... OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT Title: Overcoming CRCI Through Organization Self-Management Strategies Kayla Elstien April 24th, 2023 A capstone project submitted in partial fulfillment for the requirements of the Doctor of Occupational Therapy degree from the University of Indianapolis, School of Occupational Therapy. Under the direction of the faculty capstone advisor: Katie Polo, DHS, OTR, CLT-LANA 1 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 2 Abstract Chemo brain is often used to describe the brain fog that cancer patients experience, yet the correct term is cancer-related cognitive impairments (CRCI) which can happen to anyone diagnosed with cancer, not just those receiving chemotherapy. Due to the limited teachings of this, a 3-part educational program was developed to teach those with CRCI organizational selfmanagement strategies. Three main goals were created which consisted of an increase in participant knowledge, confidence, and resource utilization into daily activities following the completion of the program. The workshops were held using a hybrid model as 90-minute sessions once a week for three weeks addressing the main themes of: time management, physical decluttering, and mental organization. Results indicated a significant increase in all three goals following each presentation theme. The findings from this program highlight the role of OT in providing effective education to cancer patients and survivors experiencing CRCI. Keywords: CRCI, OT, organization, self-management OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 3 Introduction Cancer Support Community (CSC) is a non-profit organization with over 175 locations nationwide that provides educational programs and psychosocial support to cancer patients, survivors, and loved ones alike at no cost. The overall mission behind CSC is to ensure that all people impacted by cancer are empowered by knowledge, strengthened by action, and sustained by community (Cancer Support Community Indiana, 2022). It is with their mission in mind that led to the development of my doctoral capstone project which is to create a three-part educational workshop series for cancer survivors involved in CSC who are experiencing cognitive impairments as a result of their treatments, impacting their ability to engage in organization self-management activities of daily life. Research has found that approximately 70% of cancer survivors experience CRCI effects during chemotherapy with a remaining 30% of individuals noting long-term cognitive effects post-treatment (Bolton & Isaacs, 2018; Green et al., 2019, & Wolf et al., 2016). Cancer-related cognitive impairments, (CRCI), are typically noted in areas affecting memory, thinking, and executive function; resulting in further problems related to problem solving, organization, and planning. Therefore, the development of this program is necessary to meet both the needs of cancer survivors involved in CSC struggling with organizational management and the needs of cancer survivors alike experiencing CRCI impacting their abilities to participate in ADLs. The goal of this project is to provide education through an OT lens on organization self-management strategies to improve participation in daily activities that are affected by CRCI. This paper will continue to explore evidence-based findings pertaining to CRCI and the role of OT in cancer survivorship, the design and implementation of the educational workshops, and the outcomes of the program and the impact on both the CSC members apart of the program and the profession as a whole. OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 4 Background Cancer Support Community (CSC) began over 40 years ago when Dr. Harold Benjamin had a vision to create a community that would provide free social and emotional support to cancer patients and their loved ones (Cancer Support Community, 2023). What once began as a call to action is now a global community with hundreds of programs and resources available to cancer patients, survivors, caregivers, and loved ones affected by cancer. In 2016, Cancer Support Community conducted a study titled, Access to Care in Cancer 2016: Barriers and Challenges involving 982 CSC members who have a history of cancer with significant results indicating detriments of the healthcare system in providing the care necessary to cancer patients (Cancer Support Community, 2016). Specifically, related to access to service and treatment decision making, 25% of respondents did not feel confident that they received the care they need, 53.5% of respondents reported not receiving social or emotional support services (Cancer Support Community, 2016). Such findings align with existing literature which reports the most frequent unmet need specific to this population was comprehensive care, followed by medical care (Giuliana et al., 2016). Additionally, 22% of respondents reported skipping recommended treatments to maintain out-of-pocket costs (Cancer Support Community, 2016). At Cancer Support Community in Central Indiana, I was informed that about 75% of members were between 60-65 years of age with the remaining 25% under 30 years of age and there is a 3:1 ratio of women to males involved in CSC. Following, most CSC members are at a middle-low income level, hence the necessity of maintaining programs as most clients cannot comfortably afford continuous supportive services. These findings indicate how vital it is to have a global non-profit organization such as Cancer Support Community to provide free educational and supportive services to a underrecognized population. OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 5 During my population needs assessment, I conducted a formal interview with my site mentor to determine what my project would be that would fill the greatest need at CSC Central Indiana. When asked, what is the common challenge CSC