Health promotion research conducted by the Center for Research on Women with Disabilities strongly suggests that our traditional, face-to-face workshop format shows great promise for helping women aging with physical disabilities improve their health. A larger, national sample with more diverse characteristics is now needed to demonstrate its wider applicability. We propose (1) to refine and further test our health promotion workshop intervention for women aging with disabilities. To address the needs of women who lack access to traditional formats due to multiple barriers such as transportation problems, mobility limitations, and secondary conditions such as pain and fatigue, we propose (2) to develop and establish the feasibility and efficacy of an online health promotion program designed to offer the same content and behavior change strategies using the technique of serious gaming. To fulfill Aim 1, we will collaborate with 12 centers for independent living around the U.S. to conduct a randomized, controlled trial of our workshop intervention. To fulfill Aim 2, we will collaborate with researchers at Case Western Reserve University to develop an online intervention based on their self-paced, web-based health promotion course. We will test three hypotheses: (1) Participants in the workshop intervention group will report significantly higher scores on measures of self- efficacy, health behavior, and health status at the completion of the 8-session intervention and at 6 and 12 months after baseline compared to participants in a wait-list control group; (2) The effect of the workshop intervention on physical and psychological health status will be mediated by self-efficacy and health behavior; (3) Participants in the Internet group will report significantly higher scores on measures of self- efficacy, health behavior, and health status compared to participants in a wait-list control group. To test the first two hypotheses, a sample of 312 women with physical disabilities will be recruited and randomly assigned to the workshop group or a wait-list control group. To test the third hypothesis, an additional 100 women will be randomly assigned to the internet group or a wait-list control group. These interventions are designed for use in clinical and social service settings and to advise public health policy governing the delivery of health services to people with physical disabilities. ? ? ?
