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1.
Background
Enjoyment in school-based physical activity (PA) programs, such as recess or physical education may be important for promoting children's health, but there is a lack of evidence explaining how enjoyment affects health in children with disabilities.Hypotheses
Enjoyment in school-based PA programs will positively influence general health through participating in more daily PA, and this relationship will vary between younger and older children with disabilities.Methods
We conducted secondary analysis of data from the 2012 National Youth Fitness Survey. The sample included 241 children with disabilities (age 5–15 years; 129 boys and 112 girls) identified using three criteria: (a) having an impairment, health problem and mobility limitations; (b) needing special equipment; or (c) receiving special education services. Variables extracted were the number of days per week participating for at least 60 min in PA a day; general perceived health; enjoyment in school recess (for ages 5–11 y) or physical education (for ages 12–15 y). Mediation analysis was conducted to test the research hypotheses.Results
Daily PA participation significantly mediated the relationship between enjoyment in physical education/recess and general health. Children who enjoyed physical education or recess more participated in PA, and those who spent more days being physical active were healthier than their counterparts. However, this mediating relationship, when divided by age groups, was shown for only older group (ages 12–15 y) that received physical education.Conclusions
Physical educators should provide enjoyable PA opportunities during physical education classes for students with disabilities for promoting their health. 相似文献2.
Adam Whitworth 《Disability and health journal》2018,11(4):568-575
Background
Health-related unemployment is a major issue across advanced economies. Modified versions of well-evidenced Individual Placement and Support (IPS) models of employment support for health cohorts offer considerable potential. A significant gap currently however is the lack of evidence around their financial return on investment.Objective/Hypothesis
To provide robust financial return on investment estimates for analytically derived alternative specifications of modified IPS services for the first time in the literature, sensitivity tested across various levels of performance.Methods
Brings together modelled cost and savings estimates based on best available evidence to deliver modelled return on investment estimates.Results
The modelled estimates show that well-designed modified IPS services can deliver financial savings whilst tackling health-related unemployment, even at higher average unit costs than are typically considered viable in some national contexts.Conclusions
Modified IPS services offer a viable route to delivering enhanced employment outcomes for individuals with health conditions and disabilities and financial savings for governments. 相似文献3.
Background
According to prior studies, it is possible to consider the emergency care utilization due to ambulatory care sensitive conditions (ACSCs) as a proxy measure of access to primary care but there was no confirmed study among people with disabilities.Objective/Hypothesis
We examined overall emergency department (ED) utilization patterns among people with disabilities compared with the general population and estimated factors affecting ED utilization. Additionally, we examined whether there were any differences in ED visits due to ACSCs according to type and severity of disability.Methods
The nationally representative Korean Health Panel Survey was used. Data from 14,616 individuals who participated in the survey from 2008 to 2012 were analyzed. The frequency and causes of emergency visits were examined between individuals with and without disabilities. A generalized regression model with Poisson distribution was applied to identify factors that affect ED visits.Results
In 2012, people with disabilities were about two times as likely to visit the ED compared to people without disabilities, and people with external disability represented the largest proportion of people with disabilities. According to generalized linear model, disability was a strong predictor of ED visits, along with lower education level, being elderly, having a chronic disease, and being less healthy. Overall, ED visits due to ACSCs were about three times higher in the disabled group than in the non-disabled group.Conclusions
Public health authorities should consider strengthening the primary care system to avoid unnecessary and preventable ED utilization among all Korean people, including people with disabilities. 相似文献4.
Mónica Pinilla-Roncancio 《Disability and health journal》2018,11(3):398-404
Background
Disability and poverty are interconnected and although this relationship has been recognised, there is a lack of empirical evidence to support any possible causal relationship in this topic, particularly in the context of Latin America (LA).Hypothesis
This study tests the hypothesis “Disability increases the risk of multidimensional poverty of people living with disabilities and their families”.Methods
Using national census data from Brazil, Chile, Colombia, Costa Rica and Mexico, the Global Multidimensional Poverty Index (Global MPI) was calculated with the aim of measuring and comparing the levels of multidimensional poverty of people living in households with and without disabled members in the five countries.Results
We found that in the five countries people with disabilities and their families had higher incidence, intensity and levels of multidimensional poverty compared with people living in other households. Their levels of deprivation were also higher for all the indicators included in the Global MPI and the contribution of this group to the national MPI was higher than their share of the population, thus people with disabilities and their families are overrepresented in those living in multidimensional poverty.Conclusions
People with disabilities and their families are in worse conditions than poor households without disabled members and social policies should aim to reduce their high levels of multidimensional poverty and deprivation. 相似文献5.