members are facing and would like additional resources on, my site mentor, Lora Hays, informed me that she has consistently been told by members that they are struggling to stay organized both physically and mentally, feeling overwhelmed (L. Hays, personal communication, March 6, 2022). Based on this common concern, my project was created to develop an educational program focused on overcoming CRCI through organizational self-management strategies. The program would be held as a mini workshop series in which I would provide education and resources on physical and emotional organization ideas in addition to time management strategies. The main outcome goal of this educational program is to see an increase in self-help and satisfaction with the CSC members participants through the resources provided (L. Hays, personal communication, March 6, 2022). When combining the goals from my needs assessment with previous literature, occupational therapy has the potential to play a vital role in cancer survivorship. Researchers Pergolotti and colleagues (2016) emphasized that OT is relevant when cognitive decline has affected ADL/IADL ability, self-care, and activity participation (Pergolotti et al., 2016). This particular study demonstrates the role of OT in cancer care and for my role offering education on CRCI impacts in organization. Following, additional research has suggested interventions focused on increasing knowledge via pamphlets, memory logs and planners, and other adaptations such as home modifications and work-related changes have all been found to improve CRCI and daily functions of cancer patients and survivors (Abraham et al., 2020, Bernstein et al., 2018, Amidei, 2018; & Green et al., 2019). Each of the above interventions have been incorporated into the design of the program. Following, one particular study conducted by OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 6 Newman and colleagues (2019), examined CRCI effects in cancer survivors and their ability to independently manage their daily routines while providing strategies to increase occupational engagement through an OT model. While a different program design was utilized, there are similarities in the implementation of the program by offering workshops focused on OT management for CRCI, compensatory strategies, problem-solving, and action planning (Newman et al., 2019). Results from the study indicated significant increases in quality of life, cognitive function, occupational performance, and goal setting (Newman et al., 2019). This study alone shines a promising light on the potential benefits of the educational program created here on improving organizational self-management for those with CRCI. While research in cancer care and survivorship is starting to increase, there is still an overall lack of research addressing CRCI both cancer patients and survivors often experience, supporting the necessity for my educational program to fill the gaps in literature. This program has the ability to add to the limited network of information available on the aftermath of cancer involving CRCI while increasing independence in organizational skills for improved quality of life and participation in daily activities for the participants involved in this program. Program Development Individualized Needs Assessment In order to develop a focused plan for creating the mini educational program lecture series, I conducted an informal interview where participants answered a series of 14 open-ended background questions in addition to 45 4-point Likert scaled questions on various subcategories of executive functioning. This informal interview acted as a second needs assessment at an individual level where only participants who are or have experienced cancer-related cognitive impairments could take-part in in order to develop a more specialized and purposeful workshop OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 7 series. Such background questions consisted of, where are you at in your journey with cancer and what type of treatments have you received? how are some of your cognitive struggles impacting your ability to maintain organization?, and what are your biggest strengths and weaknesses when it comes to organization? As for the 45 questioned 4-point Likert scale, 6 questions were based on planning and prioritizing, 10 questions on organization, 9 on memory, 6 on attention, 8 on time management, and 7 on limbic dysfunction and emotional regulation as those were the common areas of dysregulation during and post cancer treatments. The Likert Scale consisted of 1 being strongly disagree to 4 being strongly agree Overall, the questions where more than 80% of individuals reported a 4 were incorporated into the workshop series. Refer to table 1 in the appendix for individual needs assessment data collected and which workshop focused on providing education and resources to such questions and concerns. From this information, I developed my 3-part workshop series with a focus on time management, physical decluttering and organization, and mental and emotional organization. Theoretical Model and Frame of Reference The development of my educational program stemmed from the Dynamic Interactional Model which focuses on highlighting cognition as a continuous, dynamic component between the individual, task, and environment. The models intent is to provide a foundational understanding of function and dysfunction in cognition to develop treatments for adults with brain-injuries (Toglia & Abreu, 1987 ). While not all cancer is specific to the brain, cancer of any kind, any intensity, and any size can have drastic effects on cognition, making this an appropriate occupation-based model to provide an overview for the necessity of my educational program. Additionally, the model specifically assesses structural capacity, metacognitive processes, and learner characteristic. These individual