Evaluation of a Virtual Home Exercise Program Environmental Assessment Tool

Importance: Virtual home exercise programs are an emerging area of research and have been found to greatly improve health outcomes in older adults. However, research shows this population has low adherence rates, indicating the need for tools or interventions to improve adherence. Objective: This study was conducted to develop and evaluate the usefulness and usability of a home environment assessment tool designed to prepare older adults’ home environments for virtual home exercise program participation. Design: This project used an applied research design. Following the development of the assessment tool, quantitative and qualitative data were collected from occupational therapists and occupational therapy students through a one-time, online survey. Participants reviewed the assessment tool and then answered questions regarding its usefulness and usability. Setting: The assessment tool developed by this study was initially created to be used by home health occupational therapists who work with older adults. Participants: Occupational therapy students and occupational therapists working in any setting across the United States were recruited by email. Outcomes and Measures: The primary outcome of this study was the development of a useful and usable assessment tool that home health occupational therapists can utilize to assess their older adult clients’ home environments and to advise their clients on how to prepare their surroundings for enhanced virtual home exercise program adherence. Results: There were 27 respondents (17 practitioners, 10 students). All Likert scale items regarding the usefulness and usability of the tool had above average means. However, two usefulness items regarding the implementation of the tool were found to be outliers. Practitioners reported reasons such as documentation burden for their lower usefulness ratings and also suggested that new graduates may benefit more from the tool. Conclusions and Relevance: Though the tool does not need to be refined to improve its usability and usefulness, therapists were found to be hesitant to adopt the tool due to the perceived increase in workload. This suggests the need to improve prospective intervention planning in occupational therapy. Additionally, it was found this tool may be especially beneficial for new graduate therapists and therapists new to the population or setting (geriatrics or home health). Plain-Language Summary: This study was able to successfully develop and evaluate an environmental assessment tool to prepare older adults’ home environments for virtual home exercise program participation. The findings of the study reveal both practicing occupational therapists and occupational therapy students find the tool to be useful and usable. However, it was found that there is hesitancy in adopting this assessment due to the increased workload associated with it. While this tool may initially increase the workload of therapists, it was designed to improve older adult virtual home exercise program adherence and therefore lead to improved client health outcomes and lessen therapists’ workloads in the long run. This indicates a need for an increased emphasis on prospective planning in occupational therapy. Additionally, the tool created by this project may be more beneficial for new occupational therapists or occupational therapists new to the geriatric population or home health setting.