This clinical trial will look at whether young adults with intellectual and developmental disabilities (YA-IDD) have better outcomes when a travel training intervention called Ready to Ride (R2R) is taught by a specially trained Peer Supporter (PS) who shares the lived experience of having an IDD than YA-IDD who are taught Ready to Ride by staff at their community services organization. The aspects of life being looked at are loneliness, satisfaction with social activities, travel skills, service use and access, employment, and health related quality of life.
The researchers think the following things will happen.
1. YA-IDD who learn from a Peer Supporter will report significantly higher satisfaction with social activities, increased social connectedness and significantly less loneliness compared to YA who are taught organization staff. 2. Both groups will learn the same amount of travel skills. 3. YA-IDD who learn from a Peer Supporter will show larger increases in access to community-based services, transportation use, employment and health related services after 4 months than the YA taught by organizational staff.
Between the ages of 18 to 27 years old during the start of the study
Receives services at one of the eight community service organizations participating in the study.
Meets the federal diagnosis of a developmental disability (DD)
Qualifies for services related to their DD.
Independently uses public transportation >4 times/month.
Is not able to independently mobilize through walking or use of a mobility device.
Has significant non-corrected visual impairments.
Parallel
Ready to Ride - Standard Delivery
BehavioralThe standard delivery will be implemented by non-peer staff serving as interventionists. These staff will deliver the Ready to Ride (R2R) training, an established evidence-based travel training program. The intervention includes a total of 16 sessions. Six sessions consist of structured lessons focused on travel safety, awareness, preparedness, and skill development. The remaining sessions involve community-based learning, where participants practice travel skills in real-world settings with varying levels of support provided by the interventionist.
Ready to Ride - Peer Support Delivery
BehavioralThe peer support delivery will be implemented by trained peer interventionists. Peer interventionists are individuals with lived experience of disability who are trained to provide structured support while sharing their experiences. They will deliver the Ready to Ride (R2R) training, an established evidence-based travel training program. The intervention includes a total of 16 sessions. Six sessions consist of structured lessons focused on travel safety, awareness, preparedness, and skill development. The remaining sessions involve community-based learning, where participants practice travel skills in real-world settings with varying levels of support. Peer interventionists will provide support through modeling, shared experience, encouragement, and guided practice.
Progressive Evaluation of Travel Skills (PETS)
The Progressive Evaluation of Travel Skills (PETS) ) is a direct observation measure of independent travel, as rated by the level of support needed for participants to complete transportation-related skills. This tool has established content and construct validity with people with IDD. The PETS will be administered by research staff masked to group assignment who will evaluate each participant on a standardized route. The standardized routes have comparable difficulties across local public transportation systems.
NIH Toolbox® Item Bank v3.0 - Loneliness (Ages 18+) - Fixed Form (PROM)
Loneliness-NIH Toolbox® Item Bank v3.0 has 5 questions rated on a 5-point scale. This measure has acceptable psychometric properties in the general population and is used in clinical populations and with people with disabilities, including IDD. The tool includes questions that have detected differences in loneliness between individuals with and without IDD. A total standard T-score will be used to analyze the data.
PROMIS Short Form v1.0 - Satisfaction with Participation in Discretionary Social Activities 7a (PROM)
Satisfaction with Participation in Discretionary Social Activities-PROMIS Short Form v1.0 has 7 items that assess contentment with leisure interests and relationships with friends. It has been used with adults with a range of disabilities, including IDD. In a study with people with disabilities (including IDD), increased access to transportation predicted higher scores on this measure. A total standard T-score will be used to analyze the data.
Service attendance
Service attendance will be collected retrospectively at pre-test and then weekly after pre-testing through the post-test 2 time period. At pre-test, participants with assistance from family/staff or trusted adults/guardians when needed, will self-report the number of scheduled and missed primary, specialty, mental health, and dental appointments due to lack of transportation over the previous four months. Following the completion of pre-test data collection, participants (or trusted adults/guardians) will receive weekly emails, texts or phones calls to respond to a monitoring survey. From the weekly reports, we will calculate the total number of missed health and service appointments.
Accessibility Subscale of the Perceived Access of Health Care Services (PROM)
Accessibility Subscale of the Perceived Access of Health Care Services is a PROM that assesses the perceived distance, time, and ability to get to and from the place of services. The subscale has 4 items with response options on a 5-point Likert scale from "absolutely agree" to "absolutely disagree." It has established content and construct validity and strong internal consistency. Subscale total sum score will be used in analysis.
Transportation Use
Transportation Use data will be collected through weekly monitoring surveys that ask two brief questions about the use of public transportation in the past week. The questions ask about the: 1) Use of public transportation on the goal route in the past week, and if that trip was taken independently or not and 2) Use of other public transportation fixed routes in the past week, and if that trip was taken independently or not. This data will allow us to directly measure increased public transportation skills and use.
Self-Reported Employment Data (status, hours/week, wages, percentage of missed work shifts)
Descriptive information on employment status in the last 4 months will be collected from participants with assistance from family/staff if needed. Data on employment status including working/maintaining work or not working/loss of work is collected at pre-test and post-test 2. If the participant is working, data will also be collected on number of hours worked weekly, hourly wage, and number of missed work shifts due to transportation. Percentages will be calculated for the total sessions/missed sessions.
Adaptive Behavior Assessment System - Third Edition (ABAS-3 )
Adaptive Behavior Assessment System Third Edition (ABAS-3) aligns with standards for diagnosing conditions such as IDD and has strong psychometrics when used with people with IDD across the life course. Family or staff assess 11 essential skill areas within 3 major adaptive domains: 1) Conceptual, 2) Social, and 3) Practical. It provides scaled scores, domain standard scores, and a general adaptive composite score, each associated with interpretive categories (e.g., below average). Scores will be used for Aim 2 analysis.
PROMIS Anxiety Short Form
PROMIS Anxiety Short Form is an 8-item survey rated using a 5-point Likert scale (Never, Almost Never, Sometimes, Often, Almost Always). Higher scores indicate more anxiety. The PROMIS Measurement System uses IRT-based scores to generate a precise score. This measure was previously used with young adults with IDD, ages 18-26. In these previous studies, our community engagement team preferred the youth/pediatric scale to the adult version due to its increased accessibility and clarity of items . This measure has been validated in both clinical and non-clinical samples of youth ages 7-18 years old. It demonstrates strong internal consistency (ω = 0.89) and test re-test reliability (r = 0.75, p \< .001). Additionally, it demonstrates strong convergent validity with measures of general anxiety and divergent validity with measures of specific anxieties (e.g., social, separation). Scores will be used for Aim 2 analysis.
Comprehensive Demographic Questionnaire
Comprehensive demographic questionnaire will document relevant individual and family characteristics (e.g., racial and ethnic identity, parent educational level) and other services received.
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Temple University
Lead sponsor
University of Florida
Collaborator
University of New Hampshire
Collaborator
University of Minnesota
Collaborator
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