Background
Previous literature suggests that individuals with disabilities have increased rates of obesity and decreased participation in physical activity contributing to overall higher incidence of secondary health conditions compared to the general population without disabilities.Objective/hypothesis
The purpose of this research study was to examine the differences in physical activity rates for college students with Attention Deficit Hyperactivity Disorder (ADHD) and Learning Disabilities (LD).Methods
A secondary analysis was utilized to examine differences in physical activity rates based on disability, gender, and factors influencing participation in physical activity. The 2011 Fall National College Health Assessment was used as the reference group with a sample of 27,774 students. Multiple independent samples t-tests were utilized in this research.Results
The results of this study indicated that physical activity for college students with disabilities does not have significant variations compared to those without disabilities. However, gender influences participation in physical activity for this population.Conclusions
This research helps in narrowing the research gap in this topic through analysis of the college population with ADHD and LD. This paper concludes with implications that could benefit the health status of this population. 相似文献6.
7.
Background
The built environment can facilitate or impede an individual's ability to participate in society. This is particularly so for people with disability. Architects are well placed to be advocates for design that enhances societal equality.Objective
This qualitative study explored architectural design students' perceptions of inclusive design, their reflections resulting from an experiential learning module and the subsequent influence of these on their design practice.Methods
Twenty four architectural design students participated in focus groups or individual interviews. Data were analyzed thematically.Results
Three themes were evident: 1) Inclusive design was perceived as challenging, 2) Appreciation for the opportunity to learn about the perspectives of people with disabilities, and 3) Change of attitude toward inclusive design. Experiential learning had fostered reflection, changes in attitude and the realization that inclusive design, should begin at the start of the design process.Conclusions
For equitable access for all people to become reality, experiential learning, coupled with positive examples of inclusive design should be embedded in architectural education. 相似文献8.
Background
Enhanced methods of evaluation are necessary to identify community-based exercise interventions that promote physical activity and improve health and participation for individuals with disabilities. The heterogeneity of the populations served, interventions implemented, and outcome measures used remains a barrier to effectively evaluate programs and generate evidence to inform best practice.Objective
To explore goals and benefits of community-based exercise for individuals with disabilities and determine barriers and facilitators to evaluation in a community setting.Methods
We conducted semi-structured interviews with exercise participants and staff of a community-based exercise program for individuals with disabilities. We then coded responses to interview questions for themes using thematic analysis or deductive content analysis, with codes linked to categories within the International Classification of Functioning, Disability and Health (ICF).Results
Identified goals and benefits spanned the ICF domains of Body Functions and Activities and Participation. Commonly cited goals and benefits included improving strength and endurance, general health, self-efficacy, community participation, and the importance of returning to exercise. Barriers and facilitators to evaluation identified by staff included maintaining a balance between evaluation and services, negative attitudes toward evaluation, access to data, and consistency with scheduling.Conclusions
These results can be used to enhance evaluation within community-based exercise programs for individuals with disabilities, which may improve both the quality and impact of these programs. 相似文献9.
Background
People with disabilities experience mental health disparities and higher rates of violence compared to people without disabilities. Few studies have examined the psychological consequences of violence against people with disabilities, and whether they differ from those experienced by people without disabilities.Objective
This study compared psychological consequences of violence among men and women with and without disabilities.Methods
We analyzed data from the 2008–2014 waves of the National Crime Victimization Survey. Multiple logistic regressions were estimated to compare the psychological impact of violent crime on respondents without disabilities to those with disabilities, who comprised roughly 20% of the sample (n?=?8,070). We stratified by gender to compare the effects of violence experienced by men and women.Results
Men with disabilities were more likely than men without disabilities to report severe distress (AOR?=?2.07, p?<?0.001), anxiety (1.79, p?<?0.001), depression (2.32, p?<?0.001), and anxiety and depression (2.34; p?<?0.001), but were less likely to experience each outcome compared to women with disabilities. Men with disabilities had similar odds of adverse psychological outcomes compared to women without disabilities. Women with disabilities had higher odds of severe distress following violence compared to men without disabilities (3.90, p?<?0.001) or women without disabilities (1.86, p?<?0.001). Similarly, women with disabilities had higher odds of anxiety, depression, and anxiety and depression compared to men and women without disabilities.Conclusions
Women with disabilities are at higher risk of negative psychological consequences resulting from violence compared to other gender-disability groups. Men with disabilities also experience worse outcomes relative to men without disabilities. 相似文献10.
