Susan Magasi | University of Illinois at Chicago (original) (raw)

Papers by Susan Magasi

Rehabilitation Psychology, Nov 1, 2017

Objectives-First, to evaluate the frequency with which individuals with neurological conditions r... more Objectives-First, to evaluate the frequency with which individuals with neurological conditions require test administration accommodations for the NIH Toolbox-Cognition Battery (NIHTB-CB). Second, to evaluate the appropriateness of accommodations provided by administrators, including adherence to NIHTB-CB Reasonable Accommodations Guidelines. Method-Adults with traumatic brain injury, spinal cord injury, or stroke (n=604) completed the NIHTB-CB and other assessments as part of a multi-site study. We provide a descriptive, secondary analysis of test administrator notes to determine use and appropriateness of accommodations. Results-Four hundred and fifty participants (75%) completed the NIHTB-CB using standard administration procedures, but 137 (22.6%) encountered accessibility challenges which required accommodations. Participants with motor function impairments were most likely to receive at least one of three kinds of accommodations: (a) non-standard methods of entering responses using standard input devices, (b) use of alternate input devices, or (c) directing the test administrator to

Quality of Life Research, May 20, 2016

To develop a measure of natural environment and human-made change features (Chapter 2 of the inte... more To develop a measure of natural environment and human-made change features (Chapter 2 of the international classification of functioning, disability, and health) and evaluate the influence of perceived barriers on health-related quality of life. A sample of 570 adults with stroke, spinal cord injury, and traumatic brain injury residing in community settings reported their functioning in home, outdoor, and community settings (mean age = 47.0 years, SD = 16.1). They rated 18 items with a 5-point rating scale to describe the influence of barriers to moving around, seeing objects, hearing sounds, hearing conversations, feeling safe, and regulating temperature and indicated whether any difficulties were due to environmental features. We used Rasch analysis to identify misfitting items and evaluate differential item functioning (DIF) across impairment groups. We computed correlations between barriers and patient-reported outcomes measurement information system (PROMIS) social domain measures and community participation indicators (CPI) measures. The 18 items demonstrated person reliability of .70, discriminating nearly three levels of barriers. All items fit the Rasch model; impairment-related DIF was negligible. Ceiling effects were negligible, but 25 % of the respondents were at the floor, indicating that they did not experience barriers that they attributed to the built and natural environment. As anticipated, barriers correlated moderately with PROMIS and CPI variables, suggesting that although this new item bank measures a construct that is related to participation and health-related quality of life, it also captures something unique. Known-groups validity was supported by wheelchair users reporting a higher level of barriers than did ambulatory respondents. Preliminary evidence supports the reliability and validity of this new measure of barriers to the built and natural environment. This measure allows investigators and clinicians to measure perceptions of the natural environment and human-made changes, providing information that can guide interventions to reduce barriers. Moderate relationships between barriers and PROMIS and CPI variables provide support for the measurement and theory of environmental influences on social health and participation.

Archives of Physical Medicine and Rehabilitation, 2018

To test the effect that indicators of mobility device quality have on participation outcomes amon... more To test the effect that indicators of mobility device quality have on participation outcomes among community dwelling adults with spinal cord injuries (SCI), traumatic brain injuries (TBI) and stroke using structural equation modeling. Survey, cross-sectional study, and model testing. Clinical research space at 2 academic medical centers and one free-standing rehabilitation hospital in the Midwestern United States (St. Louis, Ann Arbor, Chicago). Community-dwelling adults (mean age= 48 years(SD 14.3)) with SCI, TBI and Stroke (n=250). Not applicable MAIN OUTCOMES MEASURES: The Mobility Device Impact Scale, PROMIS Social Health (v2.0) questionnaires, including Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities questionnaires and the 2 Community Participation Indicators&amp;amp;amp;amp;amp;#39; Enfranchisement Scales. Details about device quality (reparability, reliability, ease of maintenance) and device type were also collected. Respondents used ambulation aids (30%), manual (34%), and power wheelchairs (30%). Indicators of device quality had a moderating association with participation outcomes, with three device quality variables, ease of repairs and maintenance, and device reliability accounting for 20% of the variance in participation. Wheelchair users reported lower participation enfranchisement than persons using ambulation aids. Mobility device quality plays an important role in participation outcomes. It is critical that people have access to mobility devices and that these devices be reliable.

