Posted on February 25, 2021

By Lucy Lund, CQL Quality Enhancement Specialist

Throughout the course of the COVID-19 pandemic, the utilization of technology has become a bridge to connection, relationships, and participation in activities, while maintaining a safe distance and protecting others. Engaging with people receiving services in a Personal Outcome Measures® (POM) interview, even through virtual platforms, remains a valuable avenue to discover information about quality-of-life outcomes and supports. Virtual POM interviews provide an opportunity to generate ideas for innovative and safe supports even within the context of the pandemic, when using technology is the only way to conduct interviews.

Despite the pandemic, it is important for POM interviews to occur. The pandemic will undoubtedly have an impact on what you learn during a POM interview. Keep in mind though, that the POM is intended to gain perspective on the person’s life in that moment of time. It is important to capture the experience and impact of the pandemic and yet continue to look for avenues to enhance one’s life through all means, including virtually. The POM interview becomes a platform to start virtual conversations and reshape supports that may be effective beyond the pandemic.

Service providers across the world expanded the utilization of technology for people to connect, hold virtual advocacy groups, and have fun, while dealing with COVID-19 restrictions. As the pandemic wore on there were creative solutions being discovered by both providers and CQL, that would allow for the successful implementation of virtual POM interviews.

The connection occurring through the virtual POM conversation is valuable. Having the interaction through these conversations has proven to be incredibly beneficial for mental health purposes, as loneliness markers increase due to the pandemic. People who are dependent upon services have increased indicators for loneliness, and the pandemic amplified social isolation (Wormald et al., 2019). A virtual POM conversation can identify possible areas of connection and opportunities to enhance one’s quality of life.

Technology Access For People With Disabilities

Access to technology is essential to having a virtual POM interview. At the start of the pandemic, many people lacked the resources to have private conversations while practicing social distancing. Technology resources, including computers, tablets, and even personal phones have not historically been widely available for people with disabilities. Barriers to technology include funding, awareness, access, and assessment (Boot et al., 2018). Throughout the pandemic, many service providers sought and found solutions to these issues, yet opportunities to expand access – through funding, training, and with a focus on success for the person utilizing technology – remains an ongoing pursuit.

Numerous resources are available to both understand the application of technology for people receiving services and improve their access to that technology. There are organizations that can help open funding streams, and there are grants available within local sectors. Along with the cost of technology decreasing dramatically in recent years, the dedication to enhancing technology access through supports has never occurred at a more important time.

Technology-Related Resources

• The TEC Lab: Technology-Enhancing-Capabilities
• Coleman Institute for Cognitive Disabilities
• Assistive Technology Act Services Supports
• State of the States in the Use of Technology

Conducting Virtual Personal Outcome Measures® Interviews

To begin the virtual POM interview process, one must reach out to the service provider and person receiving services to see if this is something that they would like to do. It is always essential to obtain informed consent, reviewing the purpose and process before getting started. Reviewing the Outcomes Overview Guide and Consent Form virtually prior to the interview helps everyone become familiar with the chosen technology. There are numerous video communications platforms available, so finding what works best and what the person and service provider prefer is a necessary starting step.

A virtual POM interview allows for flexibility in time and location. Some people may want their device set up at the dining room table, while some may want it set up in their bedroom. Some people may want the interview to occur over a cup of coffee throughout a few mornings during the week, while others may want a longer conversation in the evening or on a weekend. Many location and time barriers are eliminated with technology, and so ensuring the person interviewed guides the framing decisions for the conversation remains incredibly important.

Once the interview is set up, finding ways to customize the preferences for the person receiving services is essential. One example would be to drop off a drink or snack before the interview on a doorstep. This is a way to show appreciation for them taking the time for the POM interview and to personalize the process as much as possible before the conversation occurs.

When it’s time for the interview, log in early, make sure the person is comfortable, and review the purpose and process of the Personal Outcome Measures® conversation once again. It is always important in any POM interview for the person to take the lead. CQL has created the ‘Personal Outcome Measures® Virtual Interview Tips Guide’ that shares additional information.

During the virtual POM conversation, privacy remains of upmost importance. The environment chosen by the person must have the capacity for people to share freely. This should be in place during the conversation and during the follow-up conversation for the person who knows them best.

As the virtual POM interview comes to a close, it is important to thank the person receiving services once again. This can be done with a thank you note or token of appreciation for taking part in the conversation. During this unique time, finding creative ways to keep the connections we have in place remains essential.

