Promoting Social Participation among Older Adults with Chronic Disease: Identifying Modifiable Targets for Occupational Therapy Intervention

Research Objectives: To examine examine what measures of self-efficacy, occupational performance, physical and executive functioning predict social participation in adults aging with chronic diseases

Design: This study is part of a 2-arm parallel RCT investigating the efficacy of an occupational therapy focused disease management and health promotion intervention. Cross-sectional data for study participants collected at baseline were analyzed for this study.

Setting: The study took place in the general community setting with participants recruited from primary care clinics, health clinics, and community/religious centers.

Participants: 40 community-dwelling adults (average age=67 yrs) with diabetes or heart disease.

Interventions: Not applicable

Main Outcome Measures: Measures for independent variables (IVs) included self-efficacy for chronic disease management, PROMIS Physical Function, Physical Performance Test,PROMIS Global Mental Health Subscale, Executive Function Performance Test, and Performance of Self-Care Skills. Dependent variable was measured using the Late Life Functioning and Disability Index.

Results: Hierarchical regression models were estimated with demographic variables as covariates and block entry of IVs.
In model 1, self-efficacy for doing chores (β=2.87, p=.008) significantly predicted social participation with demographics and self-efficacy measures explaining 38%of the variance in social participation. In model 2, mental health (β=0.64, p=.017) and physical functioning (β=0.76, p=.021) significantly predicted socialparticipation. 54% of the variance in social participation was explained with significant improvement in overall model fit (p=.009).

Conclusions: Self-efficacy for doing chores, mental health, and physical functioning were the strongest predictors of social participation. These findings support use of interventions that holistically facilitate social participation by addressing client factors (mental health) and performance skills (self-efficacy & physical function).

Author(s) Disclosures: No conflict of interest.