Parent Page: Research Centers & Labs id: 25674 Active Page: Healthy Aging through Performance and Participation (HAPP)id:26374

Healthy Aging through Performance and Participation (HAPP)

Research in the Healthy Aging through Performance and Participation Lab focuses on assessment and intervention of people with chronic medical conditions that require ongoing self-management, and where needed, caregiver training.  

performanceOccupational performance is defined as how people perform everyday activities in self-care, home management, work, school, use of transportation, caregiving, socialization and community integration. 


participationParticipation is defined as how people engage in everyday life situations and roles. For example, being able to dress oneself, and then take a bus with a friend to attend a movie in the community supports the life role of being a friend.



Major Focus of Research


  • Everyday activity as an indicator for early disease identification
  • Pre-post examination of everyday activity for intervention studies
  • Longitudinal studies examining change in everyday activity over time in people with and without disease processes.


  • Individual and group-based intervention offered on-site or through telehealth
  • Intervention development and testing

Current Projects

Skill-building thru Task-Oriented Motor Practice (STOMP) Intervention for Dementia
We are examining the dose-specific response to the manualized and individualized STOMP home intervention. We postulate that everyday activities can be improved by individualizing 1) task-oriented training using massed practice, 2) assistive technology, and 3) caregiver training.

skill building

Rapid, Multi-Disciplinary Needs Assessment for Patients with COVID-19 Transitioning Hospital to Home
In this study, we are assessing people that were hospitalized with COVID-19 and then discharged home across broad variables in function, cognition, physical and psychological abilities using a “Rapid Needs Assessment” methodology. Occupational therapy, physical therapy, nursing and social work are examining people one time per week for four weeks via phone or Zoom technology.

rapid project


  • 2021:Winner, Outstanding Abstract in Clinical Care or Research Category for “Goal-directed, Task-Specific Training Improves Activity of Daily Living Performance in People with Alzheimer’s Disease and Related Dementias. 
  • 2020: Outstanding Reviewer Award, American Journal of Occupational Therapy
  • 2020: Certificate of Appreciation, American Occupational Therapy Association
  • 2015: College of Allied Health Faculty Excellence in Service Award (under 5 years)
  • 2015: Nominated for CAH Student Council Teacher of Year 
  • 2014: American Occupational Therapy Association Service Commendation
  • 2014: College of Allied Health Outstanding Faculty in Research (under 7 years)
  • 2013: Oklahoma Occupational Therapy Service Award
  • 2013:  Fellow, American Occupational Therapy Association
  • 2012: Nominated for OUHSC Student Association Dr. Robert Magarian Faculty Award
  • 2012:  College of Allied Health Outstanding Faculty in Teaching Award (under 7                   years)
  • 2010: Graduated with Distinction, University of Texas Medical Branch
  • 2009: Best Poster Award for “Hospital Depressive Symptoms increase the Odds of Post-Hospitalization ADL Limitations”: Sealy Center on Aging, 13th Annual Forum, University of Texas Medical Branch
  • 2008: Best Poster Award for “Depressive symptoms in hospitalized older adults: Patterns and correlates of change in a 3-month follow-up study”: Sealy Center on Aging, 12th Annual Forum, University of Texas Medical Branch
  • 2006: Occupational Therapist of the Year: Oklahoma Occupational Therapy Association
  • 2004: Service Award: Oklahoma Occupational Therapy Association
  • 1997: Service Award: Oklahoma Occupational Therapy Association
  • 1990: Graduated with Distinction, OU



  • National Institutes of Health
  • Health Resources and Services Administration
  • Alzheimer’s Association
  • Donald W. Reynold Center of Geriatric Nursing Excellence

Rapid, Multidisciplinary Needs Assessment for Patients with COVID-19 Transitioning Hospital to Home
The project aim is to identify the clinical characteristics of COVID-19 patients post hospitalization by administering an interdisciplinary rapid needs assessment. The assessment emphasizes biopsychosocial and functional needs.  Part of the rapid-needs assessment will be describing the natural course of recovery of the COVID-19 survivor over a 30-day monitoring period. Funder: University of Oklahoma Vice President of Research. Role: PI (multiple PI); Award: $20,000; 4/30/2020-5/1/2021. 

Improving the methods of the STOMP intervention for mechanistic and large-scale trials.
The purpose of this award is to develop a defensible measurement model that examines correlates of change that parallel changes in activities of daily living, as well as to strengthen recruitment within the OKC metropolitan area through a qualitative assessment of barriers to research recruitment with various stakeholders. Funder: Donald W. Reynolds Center of Geriatric Nursing Excellence
Role PI (15% effort). Award $20,118; 9/1/2016 - 8/31/2017.                                                                                                     

High-dose, mass practice intervention to reduce ADL disability in dementia.
The purpose of this award was to examine differences in ADL outcomes between the intensive STOMP protocol and a less-intensive STOMP protocol in people with mild-moderate dementia. Funder: Alzheimer’s Association. Role: PI (20% effort). Award: $99,987; 10/1/14 - 9/30/16. 