characteristics interact with the environment and task, OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 8 and all require a higher set of cognitive skills, such as executive functioning, in order to process information and adapt to the demands of the task at hand. The entire program is based on CRCI where executive dysfunction is a major area of concern, hence the 45 Likert scaled questions during the individual interview portion based on executive functioning to address such issues impacting task completion in the individuals personal and professional environments. Due to the cognitive impairments cancer patients and survivors taking part in my educational workshop have experienced, I adopted a self-management frame of reference to guide my workshops into promoting effective use of self in increased time management, physical organization, and emotional organization skills. Self-management involves six key principles: problem-solving, decision making, resource utilization, patient-provider partnership, action planning, and selftailoring (Lorig & Holman, 2003). All of my workshops emphasized these six core skills by providing education, strategies and resources, and weekly homework to incorporate the newly learned strategies into their daily routines and reflect on the successes and failures of each to increase self-awareness. Goals for the Program The overall goal of this program is to educate cancer patients and survivors at CSC who are or have experienced CRCI on organizational self-management. To achieve this goal, there are three additional goals which are to increase: (1) knowledge, (2) confidence, and (3) access and utilization of available resources into daily routines. The three stated goals will be met via the development, presentation, and outcome evaluation of each educational workshop lecture. Refer to Program Design and Implementation for more information regarding the objectives and components of each workshop. OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 9 Program Design and Implementation All individualized interviews were completed prior to the start of the workshop series in order to design each PowerPoint presentation specific to the group needs. The project was carried out once a week as a hybrid in-person and virtual program for three weeks straight to increase inclusivity as not every member can or is comfortable leaving their homes. During each workshop, a pre-test and a post-test was given to assess the goals and objectives of the workshops along with a 1-page homework assignment asking participants to write down three strategies they would want to try to implement into their daily routines to address the principles of self-management. Refer to table 2 in the appendix for a specific outline of workshops. Program Evaluation Participant Demographics All 12 participants that completed the individualized needs assessment completed the first workshop presentation and 9 responded to both the pre-test and post-test. Following, there was one participant who discontinued the program due to personal illness, resulting in 11 participants and 8 responses on both the pre-test and post-test for the second and third workshop presentations. As for the summative final survey, 7 participants out of the 11 completed the questionnaire through Google Forms. Formative Outcome Results For each workshop, a pre-test and post-test was provided to assess the three main goals which are that participants will have an increase in knowledge, confidence, and resource availability and utilization following each workshop topic. To determine this, I created a Google Form with a mixture of standard agree/disagree questions and a 7-point Likert scale questions with 1 being strongly disagree, 4 being neutral, and 7 being strongly agree. The standard OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 10 agree/disagree questions pertained to straight forward knowledge questions such as I know what cancer-related cognitive impairment means. For all knowledge-based agree/disagree questions, all participants reported agree that they now know what CRCI is, what OT does, what time management means, what physical organization means, and what mental and emotional processing and organization means following each workshop, respectively. In other words, 100% of participants reported an increase in knowledge in each of the educational-based questions in every workshop, achieving the first goal of the educational program which is to increase knowledge. Moving forward, to address the other two main goals of the educational program: increase in confidence and resource allocation and utilization, the Likert scale questioning was applied. For these questions, a mean score rating of 5 or higher, slightly-strongly agree on the Likert scale, was applied in addition to computing a difference in scores from pre-test to posttest. The difference is the post-test mean minus the pre-test mean. Refer to the table below for specific workshop results in regard to each additional program goal, increased confidence and resource allocation and access. Refer to table 3 in the appendix for statistical outcomes. Summative Outcome Results Following the completion of the mini workshop lecture series, I created a summative report on Google Forms to assess the overall success of the workshop. This survey consisted of a 25 questions with a mixture of agree/disagree statements, open-ended paragraph questions for free versed writing, and another 7-point Likert scale questions with 1 being strongly disagree, 4 being neutral, and 7 being strongly agree. The survey consisted of questions based on the overall content of the workshop, the quality of the workshops and speaker, and the successes and changes participants would like to see if the program were to run again in the future. Overall, 7/7 participants reported they strongly agree that they gained valuable information