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Background
Evidence suggests there is an association between depressive symptoms and disability.Objective/Hypothesis
The objective of this study was to examine whether people with disabilities in the United Kingdom and Greece face more depressive symptoms than people without disabilities. The hypothesis was that people with disabilities in both countries are more likely to experience depressive symptoms.Methods
We used data from the 2014 European Health Interview Survey (wave 2). After performing principal-component factor analysis, we carried out logistic regressions, in order to investigate differences in depressive symptoms between people with and without disabilities, and examine the factors affecting depressive symptoms for people with disabilities.Results
People with disabilities in the UK were 2.8 times more likely to experience depressive symptoms compared to people without disabilities (95% C.I.: 2.51–3.05, p?<?.001), while in Greece, they were 2.2 times more likely to do so (95% C.I.: 1.90–2.64, p?<?.001). Our findings regarding people with disabilities showed that women, older people (in Greece), unemployed and inactive people (in Greece), and better-educated people (in the UK) were more likely to experience depressive symptoms. Married people, older people (in the UK), people living in densely-populated areas (in Greece), people who assessed their health as ‘average’ or ‘good’, and people who enjoyed social support (in Greece) were less likely to face depressive symptoms.Conclusions
Due to population-ageing and higher incidence of depressive symptoms in disabled people, it is important that policies are put in place to address the mental health needs of this population. 相似文献15.
Catherine Ipsen Cathy Chambless Noelle Kurth Sara McCormick Rebecca Goe Jean Hall 《Disability and health journal》2018,11(3):447-450
Background
Disability prevalence estimates are used to identify populations, establish priorities and allocate funding for a broad range of federal, state, and local initiatives. Increasingly, these estimates are based on a set of six questions developed and tested for use in the American Community Survey (ACS). A key assumption about the ACS disability screeners is that they sufficiently capture the entire population of people with disabilities, but some studies indicate that certain disability groups are underrepresented.Objectives
The objective of this study is to explore potential underrepresentation of certain disability groups identified by the ACS disability questions.Methods
We compared disability prevalence rates from two data sources for adolescents with disabilities, aged 14 to 16, who receive Supplemental Security Income (SSI, n = 2051). The Social Security Administration (SSA) provided disability determination data for each adolescent, and adolescents (or proxy-rater) provided baseline self-report data about functional limitation based on the six ACS disability questions.Results
Approximately 17% of the sample did not endorse any ACS questions. Excluding SSA categories with cell counts less than 10, the top five conditions not captured by ACS questions included respiratory conditions (38%), mood disorders (28%), other mental disorders (27%), schizophrenic and other psychotic disorders (27%) and developmental disorders (20%).Conclusions
Our findings suggest that people with mental health and developmental disabilities and those with respiratory conditions are among those groups under-represented by the ACS disability questions. Changes or additions to ACS questions should be considered to ensure that all disability groups are addressed in public health planning. 相似文献16.
Background
Experiences of discrimination lead people from vulnerable groups to avoid medical healthcare. It is yet to be known if such experiences affect people with disabilities (PWD) in the same manner.Objectives
To determine the association between perceived discrimination and healthcare-seeking behavior in people with disabilities and to explore differences of this association across disability types.Methods
We performed a cross-sectional study with data from a national survey of people with disabilities. Perceived discrimination and care-seeking behavior were measured as self-reports from the survey. Dependence for daily life activities, possession of health insurance, and other disability-related variables were included and considered as confounders. We used Poisson regression models and techniques for multistage sampling in the analyses. A stratified analysis was used to explore effects of discrimination across types of disability.Results
Most of PWD were 65 years or older (67.1%). Prevalence of healthcare seeking was 78.8% in those who perceived discrimination, and 86.1% in those who did not. After adjusting for potential confounders, the probability of not seeking care was higher in people who reported perceived discrimination (adjusted PR = 1.15; 95%CI: 1.04–1.28). In a stratified analysis, significant effects of discrimination were found in people with communication disability (adjusted PR = 1.34, 95%CI: 1.07–1.67) and with physical disability (adjusted PR = 1.17, 95%CI: 1.03–1.34).Conclusions
People with disabilities who perceive discrimination are less likely to seek healthcare. This association was higher for people with communication and physical disabilities. These results provide evidence to institutions who attempt to tackle discrimination. 相似文献17.