Examining the advantages of delivering the STOMP intervention in the home environment.
The purpose of this award is to examine the advantages conferred by delivering the Skill-Building through Task-Oriented Motor Practice (STOMP) dementia intervention in a home vs. clinical environment in two sites in Oklahoma City, OK and Albuquerque, NM. Funder: CTSA Inter-Institutional Pilot Project Award: UNM HSC & OUHSC 8UL1TR00004.  Role: PI. Award: $48,334; 4/1/13 - 3-31-14.           

Technology use in educating advanced practice registered nurses and allied health students for team-based care.
The purpose of this award was to examine change in student knowledge, attitudes and skills for working with older adults using a multi-disciplinary team (occupational therapy, physical therapy, and nursing) as well as to increase proficiency in examination and treatment through telehealth. Funder: U.S. Department of Health and Human Services, Health Resources and Services Administration. Co-Investigator.  Award: $1,122, 417. 9/1/12 - 9/1/15.                 

Skill-building through Task-Oriented Motor Practice (STOMP) down dementia.
The purpose of this grant was to test the feasibility and implementation methods of the STOMP intervention in a lab environment.   Funder: OUHSC Vice President of Research Grant. Role: PI. Award: $29,362; 4/1/11 - 3/30/12

Instrumental Activities of Daily Living and Role Performance in Patients with Mild Cognitive Impairment: A Pilot Study.
The purpose of this grant was to identify areas of occupational dysfunction in instrumental activities of daily living in people with mild cognitive impairment. Funder: College of Allied Health. Role: PI. Award: $4,311; 7/1/10-6/30/11.                                            


