Background: Cognitive impairments, strongly linked to reduced independence and community integration, are one of the most debilitating consequences following brain injury. Systematically trained cognitive strategies—particularly problem-solving strategies—offer a consistent means of responding to the myriad, often unpredictable breakdowns resulting from these impairments. However, due to limited funding for rehabilitation services, persons with brain injury rarely receive the training needed to learn and generalize such strategies to their everyday lives. To address this need, we received funding through the National Institute on Independent Living, Disability, and Rehabilitation Research (NIDILRR) for a field initiated project titled Generalizing Problem Solving Strategies to Everyday Environments Following TBI (90IF0087). (Start date 2012; End date 2016). The ProSolv program was the product developed and evaluated from this grant.
ProSolv Components: The ProSolv program consisted of three components: (a) six face-to-face meetings between a client and a coach who used the ProSolv Coaches’ manual to introduce the tutorial and train the client to use the app; (b) the web-based ProSolv Tutorial, which introduced the topic of problem solving and provided video instruction on how to use the ProSolv app; and (c) the ProSolv app, a resource for remembering the steps to effective problem solving and creating personalized problem–solution lists.
Methodology: We used principles of Participatory Action Research to iteratively develop the program. The development process included focus groups, structured interviews, and usability testing with individuals with brain injury, their family members, and professionals. The finalized program was evaluated in a between-subjects group study and a non-experimental single-case study.
Results: Results were mixed across studies. Participants demonstrated that it was feasible to learn and use the ProSolv program for support in problem solving. They highly recommended the program to others and singled out the importance of the coach. Limitations in app design were cited as a major reason for infrequent use of the app outside of coaching sessions.
Conclusions: Results provide mixed evidence regarding the utility of web-based mobile apps such as ProSolv to support problem solving following brain injury.
Next steps: We elected to not disseminate the ProSolv app and tutorial at the end of the project because of challenges with usability. However, we will be making the ProSolv Coaches’ Manual available at no cost off of our CBIRT website. The manual contains worksheets and other materials helpful to clinicians as they support (coach) individuals with brain injury learning to more effectively manage everyday problems.
GPS-TBI Project Publications:
Powell, L.E., Wild, M.R., Glang, A., Ibarra, S., Gau, J.M., Perez, A., Albin, R.W., O-Neil-Pirozzi, T.M., Wade, S.L., Keating, T., Saraceno, C., & Slocumb, J. (2017). The development and evaluation of a web-based program to support problem solving skills following brain Injury, Disability and Rehabilitation: Assistive Technology. http://dx.doi.org/10.1080/17483107.2017.1389999
The ProSolv Manual: Materials for Supporting Problem Solving Skills Training Following Brain Injury
Powell, L.E., Wild, M. R., Saraceno, C., Perez, A., Slocumb, J, Glang, A. Wade, S., O’Neil-Pirozzi, T. M., & Keating, T. (2017). The ProSolv manual: Materials for supporting problem solving skills training following brain injury. Retrieved from: https://cbirt.org/research/completed-projects/gps-tbi-generalizing-problem-solving-strategies-everyday-environments
For more information, contact Laurie Ehlhardt Powell – firstname.lastname@example.org