Structured Abstract
Multiple Sclerosis Structured Abstract - MS #8
Self-help guides can help clients to become better advocates
CITATION: Seekins, T., Fawcett, S. B., & Mathews, R. M. (1987). Effects of self-help guides on three consumer advocacy skills: Using personal experiences to influence public policy. Rehabilitation Psychology, 32(1), 29-38.
LEVEL OF EVIDENCE: IB2a
RESEARCH OBJECTIVE/QUESTION
To examine the efficacy of self-help guides for writing consumer advocacy letters.
DESIGN
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x |
RCT |
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Single Case |
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Case Control |
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Cohort |
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Before-After |
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Cross Sectional |
Randomly assigned treatment and control group.
SAMPLING PROCEDURE
All members of an independent living consumer advocacy group volunteered.
SAMPLE
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N = 10 |
Age range = 19-57 |
Male = NR |
Female = NR |
NR = Not reported
All members of an independent living consumer advocacy group. Disabilities included epilepsy, MS, quadraplegia, multiple heart/lung complications, postpolio syndrome, and stroke. Education ranged from 11th grade to 3 years of college.
OUTCOMES
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x |
Life roles |
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Tasks |
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Activities |
| |
Abilities/habits |
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Capacities |
OUTCOME AREAS
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Outcome Area |
Measures |
Reliability |
Validity |
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Performance in writing advocacy letters to public officials and editors both with and without self-help guides. |
Observer read letters and scored occurrence and non-occurrence of target behaviors. |
Interobserver agreement 88 to 100% |
Public officials rated how well letters were written and how likely to influence behavior |
INTERVENTION
Description
Treatment group prepared letters with self-help guides; Controls prepared similar letters without self-help guides.
Who delivered
Self-help guides
Setting
Home
Frequency
Two letters from each participant
Duration
6 months
RESULTS
Writing to public official: Treatment group averaged 80% target responses, quality 2.6, influence 2.8 on a 0-4 scale. Control group averaged 31% target responses, quality 1.9, influence 2.8.
Writing to editor: Treatment group averaged 80% target responses, quality 2.2, publication 2.2. Control group averaged 33% target responses, quality 2.1, publication 1.8.
Mann-Whitney U performed between treatment and control for all above areas suggested significant differences (p < .01).
Correlation between target responses and judge's ratings ranged from .48 to .89.
CONCLUSIONS
Biases - masking, sample size, expectation
Self-help guides are potentially a viable way to instruct individuals with disabilities in how to write effective advocacy letters.
Limitations
- Sample size was small. It is possible that one or two
participants artificially inflated the value of the experiment. Random selection helped to reduce this bias somewhat. It would have helped to have had a pretest to discover differences in the group.
COMMENTARY
Helping clients advocate for their right to participate fully in society is an important job for OT. This study suggests that self-help guides are a viable and financially sound way to assist clients in becoming better advocates. An additional piece to this would be to provide feedback for clients after they have used the self-help guides. This also suggests that certain clients would benefit from self-help guides for other tasks. This proposal would have to be researched further, however.
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice-Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Nancy Baker, ScD, OTR, and Linda Tickle-Degnen, PhD, OTR/L, FAOTA.
For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.