from this OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 11 workshop, the speaker answered all the questions appropriately and in a timely manner, the presentations were well-designed and engaging, and would take this workshop series again or recommend the series to another individual. As for the open-ended questions, significant findings consisted of the program itself and changes participants would like to see, if any. When asked, What specific topics of the workshop series did you find most valuable, answers ranged from information provided in the first workshop all to the final workshop, highlighting the unique differences of each cancer patient or survivor and the effects they personally are experiencing from CRCI effects. As for the strategies discussed and utilized, 100% of participants who completed the survey stated they would continue to utilize the strategies and resources provided from this educational program series and benefitted from the weekly homework to continue to practice and incorporate such strategies into their daily routines. When asked, What would you like to see more of next time if this workshop were to continue, participants mainly stated they would like to have more group discussion time, another workshop added, and longer workshop session in order to cover more material. Summary Cancer Support Community (CSC) is a non-profit organization dedicated to serving cancer patients, survivors, and loved ones through free educational and psychosocial supportive programs. To add to the mission of CSC, I developed an educational program for cancer patients and survivors who are experiencing cancer-related cognitive impairments (CRCI) as it is a common concern for over two-thirds of those diagnosed with cancer. More specifically, after conducting my needs assessment for CSC, it was determined my program would be presented to those with CRCI who are experiencing difficulties with organizational self-management. When developing my educational program as a mini workshop lecture series, I found a significant gap OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 12 in evidence-based literature on occupational therapys role in cancer survivorship and in education on CRCI or organizational self-management. Therefore, the development of my program filled both the gaps in literature and in member satisfaction and independence at CSC. It was from the limited research and importance of providing the most useful information to meet my participants organizational needs that I conducted an individual needs assessment. After assessing the individual needs from the 14 open-ended questions along with the 45 4-point Likert scaled questions focused on executive functioning, I created my three-part workshop series focused on three themes: CRCI and time management, physical decluttering and organization, and mental and emotional organization. The three main goals of this educational program were to increase knowledge, confidence, and access and utilization of available resources into daily activities. Each workshop focused on one of the three themes and presented utilizing a hybrid model for 90-minute sessions. For each workshop, a pre-test and post-test was given, respectively, to assess all three of my main goals along with discussion time. Additionally, homework was provided following each workshop to address self-management principles of problem-solving, decision-making, and taking action to incorporate the strategies taught in the workshops into their daily activities. When evaluating my program, results indicated a significant increase in knowledge, confidence, and resource access following each specific workshop, demonstrating success. Along with this, 100% of participants who completed the summative survey stated they gained valuable information from the workshop series and would take this program again or recommend it to another individual in need. Conclusion Overall, my educational program on overcoming CRCI effects through organizational self-management significantly increased participants knowledge, confidence, and resource OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 13 access and utilization through various strategies outlined in the workshop series to be incorporated in daily routines. Approximately 70% of cancer patients and survivors experience CRCI while an additional 30% continue to experience these effects long-term yet there is limited education and research on the topic. This program addresses the individual participants needs through the informal interview provided, the site needs through the needs assessment conducted, and the communitys need by paving a pathway for continued research and OTs role in providing care to cancer survivors struggling with CRCI to find new strategies to improve independence and engagement in daily activities. Future work should consist of adding onto this outlined program of different areas that can be affected by CRCI within our OT scope of practice such as sleep and rest, work employment and involvement, social participation, and more detailed information regarding strategies for increased engagement in IADLs. OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 14 References Abreu, B. & Toglia, J. (1987). Cognitive rehabilitation: A model for occupational therapy. American Journal of Occupational Therapy, 41(7): 439-448. Abraham, E., Khan, B., Ling, E., & Bernstein, L. (2020). The development and evaluation of a patient educational resource for cancer-related cognitive dysfunction. Journal of Cancer Education, 37: 111-119 Amidei, C. (2018). Symptom-based interventions to promote quality survivorship. Neuro Oncology, 20(S7): 27-39. Baxter, M., Newman, R., Longpre, S., & Polo, K. (2017). Occupational therapys role in cancer survivorship as a chronic condition. American Journal of Occupational Therapy, 71: 1-7. Bernstein, L., McCreath, G., Young, J., Dissanayake, D., & Rich, J. (2018). A