An Internet-Based Evaluation System for Postacute Acquired Brain Injury

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DESCRIPTION (provided by applicant): The overall objective of this project is to develop a Web-based national data base system for an assessment and outcome measure (Mayo-Portland Adaptability Inventory; MPAI-4) for acquired brain injury (ABI). The proposed database will provide a national sample of demographics; social and treatment environments; diagnosis/injury descriptors; and most importantly, change over the course of post-acute rehabilitation and outcomes for people with ABI. This database will be used to provide semi-annual feedback to participating rehabilitation providers about the effectiveness of their rehabilitation services relative to those of other providers serving similar individuals and using similar methods. Although a program evaluation system of this type is well-established for inpatient rehabilitation (i.e., Functional Impairment Measure; FIM), no such system is currently available for post-acute rehabilitation. Methods for program evaluation are required by the Committee on the Accreditation of Rehabilitation Facilities (CARF) resulting in a large number of "home-grown" measures of limited psychometric quality. In contrast, the psychometric properties and usability of the MPAI-4 have been refined over the last 15 years using state-of-the-art measurement technology (e.g., Rasch analysis) as well as traditional psychometric evaluation procedures. A prototype MPAI-4 database was developed with a small user group in Pennsylvania by Inventive Software Solutions (ISS). The proposed project will use state-of-the-art database technologies (i.e., secure web-based, on-line data collection). In addition to the immediate goal of commercialization and dissemination of this program evaluation product, ultimately data obtained may be useful for advocacy, policy development, disability determination, and determination of needs for medical, rehabilitation, vocational, independent living and other services of people with ABI. In Phase I of the project we built a new Web-based prototype. Upon successful usability testing, reviews by consortium consultants and the executive review panel, the new system was presented at focus groups held in Philadelphia, Phoenix and in Indianapolis. Evaluation forms were completed by the focus group attendees and the results were analyzed by the consortium consultants. The system was then examined by 30 pilot testers from varying backgrounds. Again, evaluation forms were completed by the pilot testers and the results were analyzed by the consortium consultants. In the proposed Phase II project the product will be further refined to be suitable for use by a large national user group. Successful marketing to develop a large user group is necessary to (a) assure a more representative sampling of chronic impairment and levels of activity and participation of people with ABI, and (b) provide an economic basis for long-term maintenance of this project through subscriber fees from participating rehabilitation programs. In this Phase II project we also propose to finalize systems, policies, and procedures in order to support the project's ongoing financial viability, scientific data and measurement integrity, ethical practices, and user education and training. PUBLIC HEALTH RELEVANCE: Methods for program evaluation are required by the Committee on the Accreditation of Rehabilitation Facilities (CARF). The MPAI-4 is a measurement tool that can meet the critically unmet need for a national database system for gathering information from rehabilitation providers to be used for the evaluation of rehabilitative services for people with acquired brain injury (ABI). In addition to the immediate goal of commercialization and dissemination of this program evaluation product, ultimately data obtained may be useful for advocacy, policy development, disability determination, and determination of needs for medical, rehabilitation, vocational, independent living and other services of people with ABI.