270164 Steps to Effective Problem-solving (STEPS) in group homes

Sunday, October 28, 2012

Sarah Ailey, PhD, RNC , College of Nursing, Community and Mental Health Nursing, Rush University, Chicago, IL
Arlene Michaels Miller, PhD, RN , College of Nursing, Rush University, Chicago, IL
Tanya Friese, RN MSN , Faculty Practice and Outreach, Rush University College of Nursing, Chicago, IL
Aggressive/challenging behaviors (A/CBs) among individuals with intellectual disabilities (ID) have serious consequences, including psychiatric hospitalizations and incarcerations. Over 400,000 (and increasing) individuals with ID live in small group homes; where 20-25% report distress from other residents' A/CBs. Punitive measures violate human rights; positive behavior supports are encouraged. Individuals with ID are susceptible to A/CBs due to deficits in social problem solving (SPS), the cognitive and behavioral activities used to solve problems. SPS training in clinical settings shows positive results on behaviors; the training needs to be translated to community settings. The group home environment can provide positive behavior support. We previously worked with individuals with ID and residential staff to modify for community settings a SPS program developed by Nezu and colleagues; now called Steps to Effective Problem-solving (STEPS). STEPS (six sessions/one booster) was piloted in two group homes (one male/one female) with a history of A/CBs. 25% of individuals with ID (mean age 36.6 [SD 10.5]) and 50% of residential staff were minorities; Attendance was 70% and 67% and high satisfaction 91% and 87% respectively. The effect size was d=.6 for individuals with ID improved SPS skills and A/CBs, d=.6 for residential staff improved SPS skills; and d=.51 for group-level improved SPS skills. Implementing STEPS in group homes is likely to improve SPS skills of individuals with ID, their residential staff, and the whole group and may decrease A/CBs. STEPS is a potentially sustainable behavior-support program that may empower individuals with ID to reduce A/CBs and their consequences.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related nursing
Social and behavioral sciences

Learning Objectives:
Identify consequences of aggressive/challenging behaviors for individuals with intellectual disabilities (ID) Describe outcomes of a pilot of the Steps to Effective Problem-solving program in group homes for individuals with ID Explain benefits of social problem-solving training as health promotion for individuals with ID

Keywords: Behavioral Research, Community Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Principle Investigator for the discussed research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.