Mayo Clinic Proceedings, Aug 1, 2016

To identify factors underlying heart failure hospitalization. Between January 1, 2012, and May 31... more To identify factors underlying heart failure hospitalization. Between January 1, 2012, and May 31, 2012, we combined medical record reviews and cross-sectional qualitative interviews of multiple patients with heart failure, their clinicians, and their caregivers from a large academic medical center in the Midwestern United States. The interview data were analyzed using a 3-step grounded theory-informed process and constant comparative methods. Qualitative data were compared and contrasted with results from the medical record review. Patient nonadherence to the care plan was the most important contributor to hospital admission; however, reasons for nonadherence were complex and multifactorial. The data highlight the importance of patient education for the purposes of condition management, timeliness of care, and effective communication between providers and patients. To improve the consistency and quality of care for patients with heart failure, more effective relationships among patients, providers, and caregivers are needed. Providers must be pragmatic when educating patients and their caregivers about heart failure, its treatment, and its prognosis.

Journal of Heart and Lung Transplantation, Oct 1, 2015

BACKGROUND: Generic and heart failure (HF)-specific health-related quality of life (HRQOL) instru... more BACKGROUND: Generic and heart failure (HF)-specific health-related quality of life (HRQOL) instruments do not address unique burdens of mechanical circulatory support (MCS). This report describes (1) a conceptual model of adjustment to MCS and HRQOL, (2) the development of a new set of items to assess adjustment and HRQOL, and (3) establishes content validity of the new model and items. METHODS: We interviewed 15 expert clinicians, 16 patients with advanced HF, and 48 MCS patients. A grounded theory approach was used to systemically examine qualitative data. We developed a coding dictionary, with codes organized under concepts. A conceptual model of adjustment to MCS and HRQOL was developed. A set of relevant items was generated from the codes, concepts, and conceptual model. After items were refined, MCS patients participated in cognitive interviews to provide feedback on their relevance and acceptability. RESULTS: Patients described how having HF and MCS affected their daily lives. Three concepts regarding adjustment to MCS and its relationship to HRQOL emerged: (1) effect of disease and treatment (satisfaction with treatment, symptoms, and self-efficacy regarding self-care), (2) resources, and (3) implant strategy. From our codes, concepts, and model, we developed a set of 652 items that were categorized by concept. The item set was reduced from 652 items to 236 (36%), and 120 of these 236 items (51%) underwent cognitive debriefing. Our final set includes 239 items with evidence of content validity. CONCLUSIONS: Our newly developed model on adjustment to MCS and HRQOL and items will undergo further testing in the future.

Archives of Physical Medicine and Rehabilitation, Sep 1, 2010

Isokinetics and Exercise Science, Aug 15, 2011

Given the functional and epidemiological significance of lower extremity strength, portable, low-... more Given the functional and epidemiological significance of lower extremity strength, portable, low-cost measures of lower extremity strength with robust psychometric properties are needed for clinical practice and research. The purpose of this study was to compare ...

Carolina Digital Repository (University of North Carolina at Chapel Hill), 2016

Objective-To conduct a longitudinal evaluation of PROMIS® Social Function measures (Satisfaction ... more Objective-To conduct a longitudinal evaluation of PROMIS® Social Function measures (Satisfaction with Participation in Social Roles, and Satisfaction with Participation in Discretionary Social Activities) in English-speaking people with chronic health conditions. Study Design and Setting-Adults receiving treatment for chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), chronic back pain, or depression completed PROMIS computer-based measures of social health at two time points approximately three months apart, and global ratings of change. Linear mixed effects models and standardized response means were estimated for the two social function measures. Results-A total of 599 people participated: 79 with stable COPD, 46 COPD exacerbation, 60 with CHF, 196 with depression and 218 with back pain. Four groups experienced improvement over time; one (COPD-stable) changed very little. Those who reported better global ratings of change in overall health experienced larger changes in social function than those who reported the same or worse global health.