brief psychoeducational intervention improves memory contentment in breast cancer survivors with cognitive concerns: Results of a single-arm prospective study. Supportive Care in Cancer, 26: 2851-2859. Bolton, G & Isaacs, A. (2018). Women's experiences of cancer-related cognitive impairment, its impact on daily life and care received for it following treatment for breast cancer. Psychology, Health, and Medicine, 23(10): 1261-1274. Cancer Support Community (2023). About Us. Retrieved on January 28th, 2023, from: https://www.cancersupportcommunity.org/about-us Cancer Support Community. (2016). Access to Care in Cancer: Barriers and Challenges. Retrieved on January 28th, 2023, from: https://www.cancersupportcommunity.org/article/access-care-cancer Cancer Support Community. (2023). Our mission. Retrieved on January 21st, 2023 from: OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 15 https://cancersupportindy.org Cole & Tufano (2020). Applied Theories in Occupational Therapy: A Practical Approach (2nd Ed.). Green, H., Mihuta, M., Ownsworth, T., Dhillon, H., Tefay, M., Sanmugarajah, J., Tuffaha, H., Ng, S., & Shum, D. (2019). Adaptations to cognitive problems reported by breast cancer survivors seeking cognitive rehabilitation: A qualitative study. Psycho-Oncology, 28: 2042-2048. Giuliani, M., McQuestion, M., Jones, J., Papadakos, J., Le, L., Alkazaz, N., Cheng, T., Waldron, J., Catton, P., & Ringash, J. (2016). Prevalence and nature of survivorship needs in patients with head and neck cancer. Head and Neck, 1097-1103. Green, H., Mihuta, M., Ownsworth, T., Dhillon, H., Tefay, M., Sanmugarajah, J., Tuffaha, H., Ng, S., & Shum, D. (2019). Adaptations to cognitive problems reported by breast cancer survivors seeking cognitive rehabilitation: A qualitative study. Psycho-Oncology, 28: 2042-2048. Lorig, K. & Holman, H. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26(1): 1-7. Newman, R., Lyon, K., Coster, W., Wong, J., Festa, K., & Ko, N. (2019). Feasibility, acceptability, and potential effectiveness of an occupation-focused cognitive selfmanagement program for breast cancer survivors. British Journal of Occupational Therapy, 82(10): 604-611 Pergolotti, M., William, G., Campbell, C., Munoz, L., & Muss, H. (2016). Occupational therapy for adults with cancer: Why it matters. The Oncologist, 21: 314-319. Polo, K. & Smith, C. (2017). Taking our seat at the table: Community cancer survivorship. OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 16 American Journal of Occupational Therapy, 71: 1-5. Ulfers, S. & Berg, C. (2017). Occupational therapists with oncology exposure: Perceived Needs of adults and older adults with cancer-related cognitive impairments. OTJR: Occupation, Participation, and Health, 37(3): 149-154. Wolf, T., Doherty, M., Kallogjeri, D., Coalson, R., Nicklaus, J., Ma, C., Schlaggar, B., & Piccirillo, J. (2016). The feasibility of using metacognitive strategy to improve cognitive performance and neural connectivity in women with chemotherapy-induced cognitive impairment. Oncology, 91: 143-152. OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 17 Appendix Table 1: Executive Functioning Skills: Pre-Workshop Focused Group Challenges Category Data Collected Subtype Workshop Correlated Planning and 1. I struggle to plan my day ahead of time Workshop Prioritizing 2. When I have a lot to do, I struggle to focus on what 1&2 is important 3. I feel overwhelmed with a busy schedule Organization 1. I often lose or misplace items Workshop 2. I struggle to keep my workspace or headspace clear 1, 2, 3 3. I rarely use supports to help me (physical, technological, friend) Memory 1. I struggle to remember names, dates, places, details Workshop 3 2. I often need reminders or repeated instructions Attention 1. I have a hard time dividing attention Workshop 2. I often feel distracted 1, 2, 3 3. When interrupted, I lose my train of thought Time 1. I have trouble started or finishing projects Management 2. I do not have enough time to accomplish daily tasks Workshop 1 3. Things seem to take longer than expected Limbic Dysfunction 1. I feel my fatigue and pain impacts my ability to stay organized Workshop 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT and Emotional Regulation 18 2. I feel overwhelmed and stress thinking about organization Table 2: Education Program Workshop Series Outline Workshop Objectives and Components Duration and Title 1: Get Date 1. Obtain completed individual needs assessments and Presentation Organized! interviews from participants prior to educational Length: 90 Time series mins Management and Energy Conservation 2. Introduce the series and incorporate a group ice breaker 3. Provide and discuss workshop pre-test/post-test 4. Define and educate on cancer-related cognitive impairments (CRCI) signs and symptoms, role of OT, time management strategies, and energy conservation 5. Allot time for Q&A at the end of the session 6. Discuss the purpose and objectives of the weekly homework 7. Follow-up with all members via email and provide all materials from presentation (i.e., PowerPoint PDF, additional list of, weekly homework) Date: 02/13/2023 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 19 2: Get 1. Review weekly homework as a group Presentation Organized! 2. Provide and discuss workshop pre-test/post-test Length: 90 Physical 3. Define and educate on physical space and home mins Decluttering organization, S.P.A.C.E strategy, and home and modifications Organization 4. Allot time for Q&A at the end of the session Date: 02/20/2023 5. Reiterate weekly homework objectives 6. Follow-up with all members via email and provide all materials from presentation (i.e., PowerPoint PDF, additional list of resources, weekly homework) 3: Get 1. Review weekly homework as a group Presentation Organized! 