Rehabilitation Research Design and Disability Center

IMPACT2 Model Long Description

Summary

This slide diagrams the IMPACT2 Model. The model demonstrates that outcomes of interventions can be described by considering the six stages of 1) Pre-Intervention, 2) Context, 3) Baseline, 4) Intervention Approaches, 5) Outcome Covariates, and lastly 6) OUTCOMES. A left to right bold arrow indicates the direction across the top of the slide. The applications of Universal Design and Health Promotion are delineated in the lower left hand corner of the slide as “Pre-Intervention”, which are two methods to improve functional performance. An arrow connects the pre-intervention approaches to the Context stage consisting of person/task/environment. The Context stage is represented as the person using assistive technology to perform a task within an environment. The Context stage is connected by an arrow to the next stage of Function, which is comprised of performance, quality of life, and participation. The fourth stage, the Intervention Approaches, has six components, which represent six methods available to improve functional performance. These are 1) Reduce the Impairment, 2) Compensate for the Impairment, 3) Use Assistive Technology Devices and Services, 4) Redesign the Activity, 5) Redesign the Environment, and 6) Use Personal Assistance. In these vertically stacked boxes the assistive technology method is highlighted and stands out from the others as an indication of the focus of the ATOMS Project. The next stage is the Outcome Covariates, which identifies potential precursor variables of satisfaction of devices and services, dissatisfaction of device or services, and use and discontinuance of assistive technologies. The final stage, Outcomes, involves measurement of the individual’s function to determine what the outcome of the intervention is. Again, just as the baseline stage did, function consists of performance, quality of life, and participation. Outcome is identified as participation, quality of life, and participation. The model considers cost as well as these six interventions. It is important to understand that the pre-intervention and the person/task/environment context must be considered throughout the process. It is also important to isolate an intervention from other concurrent interventions to understand the outcome of that particular intervention. Dollar signs are located next to the Pre-Intervention stage, the Baseline measurement of function, the Intervention Approaches, and the Outcomes measurement of function to show where cost needs to be considered.

Details

This model consists of a horizontal flowchart, with an additional section on the lower left corner leading into the horizontal flowchart. The first stage, the Pre-Intervention stage, is located in the lower left corner of the slide. It consists of a white rectangular box with the words “PRE-INTERVENTION” inside of it. Above this box is a larger light purple box with two yellow rectangular boxes vertically stacked inside of it. The lower box contains the words “Universal Design” and the upper box contains the words “Health Promotion”. There are two dollar signs located to the right of these boxes. There is a black arrow pointing upward from this stage to the next stage, Context. The context stage is the beginning of the horizontal aspect of the flowchart. This stage is depicted with a white rectangular box with the word “CONTEXT” inside of it. Below this box is a vertically aligned green rectangular box, with the word “Environment” located in the upper portion of the box. Overlapping with this box is a smaller yellow box, with the word “Task” located on the left side of the box. Another smaller white vertically aligned box layered on top of the yellow one. The word “Person” is located in the upper portion of this box, with a picture of a person in wheelchair located below the word “Person”. A black arrow points from this set of boxes to the right, to a blue box. This blue box contains the words “Function (performance, quality of life, participation)”. Above the blue box is a white rectangular box with the word “BASELINE” in it. Below the blue box are two dollar signs. From the blue box extends another black arrow to the right pointing to the next stage. This stage is depicted by six rectangular boxes aligned vertically, one above the other. The first box contains the words “Reduce the Impairment”, the second box contains the words “Compensate for the Impairment”, the third box contains the bolded words “Use Assistive Technology Devices and Services”, the fourth box contains the words “Redesign the Activity”, the fifth box contains the words “Redesign the Environment”, and the sixth box contains the words, “Use personal assistance”. There are black vertical lines on either side of these boxes that connect to each box in a ladder like manner. Each box is a light yellow color except the third box from the top, which is pink and has a gray shadow behind it. Above this stack of boxes is a white box with the words “INTERVENTION APPROACHES” inside of it. To the right of this box are two dollar signs. From this stage emerges another black arrow that extends to the right and goes behind a small orange box and ends at a blue box. The orange box contains the words “Precursor variables”. Above the small orange box is a white rectangular box containing the words “OUTCOMES COVARIATES”. A larger orange box with a shadow behind it extends from the small orange box, and is located beneath the small orange box. Inside of this larger box are three square purple boxes. The first two are connected horizontally and are located above the third box Each purple box contains two rectangular white boxes stacked on top of each other. The first box contains the word “Satisfaction” with the word “Service” located in the upper white box, and the word “Device” located in the lower white box. The second purple box, located to the right of the first, contains the word “Dissatisfaction”. Again, the upper white box contains the word “Service” while the lower white box contains the word, “Device”. The third box located below the first two, only contains two white boxes. The upper white box contains the word “Use” and the lower white box contains the word “Discontinuance”. There is a black bidirectional arrow connecting the upper and lower purple boxes. The final box, a blue box located at the end of the arrow, contains the words “Function (performance, quality of life, participation)”. Above this blue box is a white rectangular box containing the word “OUTCOMES”. Below the blue box are two dollar signs. The white rectangular boxes that label the stages across the top of the flowchart are connected with a black arrow from left to right.

The logo of the R2D2 Center is located in the upper left corner of the slide. The logo consists of a black square with the word “R2D2” in white above the word “Center” located inside of the black square. To the right of this square are the words “Rehabilitation Research Design and Disability Center” above the words “University of Wisconsin-Milwaukee”. The same logo, but on a slightly smaller scale, is also located in the lower right corner of the slide.