Title

The lived experience of an occupational intervention: An anthropological study

Presenter Information

Margaret Perkinson

Start Time

26-10-2007 10:45 AM

End Time

26-10-2007 11:45 AM

Abstract

While it is important to evaluate outcomes of an occupational intervention through the use of rigorous research design and standardized measures, that approach is not sufficient to fully understand the impact of a given program and develop valid and reliable evidence-based practice. Pivotal components of the social and physical contexts of an intervention and the meaning that participants ascribe to the experience of that intervention can impact the way a program or treatment is carried out in unanticipated and, using traditional methods of assessment, unnoticed ways. Narratives of participants' lived experiences of an intervention can provide critical insight into the process of implementation of that intervention and should be included as an essential component of program evaluation. Thirty older adults with dementia and their primary family caregivers participated in a three-month home-based, family-supervised physical activity program designed for persons with mild dementia. Evaluation of outcomes employed a traditional, quasi-experimental design: participants were randomly assigned to one of two exercise groups and given baseline and follow-up standardized assessments of balance, flexibility, strength, and endurance. Analyses indicated that most participants showed clinically significant improvement at follow-up compared to their performance at baseline. This "pre-post-only 'black-box' design" (Patton 2005), focusing on the end result or impact of the intervention, was supplemented by ethnographic process evaluation (Butler 2005). Implementation of the program was not assumed as a given, but as a process to be examined. Follow-up focus groups and in-depth interviews with the family exercise supervisors elicited the ways participants translated the training that they received into practice or action and the ways they negotiated that translation within specific social and physical contexts. Rather than passively replicating the program as it was given to them, family members had taken active measures to change it and to adapt it to fit their individual needs. Family members also identified barriers and facilitators to implementing the program and criteria they used to determine successful implementation. An anthropological focus on context, meaning, and process provides necessary insights into the way interventions are operationalized, complementing traditional assessments of outcomes and contributing to enhanced validity of evaluation research.

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Oct 26th, 10:45 AM Oct 26th, 11:45 AM

The lived experience of an occupational intervention: An anthropological study

While it is important to evaluate outcomes of an occupational intervention through the use of rigorous research design and standardized measures, that approach is not sufficient to fully understand the impact of a given program and develop valid and reliable evidence-based practice. Pivotal components of the social and physical contexts of an intervention and the meaning that participants ascribe to the experience of that intervention can impact the way a program or treatment is carried out in unanticipated and, using traditional methods of assessment, unnoticed ways. Narratives of participants' lived experiences of an intervention can provide critical insight into the process of implementation of that intervention and should be included as an essential component of program evaluation. Thirty older adults with dementia and their primary family caregivers participated in a three-month home-based, family-supervised physical activity program designed for persons with mild dementia. Evaluation of outcomes employed a traditional, quasi-experimental design: participants were randomly assigned to one of two exercise groups and given baseline and follow-up standardized assessments of balance, flexibility, strength, and endurance. Analyses indicated that most participants showed clinically significant improvement at follow-up compared to their performance at baseline. This "pre-post-only 'black-box' design" (Patton 2005), focusing on the end result or impact of the intervention, was supplemented by ethnographic process evaluation (Butler 2005). Implementation of the program was not assumed as a given, but as a process to be examined. Follow-up focus groups and in-depth interviews with the family exercise supervisors elicited the ways participants translated the training that they received into practice or action and the ways they negotiated that translation within specific social and physical contexts. Rather than passively replicating the program as it was given to them, family members had taken active measures to change it and to adapt it to fit their individual needs. Family members also identified barriers and facilitators to implementing the program and criteria they used to determine successful implementation. An anthropological focus on context, meaning, and process provides necessary insights into the way interventions are operationalized, complementing traditional assessments of outcomes and contributing to enhanced validity of evaluation research.