2. Provide and discuss workshop pre-test/post-test Length: 90 Mental and 3. Define and educate on mental and emotional mins Emotional organization, direct and indirect effects of cancer Processing treatments on emotion, and strategies to improve Date: and headspace 02/27/2023 Organization 4. Allot time for Q&A at the end of the session 5. Reiterate weekly homework objectives 6. Follow-up with all members via email and provide all materials from presentation (i.e., PowerPoint PDF, additional list of resources, weekly homework) OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 20 Table 3: Workshop Goals: Confidence and Resource Availability Program Results Pre-Test Post-Test (M)* (M)** Difference Workshop 1: CRCI Effects & Time Management Strategies Confidence (number/8) 2.6 5.0 2.4 Resource Availability 3.4 5.9 2.5 Confidence (number/7) 4.3 6.0 1.7 Resource Availability 3.7 6.1 2.4 Confidence 3.7 5.7 2.0 Resource Availability 4.0 6.3 2.3 Workshop 2: Physical Decluttering & Organization Workshop 3: Emotional Processing & Mental Organization *Mean values were calculated from 8 participants from workshop **Mean values were calculated from 7 participants from workshop 2-3. OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT Wee k 1 21 DCE Stage (orientation, screening/evaluatio n, implementation, discontinuation, dissemination) Weekly Goal Objectives Tasks Date complete Orientation 1. Complete orientation by the end of the week 2. Complete evidencebased literature search 3. Guest Speak at Educational Program Nurse Navigation meeting Meet with site mentors, staff, and other personnel on-site at CSC and introduce myself, my role, and the upcoming program I am implementin g Complete a walk-through of CSC 01/10/23 Prepare short introduction of myself, the role of OT, and the purpose and plan for my educational workshop series to present at the Nurse Navigation meeting Refer back to literature search done in class and 01/11/23 Develop a short introduction of my role, the role of OT, and the purpose of my 01/13/23 educational workshop to present to the 01/12/23 Nurse Navigator meeting and for all future meetings Update evidencebased literature Set time aside to meet with site mentors, Lora Hays and assistant Hunter Stafford to discuss future meeting OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT review new evidencebased research added since last checked utilizing UIndy databases 22 times and schedule Review my work schedule, hours, and weekly meeting times 2 Screening/Evaluatio n 1. Continue web search for upcoming workshops 2. Complete Introduction draft of Scholarly Report 3. Attend staff and program meetings Document web search findings for intervention ideas and for background information on CRCI signs and symptoms Review site and purpose of my education program Ensure speech for staff and program meetings is rehearsed Create a google drive for my capstone and folders with necessary information and findings from web search Draft Introduction section of Scholarly Report Write out speech for staff and program meetings and save in google drive to refer back to 01/17/23 01/29/23 01/16/23 01/19/23 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 3 Screening/Evaluatio n 1. Continue web search for upcoming workshops 2. Develop interview questions for CSC members participatin g in workshop series 3. Practice and take Distresser Screening 4. Rough draft of outlines for upcoming workshops 5. Complete Background draft for Scholarly Report Document web search findings for intervention ideas and for time managemen t strategies 23 Meet with Lora on Thursday to determine next weeks plan (scheduled meetings are on Thursdays) All 01/26/23 documentatio n completed prior to Thursdays 01/26/23 meeting Create a rough draft Document of interview web search questions for prebefore establish Thursdays screening meeting to tools and review assessments questions that focus with site on executive mentor functioning Create Plan a time rough draft to meet to of interview learn what questions the Distress screen is, Meet with how to take advisor to it, and how practice and to send it to take the participants Distresser screening Create a assessment rough draft of all 3 Develop a workshop rough draft outlines and of workshop have them outlines finalized and 01/26/23 01/27/23 01/29/23 01/29/23 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT Review scholarly articles and evidencebased research for my background portion of my scholarly report 4 Screening/Evaluatio n 1. Finalize interview questions 2. Complete as many phone call interviews as possible 3. Reach out x2 to each member by the end of the week for those who have not answered 4. Update CSC member information to keep track of all phone calls made and missed 5. Begin my PowerPoint presentation for my first workshop Finalize interview questions in order to begin making phone calls to CSC members interested Begin phone call interviews to CSC members interested in workshop series Quantify and qualify all answers received from phone calls and send out a follow-up email after each call 24 stored in the appropriate Google folder Draft Background section of Scholarly Report Begin to plan phone call interview times Meet with 01/30/23 Katie Polo Monday morning to ensure interview questions are 01/31/23appropriate, 02/03/23 meaningful, and effective Refer to Microsoft Excel sheet to contact CSC members interested and mark each as complete when the interview is finished Re-assess all information received during the phone calls made and 01/31/2302/03/23 02/03/23 02/05023 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 6. Complete Project draft for Scholarly Report Update all CSC member information in Microsoft Excel to track member interview completion Create at least half of my PowerPoint for my first workshop Complete the Project draft of my Scholarly Report for class 5 Screening/Evaluatio n 1. Continue to complete phone call interviews 2. Complete my PowerPoint for the first