Power Dynamics Must Be Considered When Conducting Interviews

By Carli Friedman, Ph.D., CQL Director of Research

The voices of people with disabilities, especially people with intellectual and developmental disabilities (IDD), have historically been ignored and disempowered. This is especially true in the context of research and data collection. As a result, it is very important to consider power dynamics in research, including when conducting Personal Outcomes Measures® interviews. In fact, the more we pay attention to power dynamics in interviewing and research and attempt to remedy them, the stronger the research becomes!

COVID-19 has often made virtual interviews necessary to keep everyone safe. But just because the interviewer and interviewee are not physically in the same room, it does not mean that power dynamics are still not in play. In addition, an extra person beyond the interviewer and interviewee, such as a staff member, may be in the room with the interviewee to help with technology, or to provide other support. While there certainly may be good reasons for the presence of additional people, it is necessary to remember that we may not always be able to tell if, and how, the presence of that extra person influences the interview, even though it likely does.

Distribution of Power and Authority

Think about the fact that the interviewer probably not only has more power than the person being interviewed but also likely represents an authority figure. Then if you add on top of that additional staff in the room, it becomes a very unequal distribution of power and authority. The interviewee may not feel comfortable sharing something they ordinarily would. It is also possible that the extra person may chime in and remind the interviewee of something.

These power dynamics can also result in what’s called acquiescence bias in research, which is the tendency of the interviewee to tell the interviewer what they think they want to hear and to comply because that’s what they’ve been conditioned to do. Even if they’re not looking to please the interviewer, having someone else in the room may change what the interviewee is willing to say.

It’s important to keep in mind that all of these dynamics and issues are likely happening unconsciously. The additional person in the room is not intentionally impacting the interview. I’m also not suggesting we kick out all supporters from interviews, especially if the person with disabilities wants them there. But perhaps there are creative or overlooked ways the interview can be conducted that minimize power differentials. For example, if the supporter is there to help with technology, they can help set everything up initially and then leave the room but stay nearby in case any issues should arise.

As interviewers, it’s our responsibility to consider these power issues. Doing so not only speaks to our ethical obligations as interviewers but will also help improve the quality of data collected.

Stephanie’s Experience With A Virtual POM Interview

By Lucy Lund, CQL Quality Enhancement Specialist

Stephanie Reinking receives supports from Opportunities for Positive Growth, Inc. in Fishers, Indiana. Stephanie participated previously in POM interviews that occurred in-person but shared that she felt it was an invasion of her space and time. Stephanie was asked if she would like to have a virtual POM interview. She agreed, and Stephanie set the date and time she would like the interview to occur.

Throughout the pandemic, Stephanie had missed seeing her friends and family. She also missed working at a restaurant she enjoyed. During the POM interview, Stephanie began thinking of ideas of how to virtually connect with her friends. She was asked about virtual services through a church she missed attending and began thinking of things she could do, versus her world being small. Stephanie enjoyed having the POM conversation virtually far more than when it occurred in-person.

When asked why Stephanie enjoyed this more, she responded that she could feel more open over the computer rather than if someone came to her home. She said she was nervous having the personal conversation, and the computer made it easier. Stephanie also shared, “I like that I can see everyone’s faces when I work online. I like that it feels like it is more on my time and flexible.” While this may not work for everyone beyond the pandemic, this communication platform and method of having the conversation chosen by the person should continue for years to come.

Personal Outcome Measures® Interviews In A Post-Pandemic World

The pandemic has affected everyone, and quality of life has been impacted. Knowing what changed, and why, is important for any POM conversation in and outside of a pandemic. With the right preparation, tools, and flexibility, the POM interview can occur on any platform, at any time, and remains necessary to continue to move quality supports forward. Technology will remain part of our lives. It is important that people receiving services have the access to devices and equipment that they need to continue to express the areas of their life they would like to improve and reduce any areas of loneliness that may exist.

References

• Boot, F. H., Owuor, J., Dinsmore, J., & MacLachlan, M. (2018). Access to assistive technology for people with intellectual disabilities: a systematic review to identify barriers and facilitators. Journal of Intellectual Disability Research, 62(10), 900-921.
• Wormald, A. D., McCallion, P., & McCarron, M. (2019). The antecedents of loneliness in older people with an intellectual disability. Research in Developmental Disabilities, 85, 116-130.