Quality of Life Research, Apr 25, 2017

Purpose To develop and evaluate a model of environmental factors-participation relationships for ... more Purpose To develop and evaluate a model of environmental factors-participation relationships for persons with traumatic brain injury (TBI), stroke, and spinal cord injury (SCI), and test whether this model differed across three diagnostic groups, as well as other demographic and clinical characteristics. Methods A cross-sectional observational study included 545 community-dwelling adults with neurological disorders (TBI = 166; stroke = 189; SCI = 190) recruited at three academic medical centers. Participants completed patient-reported measures of environmental factors and participation. Results The final structural equation model had acceptable fit to the data (CFI = 0.923; TLI = 0.898; RMSEA = 0.085; SRMR = 0.053), explaining 63% of the variance in participation in social roles and activities. Systems, services, and policies had an indirect influence on participation and this relation was mediated by social attitudes and the built and natural environment. Access to information and technology was associated with the built and natural environment which in turn influence on participation (ps \ 0.001). The model was consistent across Electronic supplementary material The online version of this article (

American Journal of Occupational Therapy, Nov 1, 2018

Date Presented 4/20/2018 This ethnography explored the collaborative process of a community-based... more Date Presented 4/20/2018 This ethnography explored the collaborative process of a community-based participatory research (CBPR) team, which was shaped by team members’ various occupational identities. Dual identities, although at times challenging to navigate, may serve as a bridge, facilitating collaboration in CBPR teams. Primary Author and Speaker: Amber Angell Additional Authors and Speakers: Alli Ferlin, Christina Papadimitriou, Susan Magasi Contributing Authors: Judy Panko Reis, Tom Wilson, Jennifer Thomas

Journal of Heart and Lung Transplantation, Apr 1, 2014

Results: Higher education (p< 0.01), less depression (p= 0.02), and more satisfaction with social... more Results: Higher education (p< 0.01), less depression (p= 0.02), and more satisfaction with social support (p< 0.01) predicted longer survival after HT, explaining 17% of variance. Less depression (p= 0.04) and more use of positive coping strategies (p< 0.01) predicted better HRQOL accounting for 52% of variance. When survival and HRQOL were considered together as a composite endpoint, more use of positive coping strategies (p< 0.01) and less functional disability (p= 0.04) were predictors, explaining 33% of variance. Conclusion: Among long-term HT recipients, while depression was related to survival and HRQOL when considered as independent endpoints, depression was no longer significant in the composite model. Use of positive coping was significant in analyses of HRQOL separately and in the composite endpoint. The use of positive coping strategies may reflect patient resilience (i.e., ability to cope with stress) regarding the long term stresses of heart transplantation. The emergence of functional disability, as a predictor, reflects the importance of difficulties (whether psychosocial or physical) in being able to carry out activities essential to independent living on this composite endpoint.

Neurology, Mar 11, 2013

Background: In order to develop health outcomes measures that are relevant and applicable to the ... more Background: In order to develop health outcomes measures that are relevant and applicable to the general population, it is essential to consider the needs and requirements of special subgroups, such as the young, elderly, disabled, and people of different ethnic and cultural backgrounds, within that population. Methods: The NIH Toolbox project convened several working groups to address assessment issues for the following subgroups: pediatric, geriatric, cultural, non-English-speaking, and disabled. Each group reviewed all NIH Toolbox instruments in their entirety. Results: Each working group provided recommendations to the scientific study teams regarding instrument content, presentation, and administration. When feasible and appropriate, instruments and administration procedures have been modified in accordance with these recommendations. Conclusion: Health outcome measurement can benefit from expert input regarding assessment considerations for special subgroups. Neurology â 2013;80 (Suppl 3):S13-S19 GLOSSARY AWG 5 Accessibility Working Group; CWG 5 Cultural Working Group; GWG 5 Geriatric Working Group; PWG 5 Pediatric Working Group.

Otjr-occupation Participation and Health, 2012

Independent living and community participation are long-term rehabilitation goals. Disability sch... more Independent living and community participation are long-term rehabilitation goals. Disability scholars and activists have highlighted that access to social services is vital to the ability of people with disabilities to live and participate in the community as full and equal citizens. The field of occupational therapy has paid relatively little attention to how people with disabilities negotiate these systems. This article examines the vital but often invisible occupation of negotiating the social service systems using data from a 16-month ethnographic study of women with disabilities who were transitioning to independent living. Findings revealed that material, social, and attitudinal barriers in the service delivery systems restricted the women's access to resources and forced them to be highly resourceful to find, secure, and manage the social services they needed to maintain independent living. Theoretical and clinical implications for occupational therapy are discussed.