workshop series Continue phone call interviews in order to have as much information going into series as possible 25 send out a follow-up email to each individual with their results from my questions without the notes added. Separate the notes and questions into different documents and store all in Google drive folder dedicated to CSC Interview Completions Develop part of my PowerPoint for the first workshop series Draft the Project section of the Scholarly Report Meet with Hunter Stafford to discuss successes and challenges with phone call interview process 02/07/202 3 02/06/202 302/12/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 3. Update CSC information to keep track of all phone calls made and missed 4. Open CSC on Saturday independent ly 6 Screening/Evaluatio n& Implementation 1. Present first workshop series 2. Ensure PowerPoint is ready to be presented Complete PowerPoint and send to be reviewed Update all CSC member information in Microsoft Excel to track member interview completion 26 Refer to Microsoft Excel sheet to determine when to recontact CSC member who I was unable to get a hold of prior to workshop Re-assess all information received from Review interviews Saturday and send a program follow-up itinerary and email to each protocols participant when completed Finalize all PowerPoint details Set-up the room I will be Open CSC independentl y Saturday, set up the center and all rooms being utilized by various groups, close the center with everything armed and locked Review PowerPoint prior to presenting Complete room set-up including all 02/06/202 302/12/202 3 02/11/202 3 02/13/202 3 02/13/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT and working as planned 3. Wrap-Up final phone call interviews if leftover 4. Begin and complete my second PowerPoint for the following workshop 5. Send out a thank you email for attending with all relevant information attached 7 Implementation 1. Present second workshop series 2. Ensure PowerPoint is ready to be presenting in Update all CSC member information in Microsoft Excel Update all information, interviews, and surveys in Google Drive Draft Second PowerPoint Have second PowerPoint reviewed and finalized 27 technology with hybrid course layout Draft 2nd PowerPoint in order to get it assessed by Katie Polo and Hunter Attend weekly meeting on Thursday with PowerPoint draft completed Send out all thank you, list of interventions , weekly homework, and Send out PowerPoint thank-yous, PDF to all list of members additional intervention Answer all s, and emails within weekly 24 hours of homework receiving from members Finalize all Review PowerPoint PowerPoint details prior to presenting Set-up the room I will Complete be room set-up including all 02/14/202 302/15/202 3 02/16/202 3 02/14/202 3 02/14/202 302/19/202 3 02/20/202 3 02/20/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT presented and working as planned 3. Begin and complete my third PowerPoint for the following workshop 4. Send out a thank you email for attending with all relevant information attached 5. Complete Midterm Evaluation 8 Implementation & Discontinuation 1. Present third and final workshop series 2. Ensure PowerPoint is ready to presenting in Update all CSC member information in Microsoft Excel Update all information, interviews, and surveys in Google Drive Draft Third PowerPoint Have third PowerPoint reviewed and finalized 28 technology with hybrid course layout Draft 3rd PowerPoint in order to get it assessed by Katie Polo and Hunter Attend weekly meeting on Thursday with PowerPoint draft completed Send out all thank you, list of interventions , weekly Send out homework, thank-yous, and list of PowerPoint additional PDF to all intervention members s, and weekly Answer all homework emails within 24 hours of receiving from members Finalize all Review PowerPoint PowerPoint details prior to presenting Set-up the room I will Complete be room set-up including all 02/21/202 302/22/202 3 02/23/202 3 02/21/202 3 02/21/202 302/26/202 3 02/28/202 3 02/28/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 3. 4. 5. 6. 7. be presented and working as planned Begin and complete my third PowerPoint for the following workshop Send out a thank you email for attending with all relevant information attached Go to food pick-up for new initiative Tuesday with CSC staff member into the community Meet with Katie Polo virtually to discuss program measureme nts and outcomes Finalize condensed PowerPoint to present at CSC Bloomingto n presenting in Update all CSC member information in Microsoft Excel Update all information, interviews, and surveys in Google Drive 29 technology with hybrid course layout Attend weekly meeting on Thursday to discuss program Send out all thank you, list of interventions , weekly homework, Send out and thank-yous, PowerPoint list of PDF to all additional members intervention s, and Answer all weekly emails within homework 24 hours of receiving Offer 1-1 from coaching members session to all Contact participants George and ensure our Go with times George, CSC staff, Meet to assist in virtually with food Katie Polo initiative on food pantry Wednesday pick-up to discuss program Meet with measurement Katie Polo s, outcomes, on and data Wednesday 03/02/202 3 02/28/202 3 02/28/202 303/06/202 3 02/28/202 3 03/01/202 3 03/03/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 9 10 Dissemination Dissemination 1. Begin to help and work at the front desk T/Th 2. Meet with Katie Polo on Tuesday virtually 3. Meet with Hunter for our weekly meeting on Thursday to check-in 4. Begin to research for Family Day event ideas 5. Start to assess disseminati on plans 1. Begin to help and work at the front desk T/Th 2. Meet with Katie Polo Complete and send Katie Tremel, CSC Bloomingto n, condensed organization PowerPoint Work the front desk Tuesday and Thursday from 9:3011am Meet with Katie virtually Tuesday to