T HE LEND O UTCOMES F OLLOW -U P S URVEY : D EVELOPMENT AND P RELIMINARY F INDINGS Lauren Bishop-Fitzpatrick, 1 Anne Bradford Harris, 1 Paula Rabidoux, 2 Karyn E. Esbensen, 1 & Robert B. Noll 3 1 University of Wisconsin-Madison; 2 The Ohio State University; 3 University of Pittsburgh
B ACKGROUND U NDERSTANDING LEND’ S E FFECTIVENESS § Does LEND training deliver? § Current funding climate for programs, services, and research § Your tax dollars at work
B ACKGROUND Research on Measuring Trainee Outcomes Clinical Practice Research Social Services/Advocacy Participants Participants Participants PhD or MD Grads Service Providers Mostly Medical Students or Residents Comparison Peers Timeline Timeline Timeline Pretest Posttest Posttest Posttest Outcome Measures Outcome Measures Outcome Measures Perceived Self-Efficacy Career Positions, Titles Perceived Self-Efficacy Professional Settings Patient Outcomes Publications Grants, Awards, Funding
B ACKGROUND H OW A RE LEND T RAINEE O UTCOMES T YPICALLY M EASURED ? § NIRS Survey ( the survey LEND Directors love to hate ) § Common program evaluation technique § Comparison of long-term to short-term trainees (Kavanagh et al., 2015) § New Techniques § Faculty observation of family centered and interprofessional care using the I-FOR (Brosco et al. 2018) § Studies generally find that: § Trainee skills improve during LEND training (Brosco et al. 2018) § Long-term trainees are more likely to work on interdisciplinary teams and with MCH and vulnerable populations (Kavanagh et al., 2015)
B ACKGROUND A LL THAT GLITTERS IS NOT GOLD : Could previous positive effects of LEND be caused by something other than LEND training?
LEND O UTCOMES S TUDY T HE LEND O UTCOMES S TUDY § Multi-site (Pittsburgh, Nisonger, Waisman) § Matched case control study § Closest ethically and programmatically feasible methodology to randomized controlled trial § Prospective § Longitudinal (at least 10 years; currently in year 4)
LEND O UTCOMES S TUDY LEND O UTCOMES S TUDY T IMELINE 2015 C OHORT T IMELINE 2014-2015 2015-2016 2016-2017 2017-2018 81 Participants 79 Participants Developed Manual Analysis of Data from 3 rd Year Revised Manual Based on Pitt Partnered with AUCD Feasibility Presentation Feedback from Other Sites NIRS Survey Nisonger and Waisman AUCD Focus Groups ITAC Grant Received Survey Pilots Initial LEND Outcomes Follow- Key: Data Analysis LEND Outcomes Study Up Survey Development AUCD Outcomes Presentation LEND Outcomes Follow-Up Survey Study
LEND O UTCOMES F OLLOW -U P S URVEY D EVELOPMENT LEND O UTCOMES F OLLOW -U P S URVEY § Initial core competency survey developed based on “expert” opinion of trainee skills and competencies § Surveyed non-trainees in research labs Non-trainees thought that their skills in LEND Core Competencies were excellent
LEND O UTCOMES F OLLOW -U P S URVEY D EVELOPMENT F OCUS G ROUPS § 2017 AUCD Annual Meeting § Questions: § What types of leadership roles are you training your trainees to take on? § What makes LEND graduates different from their peers who did not receive LEND training? § How are you defining MCH populations with your trainees? § Transcribed and analyzed using content analysis
LEND O UTCOMES F OLLOW -U P S URVEY D EVELOPMENT F OCUS G ROUPS : F IVE T HEMES T HE “A CTIVE I NGREDIENTS ” OF LEND T RAINING In clinical trials, the Life Course “active ingredients” Perspective should align with how treatment effects are Advocacy Systems-Level measured… Engagement Orientation Other Possible “Active Ingredients”: Intersectional What • Leadership Interdisciplinary Differentiates Orientation • Engagement with Approach LEND disabilities/SHCN (Vulnerable Populations & Trainees Cultural Competency) • Research experience
LEND O UTCOMES F OLLOW -U P S URVEY D EVELOPMENT B ACK TO THE D RAWING B OARD Faculty Pilot Process and Results Revisions Based on Faculty Pilot • Piloted with 14 LEND and non-LEND faculty • Reduced long and burdensome questions members and family stakeholders • Removed redundancy • Feedback obtained from AUCD staff • Reduced focus on academia and academic • Took, on average, 25.29 minutes to complete leadership • Suggestions to: • Added questions about: • Remove redundancy • MCH competencies • Reduce focus on academic positions and • Core LEND leadership skills academic leadership • Job satisfaction and reason for taking • Add questions: MCH competencies, core current position LEND leadership skills, job satisfaction and reason for taking current position