  1. Steinheider, B., Shortridge, A., Hoffmeister, V., Randall, K., & Ciro, C. (2020). Revisiting the attitudes toward health care teams scale: Developing a short version for graduate health care education. Journal of Interprofessional Care, 1-8.
  2. Manson, A., Ciro, C., Williams, K. N., & Maliski, S. L. (2019). Identity and perceptions of quality of life in Alzheimer's disease. Applied Nursing Research, 151225.
  3. Shortridge, A., Steinheider, B., Bender, D. G., Hoffmeister, V. E., Ciro, C. A., Ross, H. M., ... & Loving, G. (2019). Teaching and evaluating interprofessional teamwork using sequenced instruction and TeamSTEPPS™ Team Performance Observation Tool (TPOT). Journal of Interprofessional Education & Practice, 16, 100233.
  4. Babulal, G. M., Quiroz, Y. T., Albensi, B. C., Arenaza-Urquijo, E., Astell, A. J., Babiloni, C., Bahar-Fuchs, A., Bell, J., Bowman, G.L., Brickman, AM, Chetelat. Ciro, C. ... & Chételat, G. (2018). Perspectives on ethnic and racial disparities in Alzheimer's disease and related dementias: Update and areas of immediate need. Alzheimer's & Dementia.
  5. Gaeta, L., Azzarello, J., Baldwin, J. Ciro, C., Hudson, M., Johnson, C. and John, A. (2018). Effect of Reduced Audibility on Mini-Mental State Examination Scores. Journal of American Academy of Audiology. 00:1-11. DOI: 10.3766/jaaa.17139.
  6. Crawford, D.A., Terry, R.H., Ciro, C.A., Sisson, S.B., Hamilton, T.B., and Dionne, C.P. (2018). Examining the health action process approach for people with back pain. Health Behavior Research, 1(2): DOI: 10.4148/2572-1836.1016
  7. Shortridge, A. M., Ross, H. M., Randall, K. E., Ciro, C. A., Loving, G. L. (2018). Telehealth technology as e-learning: Learning and practicing interprofessional patient care. International Journal on E-Learning. 17(1), 95-110
  8. Peloquin, S., Ciro, CA, Fingerhut, P., and Patterson, P. (2017). Population-centered groups for women in recovery: Perceptions of satisfaction, engagement, and lessons learned. Occupational Therapy in Mental Health. 33(4): 1-13. (IF: .39)
  9. Randall, K., Isaacson, M., & Ciro, C. (2017). Validity and Reliability of the Myers-Briggs Personality Type Indicator: A Systematic Review and Meta-analysis. Journal of Best Practices in Health Professions Diversity, 10 (1): Spring.
  10. Smith, S., DeGrace, B., Ciro, C.A., Bax, A., James, J., and Evans, A (2017). Exploring Alaskan families’ experiences of health: Contributions to a model of family health. Psychology, Health and Medicine. 22(10): 1239-1247.
  11. Randall, K.E., Steinheider, B., Isaacson, M., Shortridge, A., Byrd, S., Ciro, C., Ross, H., & Loving, G. (2016). Measuring knowledge, acceptance, and perceptions of telehealth in an interprofessional curriculum for student nurse practitioners, occupational therapists, and physical therapists. Journal of Interactive Learning Research, 27(4), 339-353. 
  12. Kletzel, S.L., Cary, M., Ciro, C., Dawson, D., Thai, M., Pham, P., Berbrayer, D., and Heyn, P. (2016).  Brain gaming: A user's product guide for the clinician. Archives of Physical Medicine and Rehabilitation: 97(18): 1399-400. 
  13. Ciro, C.A., Stoner, J.A., Prodan, C., Hershey, L. (2016). Skill-building through Task-Oriented Motor Practice (STOMP) intervention for activities of daily living in dementia: Study protocol for a randomized controlled clinical trial. Clinical Trials and Degenerative Disease: 1(2):45-50.
  14. Ciro, C.A. and Isaacson, M. (2016). Student rating of skill performance opportunities in faculty-directed research. The Open Journal of Occupational Therapy: Vol. 4: Iss. 3, Article 3.
  15. Shortridge, A., Stienheider, B., Ciro, C., Randall, K., Costner-Lark, A., Loving, G. (2016). Simulating interprofessional geriatric patient care using telehealth: A team-based learning activity. MedEdPORTAL Publications: 12:10415.
  16. Ciro, C.A. and Smith, P.A. (2015). Improving personal characterization of meaningful activity in adults with chronic conditions living in a low-income housing community. Special Issue: Occupational Therapies and Human Well Being. International Journal of Environmental Research and Public Health: 12, 11379-11395; doi:10.3390/ijerph120911379 
  17. Ciro, C.A., Randall, K., Robinson C., Loving, G., and Shortridge, A. (2015) Preparing Occupational Therapy Students for the Future of Healthcare by Incorporating Telehealth into Interprofessional Education. OT Practice: 20(7), 7-10.
  18. Ciro, C.A., Anderson, M.P., Hershey, L., Prodan, C. and Holm. M. (2015). A comparison of instrumental activities of daily living and role satisfaction in people with and without mild cognitive impairment: A pilot project. American Journal of Occupational Therapy: 69, 6903270020p1-6903270020p10. doi:10.5014/ajot.2014.015198. 
  19. Nagykaldi, Z, Jordan, M, Quitoriano, J., Ciro, C. and Mold, J.  (2014). User-centered design and usability testing of an innovative health-related quality of life module. Applied Clinical Informatics: 5(4):958-970. 
  20. Ciro, C.A., Poole, J.L., Skipper, B. and Hershey, L.A.. (2014). Comparing differences in ADL outcomes for the STOMP intervention for dementia in the natural home environment versus a clinic environment. Austin Alzheimer’s and Parkinson’s Disease: 1(1): 1-7.
  21. Ciro, C.A., Dung Dao H., Anderson M., Robinson, C.A., Hamilton, T.B. and Hershey, L. (2014) Improving daily life skills in people with dementia: Testing the STOMP intervention model. Journal of Alzheimer’s Disease and Parkinsonism:  4: 165.
  22. Ciro, C.A. (2014) Maximizing ADL performance to facilitate aging in place for people with dementia. Nursing Clinics of North America Special Issue: Facilitating Aging in Place: Safe, Sound, and Secure: 49(2): 157-169. 
  23. Ciro, C.A., Hershey, L.A., and Garrison, D.G. (2013). Enhanced task-oriented training in a person with dementia with Lewy-Bodies.  American Journal of Occupational Therapy: 67:556-63. 
  24. Ciro, C.  (2013) Improving occupational performance in people with dementia through role-based, task-specific training. OT Practice: 18 (3): 9-12.
  25. Peloquin, S.A. and Ciro, C.A. (2013) Population-centered life skills groups: Perceptions of satisfaction and engagement. American Journal of Occupational Therapy: 67 (5), 594-600. 
  26. Peloquin, S.A. and Ciro, C.A. (2012). Self-development groups among women in recovery: Client perceptions of satisfaction and engagement. American Journal of Occupational Therapy: 67 (1), 1-9.  
  27. Ciro, C.A. (2011).  Enhancing our collective research acumen by employing an epidemiological perspective. American Journal of Occupational Therapy: 65:594-598. 
  28. Ciro, C.A., Ottenbacher, K.J., Graham, J.E., Fisher, S., Berges, I.M., and Ostir G.V. (2011) Patterns and correlates of depression in hospitalized older adults. Archives of Gerontology & Geriatrics. 54 (2012) 202–205.