Ilanit Hasson-Ohayon Meiran Hason-Shaked Tamar Silberg Carmit-Noa Shpigelman David Roe 《Disability and health journal》2018,11(4):612-617
Background
Women with disabilities may face social negative attitudes with regard to their being mothers. In addition, attitudes toward different disabilities form a hierarchy, with more positive attitudes being displayed toward persons with physical disabilities than toward persons with psychiatric disabilities.Objective
Current observational study examined whether the relationship between a woman's type of disability (psychiatric vs. physical) and the social attitude towards her would be moderated by her being presented as a mother.Method
University students (N?=?100) filled out the Multidimensional Attitudes Scale Toward Persons With Disabilities and the Social Distance Scale, after reading one of six randomly assigned fictitious vignettes. The vignettes consisted of a woman with a physical disability/a woman with a psychiatric disability/a woman without a disability, who either was or was not a mother.Results
Type of disability was found to have a main effect in some attitude domains, suggesting that attitudes toward women with physical disabilities were better than attitudes towards women with psychiatric disabilities. An interaction between type of disability and motherhood was found for the interpersonal distress subscale of the attitudes scale. It was found that when women had physical disabilities, there was no change in attitude towards them regardless of whether they were presented as mothers or not; However, when the target woman had a psychiatric disability, and she was presented as a mother, negative attitudes were generated towards her.Conclusions
The study demonstrates the existence of a hierarchy of stigmatization and the effect of being a mother on stigmatization. 相似文献18.
Carli Friedman 《Disability and health journal》2018,11(3):351-358
Background
The Personal Outcome Measures® is a person-centered tool to measure the quality of life (QOL) of people with disabilities, especially those who receive long term services and supports. While the outcomes examine people's satisfaction with their lives in a wide range of areas, the organizational supports determine if service agencies are appropriately supporting people with disabilities to ensure people with disabilities have the best possible QOL. The Personal Outcome Measures® has been administered to tens of thousands of people with disabilities and older adults over its twenty-five years of existence.Objective
In order for the Personal Outcome Measures® to adequately measure the QOL of people with disabilities, it must continuously be refined in alignment with the advances made by people with disabilities, and the disability service system. Therefore, the purpose of this study was to re-validate the Personal Outcome Measures®.Methods
A Principal Components Analysis was used to analyze data from 1473 people with disabilities to determine if any indicators needed to be removed as well as the underlying structure of the Personal Outcome Measures®.Results
The analysis revealed the Personal Outcome Measures® has construct validity. It also found that the 21 indicators fall into five underlying factors: my human security; my community; my relationships; my choices; and, my goals.Conclusions
Taken together these twenty-one indicators and five factors represent a multifaceted and comprehensive QOL assessment that aims to improve the lives of people with disabilities. 相似文献19.
Angela Rosenberg Deborah Zuver McCafferty Kermon Claudia Fernandez Lewis H. Margolis 《Disability and health journal》2018,11(2):293-297
Background
To advance equity and to enhance leadership skills, self-advocates with intellectual/developmental disabilities are now part of the cohort of trainees in the University of North Carolina LEND, which means that they fully participate in the Interdisciplinary Leadership Development Program, a collaboration among programs in public health, social work, and LEND, which meets monthly.Objective
Given this important new participation by self-advocates, this study analyzes the reflections of graduate students on the contributions of self-advocates to their leadership training.Methods
At the conclusion of the program each year, graduate students respond to a questionnaire about how self-advocates influenced the content and interactions/discussions of the monthly workshops and are asked to provide specific examples to explain their perceptions. The 12 MCH leadership competencies were used to guide the coding of the comments for this qualitative, directed content analysis.Results
Forty-six of 58 students (79.3%) from two consecutive cohorts responded for this cross-sectional study. Interactions with self-advocates prompted comments on 8 of the 12 leadership competencies, including interdisciplinary team building (29% of the comments); developing others through teaching and mentoring (22%); and self-reflection (18%).Conclusions
The inclusion of self-advocates throughout an interdisciplinary leadership development program for graduate students in health affairs can strengthen MCH leadership competencies for all participants as they enter an increasingly interdisciplinary workforce. 相似文献20.