LEND O UTCOMES F OLLOW -U P S URVEY D EVELOPMENT LEND O UTCOMES F OLLOW -U P S URVEY § 31 questions § Administered via RedCap through UW-Madison § Informed consent obtained
F INDINGS F EASIBILITY § Recruited 93.7% of eligible participants (74 out of 79) § Took participants, on average, 24:45 to complete the survey § No missing data § Cost: $25 compensation per completed survey
F INDINGS P ARTICIPANT B ACKGROUND C HARACTERISTICS 96.7% 100.0% 88.4% 90.0% 80.0% 70.0% 60.0% 55.8% 50.0% 43.3% 40.0% 34.9% 26.7% 30.0% 20.0% 10.0% 0.0% Has Disability or SHCN Family Member has Disability or SHCN Female
F INDINGS P ARTICIPANT D ISCIPLINES 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% y y h k y y r s y g e n y n e g g p g p c n t r n o c o h l o a o o o a i a i a i i i t s W c t t t l l r e c l r e i a O o o o r i r e e n d o u H t c h i h h u h e l e v d u N a c t N T T a u G c M d d i y c i A P A E l l s l b a a o - P e n u S f l c l a P e g o i s i S c a i y t e u a h p p g P S u n a c c L O - h c e e p S
F INDINGS P ARTICIPANT W ORK T YPE Control (N=30) LEND Trainee (N=44) Full Time Other Student 2% 5% Part Time Paid 7% Full Time Paid 100% Full Time Paid 86%
F INDINGS P ARTICIPANT W ORK S ETTINGS LEND Trainee (N=44) Control (N=30) 8% 9% 19% 12% 32% 20% 12% 8% 4% 4% 7% 37% 28%
F INDINGS NIRS (S IGNIFICANT D IFFERENCES ) 100.0 90.0 85.7 85.7 80.0 68.0 70.0 Percentage 60.0 48.0 50.0 40.0 30.0 20.0 10.0 0.0 Works with MCH Populations Works with Underserved Populations
F INDINGS NIRS (S IGNIFICANT D IFFERENCES ) 6 5.58 5 3.87 4 Number 3 2 1.29 0.89 1 0.64 0.56 0 Disciplines Worked With Leadership Activity Settings Leadership Activity Settings Focused on IDD
F INDINGS NIRS (D IFFERENCES THAT ARE NOT S IGNIFICANT ) § Proportion who work with individuals with disabilities § Type of employment setting § Number of people served via direct services
F INDINGS LEND O UTCOMES F OLLOW -U P S URVEY (S IGNIFICANT D IFFERENCES ) 60.0 50.0 48.8 50.0 40.0 Percentage 30.0 27.9 27.9 30.0 23.3 20.0 20.0 14.0 10.0 6.7 4.7 0.0 Salary Location Organizational Values Opportunity to Work with Chance to "Do Good" Special Needs Populations I TEMS L ISTED AS T OP 3 R EASONS FOR A CCEPTING C URRENT P OSITION
F INDINGS LEND O UTCOMES F OLLOW -U P S URVEY (S IGNIFICANT D IFFERENCES ) 3.00 2.58 2.58 2.50 2.14 2.10 2.10 2.00 Score (Maximum = 3.00) 1.63 1.50 1.00 0.50 0.00 Advocacy Research Policy *Resource Brokering was NOT Significant*
F INDINGS LEND O UTCOMES F OLLOW -U P S URVEY (S IGNIFICANT D IFFERENCES ) 100.0 95.3 88.4 90.0 76.7 80.0 66.7 70.0 60.5 60.0 50.0 40.0 40.0 30.0 20.0 10.0 0.0 Worked with Families of Children with Supported a Family in Advocacy Helped with Self-Advocacy Special Healthcare Needs
F INDINGS LEND O UTCOMES F OLLOW -U P S URVEY (S IGNIFICANT D IFFERENCES ) 100.0 90.0 86.0 83.7 80.0 69.8 70.0 60.0 60.0 60.0 50.0 36.7 40.0 30.0 20.0 10.0 0.0 Participated in Program Evaluation Participated in Vulnerable Populations Evaluated a Health Care Policy Research
F INDINGS LEND O UTCOMES F OLLOW -U P S URVEY (D IFFERENCES THAT ARE NOT S IGNIFICANT ) § Workplace characteristics § Distribution of work time across activities § Perception of leadership in workplace § Comfort with MCH and LEND skills and competencies § Agreement with intersectional orientation and life course perspective concepts § Interdisciplinary teaming § Job satisfaction
I MPLICATIONS B ENEFITS OF LEND § LEND trainees are more likely to: § Work with MCH populations § Work with vulnerable populations § Endorse high-level leadership skills § Work on interdisciplinary teams § Participate in research § Participate in advocacy § Participate in policy practice
I MPLICATIONS LEND D OES N OT I MPACT § Type of role or workplace § Endorsement of agreement with: § MCH skills and competencies § LEND skills and competencies § Intersectional orientation § Life course perspective
I MPLICATIONS I MPLICATIONS AND F UTURE D IRECTIONS § Strong methodology increased confidence in findings § Preliminary interpretation: identified significant differences: perspectives vs. actual activities § Both LEND trainees and comparison peers self-report that they are leaders and utilize MCH and LEND skills and competencies , but § LEND trainees actual work activities included significantly more leadership activities § Results are preliminary and analysis is ongoing: need feedback from LEND Network § Future: publication of results; refinement of survey; more data collection
Recommend
More recommend