Journal of Spinal Cord Medicine, 2008

Background/Objective: To report an evidence-based review of participation instruments that have b... more Background/Objective: To report an evidence-based review of participation instruments that have been used in spinal cord injury (SCI) clinical practice and research. Methods: Rehabilitation literature was searched for instruments used by at least 2 independent SCI researchers since 2000. Each instrument was reviewed by 2 committee members. One person reviewed the scale and documented the level of use and psychometric properties. The second committee member verified the values and made suggestions for changes. Results: Three instruments met the review criteria: Craig Handicap Assessment and Reporting Technique (CHART), Assessment of Life Habits (LIFE-H), and the Impact on Participation and Autonomy (IPA). Each instrument incorporates different perspectives in the measurement of participation. The LIFE-H uses a qualitative approach, whereas the CHART adopts a quantitative approach; both are based on societal norms of participation. In contrast, the IPA integrates individual choice and control in defining participation. CHART is the most widely used instrument, although its development predates the development of the ICF. The IPA is a relatively new instrument, and its psychometric properties have only recently published. Conclusions: Continuing research is needed to develop conceptually and psychometric valid measures of participation for use with people with SCI. Priorities include understanding the relationship between objective and subjective indicators of participation, describing the dimensions of participation, and identifying appropriate measurement models and psychometric approaches to evaluate the nonhierarchical character of participation. Researchers and clinicians should be aware of the strengths and limitations of existing measures to make informed decisions about appropriate instruments.

American Journal of Occupational Therapy, Aug 1, 2021

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limi... more Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Latinx cancer survivors experience worse physical and mental health during survivorship. This group&#39;s occupational participation during survivorship is a product of cultural values, environmental influences, and occupational gains and losses. To promote occupational justice, the OT profession is called to deliver culturally tailored care to capitalize on this group&#39;s strengths and prepare them for daily participation. Primary Author and Speaker: Ricardo Daniel Ramirez Additional Authors and Speakers: Susan Magasi

Archives of Physical Medicine and Rehabilitation, Oct 1, 2021

Objective(s) To investigate the state of the science around availability and appropriate use of a... more Objective(s) To investigate the state of the science around availability and appropriate use of accessible medical diagnostic equipment (AMDE) for patients with disabilities (PWD). Data Sources Bibliographic databases PubMed, CINAHL, Embase were searched (January 2000- February 2021). Terms included diagnostic equipment, examination table, weight scale, imaging equipment, mammography, wheelchair, disabled persons, and health services accessibility. Study Selection English-language research of any design, conducted in the US, focused on adults with physical disabilities, and describing/evaluating AMDE was included. Two researchers independently evaluated studies. Initial search yielded 813 results; 29 studies were included. All methods were in accordance with the WHO's guidelines for rapid reviews. Data Extraction Key study characteristics of included articles were extracted by one researcher and reviewed for accuracy by another. The quality of included studies was assessed independently by two researchers using the Mixed Methods Appraisal Tool. Data Synthesis Both quantitative (n=18) and qualitative (n=11) research revealed that PWD identify lack of access to AMDE as a barrier to safe and equitable primary and specialty healthcare. Providers and PWD report that the presence of AMDE doesn't translate into use of equipment by providers. Additionally, Facilities typically rated themselves higher on accessibility surveys than third party auditors. Conclusions Although access to MDE has improved slightly in recent decades, the presence and use of accessible equipment remains infrequent, creating barriers for PWD. Existing studies on AMDE are largely descriptive, establishing the scope of the issue. Future research should focus on evaluating impact, outcomes, and cost in order to facilitate greater adoption of AMDE in accordance with the US Access Board's 2017 standards and ADA. Author(s) Disclosures This rapid review was partially funded by a cooperative agreement with the National Council on Disability.

International Journal of Environmental Research and Public Health, Mar 6, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

The American Journal of Occupational Therapy

Date Presented 04/21/2023 Supports are needed to address the preparedness and mutuality of patien... more Date Presented 04/21/2023 Supports are needed to address the preparedness and mutuality of patients with mechanical circulatory support and their caregivers. OT interventions can promote daily participation as well as physical and mental health for dyads. Primary Author and Speaker: Ricardo Daniel Ramirez Additional Authors and Speakers: Susan Magasi Contributing Authors: Kathleen L. Grady

Occupational Therapy In Health Care