discuss theories and frame of reference Meet with Hunter for weekly check in Start to research Family Day ideas for organization for children and parents Work the front desk Tuesday and Thursday from 9:3011am 30 Complete and send condensed organization PowerPoint to CSC Bloomington Attend front desk duties and answer all phone calls during my shift Meet with Katie on Tuesday, plan for next meeting Meet with Hunter and discuss a summative survey Begin research for Family Day event April 29th Attend front desk duties and answer all phone calls during my shift 03/07/202 3 03/09/202 3 03/07/202 3 03/09/202 3 03/08/202 303/10/202 3 03/14/202 3 03/16/202 3 03/14/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT on Tuesday virtually 3. Send summative survey 4. Attend supportive staff meeting on Thursday 5. Start to assess disseminati on plans and work on disseminati on plan worksheet Meet with Katie virtually Tuesday to discuss disseminatio n plans and data format 31 Meet with Katie on Tuesday and discuss disseminatio n plans Create and send to all Create CSC summative members survey and summative send to CSC google form participants survey Attend Supportive Staff meeting on Thursday Attend monthly supportive staff meeting on Thursday with Lora back! 03/14/202 303/15/202 3 03/16/202 3 03/15/202 303/17/202 3 Work on disseminatio Complete n plan and worksheet disseminatio n plan worksheet and review previous paper submission and re-edit 11 Dissemination 1. Continue to help and work at the front desk T/Th 2. Meet with Katie Polo virtually 3. Review summative Work the front desk Tuesday and Thursday from 9:3011am Attend front desk duties and answer all phone calls during my shift Meet with Katie virtually and Hunter in- Meet with Katie and Hunter to discuss 03/21/202 3 03/23/202 3 03/21/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 4. 5. 6. 7. survey results Meet with Hunter Stafford inperson Tuesday Complete resource binder for CSC Open for CSC Saturday Finish disseminati on plan and continue to work on scholarly report person about my project and scholarly report Review summative survey results and randomly select 2 winners for completing the report Complete resource binder for CSC for all my work Come to CSC by 9am to open the building for support program on Saturday 32 disseminatio n plans and scholarly report Analyze summative survey results and randomly select 2 winners Start and finish resource binder for CSC Open CSC on Saturday from 9am12pm and greet all guests for supportive programs 03/20/202 303/23/202 3 03/21/202 303/22/202 3 03/25/202 3 03/20/202 303/25/202 3 Complete disseminatio Complete n plan disseminatio worksheet n plan and and work on submit drafts for scholarly Work on report drafts of scholarly report to be reviewed by Katie 12 Dissemination 1. Continue to help and work at the Work the front desk Tuesday and Thursday Attend front desk duties and answer all phone 03/28/202 3 03/30/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 2. 3. 4. 5. front desk T/Th Ensure my PowerPoint presentation is ready for CSC in Bloomingda le Present my condensed organizatio n workshop at CSC Bloomingto n on Wednesday Hold Coffee and Coloring on Thursday for Hunter Continue to work on scholarly report from 9:3011am calls during my shift Review PowerPoint for Wednesday and make sure Katie at Bloomingto n can access Review and present PowerPoint at Bloomington CSC on Wednesday Drive and present Get Organized! Workshop to Bloomingto n Wednesday Lead Coffee and Coloring Thursday since Hunter will be out of office and stay actively on Zoom with participants Lead Coffee and Coloring on Thursday 10-11am Continue to work on drafts of scholarly report to be reviewed by Katie 13 Dissemination 1. Continue to help and work at the front desk Th only (remote T) 2. Finalize Family Day Event Get Organized workshop 33 Work the front desk Thursday Finalize Family Day Event PowerPoint on organization for families 03/29/202 3 03/30/202 3 03/27/202 304/02/202 3 Continue to work on drafts for scholarly report and begin to discuss plans for SIS Quarterly Attend front desk duties and answer all phone calls during my shift Complete Family Day PowerPoint to send to 04/06/202 3 04/03/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 14 Dissemination 34 3. Meet with Hunter Thursday for my final evaluation 4. Continue to work on scholarly report, specifically abstract, summary, and conclusion since the drafts are due this week and teenagers 1. Continue to help and work at the front desk T/Th 2. Meet with Katie virtually on Wednesday 3. Continue to edit scholarly report if needed Work the front desk Tuesday and Thursday from 9:0011am Attend front desk duties and answer all phone calls during my shift Meet with Katie to discuss SIS Quarterly and any edits to scholarly report Meet with Katie from 11:30 virtually on Wednesday for scholarly report questions Meet with Hunter to complete final evaluation Continue to work on scholarly report for edits and contact Katie to meet next week to focus more on SIS Quarterly as the scholarly report will mainly be finished Hunter to review for April 29th 04/06/202 3 Meet Hunter Thursday in the conference room to 04/03/202 discuss and 3complete 04/8/2023 final evaluation and complete mine on CSC following Continue to work on drafts for scholarly report and start to look into SIS Quarterly more intensely with meeting time set-up with Katie 04/11/202 3 04/13/202 3 04/12/202 3 OVERCOMING CRCI ORGANIZATIONAL SELF-MANAGEMENT 4. Meet with Lora on Thursday 5. Outline and write SIS Quarterly draft 35 and SIS Quarterly Continue to make edits Meet Lora in as needed for scholarly her office from 3-4 report Thursday to Meet with wrap up my time at CSC Lora to catch-up Continue to with my capstone edit scholarly ending report as needed and Outline and write SIS write SIS Quarterly Quarterly 04/13/202 3 04/10/202 304/14/202 3 ...