were hay, 3 (4%) were other animal, 2 (3%) were poultry, 1 (1%) was other, and 5 (6%) were missing.

18. Primary Disabilities

19. Promoting Independence in Agriculture Do Our AgrAbility Clients Increase Their QOL?

20. McGill Pre- Post-Survey Changes

22. Promoting Independence in Agriculture Are Our AgrAbility Clients Able to Remain in Production Agriculture or to Continue Living on Their Farm/Ranch if They Choose?

23. Ability to Remain in Agriculture Subscale

25. Promoting Independence in Agriculture Are Our Group Mean Scores the Same as Those from the Population Groups’ Mean Scores? How similar/different was our sample from population mean scores?

26. Comparison of 4-State Pilot Study (N = 73-78) with Non-Agricultural Populations (N = 143) and CO Sample (N = 6-7)

28. Promoting Independence in Agriculture Are Both QOL Measures Sensitive to the Effects of AgrAbility Involvement?

29. Promoting Independence in Agriculture I cannot say about the SF-36. The data show that all of the McGill QOL group mean scores increased from pre- to post-survey. We need more data.

30. Promoting Independence in Agriculture When we get more matching pre- and post-survey data from the present 4 states and from you, I think it is likely that we will see statistically significant improvements in QOL levels.

31. Promoting Independence in Agriculture Results Yes, at least 3 AgrAbility clients did increase their QOL, although the group mean scores were not statistically significant—probably due to the small sample size. Yes, our 3 AgrAbility clients were able to remain in their homes on their farms/ranches if they chose to do so.

32. Promoting Independence in Agriculture Results Our group mean scores, for the most part were the same as those for the population group mean scores (MQOL SIS, Physical Well Being, Physical Symptoms, and MQOL Total Score). However, on the Psychological Well Being Subscale our sample of 78 on the pre-survey scored higher (p =.069).

33. Promoting Independence in Agriculture Results Our group mean scores on the pre- survey were statistically significantly lower than the norms on Existential Well Being (p <.05) and on Support (p <.001). Is this an opportunity to encourage effective, science-based peer support training?

34. Promoting Independence in Agriculture Conclusions Does the AgrAbility Program work? What do you conclude from the present study’s findings? We conclude with the caveat that we did not have a large sample, I am very hopeful that as more of you join us and as we collect more data, it looks very promising!

35. Promoting Independence in Agriculture Challenges Getting 100 new clients’ pre-surveys and matching post-survey data with complete responses is a challenge, but we already have 78 pre-surveys! Who of you are interested in helping us with the goal of 100 matching pre- and post-surveys with complete data?

36. Promoting Independence in Agriculture Recommendations That the NAEC continue the Pilot Study through September 2009 and collect more data and present at 2009 NTW. That more SRAP’s join us ASAP.

37. Promoting Independence in Agriculture Won’t You Join Us? 1.Send an email to fetsch@cahs.colostate.edu. fetsch@cahs.colostate.edu 2.Check with your IRB. 3.Study and use the procedure. 4.Adapt CO to __ on pp. 1-2 & mail. 5.Enter your data, proof perfect & send.

38. Promoting Independence in Agriculture Thank you very much!

39. Promoting Independence in Agriculture Panel Discussion What did you like about collecting the McGill QOL data in our pilot study? What did you not like about the process & what are your recommendations? How can new SRAP’s get involved? What new information about your clients has the McGill provided you?