Disability and Health Journal RSS feed: Articles in Press. Disability and Health Journal is a scientific, scholarly and multidisciplinary journal for reporting original contributions that advance knowledge in disability and health. Such contributions include reports of empirical research on the characteristics of persons with disabilities, environments, health outcomes, and determinants of health; systematic reviews and tightly conceived theoretical interpretations of research literatures; and evaluative research on new interventions, technologies and programs. The focus will be public health, health promotion, health education, wellness and prevention, reducing the incidence of secondary conditions and medical conditions. http://www.disabilityandhealthjnl.com//inpress?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. Disability and Health Journal1936-65742010-07-26 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.disabilityandhealthjnl.com/article/PIIS1936657410000488/abstract?rss=yesAbstract: Objective/hypothesis: We conducted a review of four health behavior change (HBC) theories (Health Belief, Theory of Planned Behavior, Social Cognitive, and Transtheoretical) to consider how these theories conceptually apply to people with disabilities.Methods: We identified five common constructs across HBC theories and examined how these commonalities fit within the International Classification of Function (ICF).Results: Four of the HBC constructs appear to be Personal Factors within the ICF, while the fifth represents Environmental Factors.Conclusions: Using the ICF framework to understand disability and HBC, we propose that including a sense of meaning as another personal factor will further develop HBC theories that lead to more effective HBC interventions for people with disabilities.Disability and health behavior change - Corrected ProofCraig Ravesloot, Casey Ruggiero, Catherine Ipsen, Meg Traci, Tom Seekins, Tracy Boehm, Desirae Ware-Backs, Bethany Rigles10.1016/j.dhjo.2010.05.006Disability and Health Journal (2010)2010-07-26Disability and Health Journal2010-07-26http://www.disabilityandhealthjnl.com/article/PIIS193665741000049X/abstract?rss=yesAbstract: Background: The conceptualization of disability has shifted from a medical to a social model with a consequent focus away from impairments and toward activities and participation. The International Classification of Functioning, Disability and Health (ICF) provides a common point of reference and a common language in a developing disability discourse.Objectives: We sought to apply a model for the measurement of disability based on the activity and participation constructs of the ICF to persons with movement difficulty as a result of injury-related causes.Methods: Data from sample adults aged 18 years and over in the 2001–2006 National Health Interview Survey (NHIS) were used for analysis. Disability among adults with injury-related movement difficulty was assessed through measures of difficulty performing basic actions (movement, sensory, emotional, and/or cognitive functioning); and limitations of complex activities (defined through measures of self-care, social participation, and work participation). SUDAAN 9.0 was used in all analyses to account for the complex sampling design and weighting of the NHIS data.Results: Approximately 16% of noninstitutionalized adults who reported movement difficulty mentioned injury as a cause. On average, between 2001 and 2006, about 7.6 million adults had injury-related movement difficulty in the United States. Overall, 50% of adults who experienced injury-related movement difficulty also experienced some complex activity limitation.Conclusions: Using NHIS data, we have demonstrated the applicability of an approach using basic actions difficulty and complex activity limitations to measure functioning and participation in individuals with a specific type and cause of difficulty: injury-related movement difficulty. The operationalization of these constructs provides a possible tool to monitor progress toward the attainment of the equalization of opportunities among people with injury-related movement difficulty.Assessing injury-related movement difficulties: A method for analyzing the association between functional limitations and social participation - Corrected ProofMitchell Loeb, Li-Hui Chen10.1016/j.dhjo.2010.05.007Disability and Health Journal (2010)2010-07-26Disability and Health Journal2010-07-26http://www.disabilityandhealthjnl.com/article/PIIS1936657410000361/abstract?rss=yesAbstract: Background: Secondary conditions can have very serious outcomes for people with physical disabilities. Such consequences can range from immobility due to pressure sores to withdrawal and isolation due to depression, decreasing participation in the community.Objective/Hypothesis: To further investigate these assumptions, we conducted a review of the literature on health promotion interventions that include physical activity for adults with disabilities to determine whether they have a positive effect on the reduction of secondary conditions and increased community participation.Methods: We conducted a secondary analysis of the results of a scoping review of health promotion programs containing physical activity for people with mobility impairments (N = 5). This secondary analysis examined the relationship between health promotion containing physical activity and prevention of secondary conditions among people with various physical disabilities. We further examined evidence and effects of independent variables on the outcome of increased community participation for study participants.Results: The outcomes from this investigation are varied, with 2 studies providing evidence of reducing secondary conditions while another shared anecdotal statements referencing a decrease in secondary conditions. Of the remaining 2 studies in this paper, 1 showed no intervention effect on reducing secondary conditions while the remaining study reported an increase in secondary conditions. Regarding increased participation in the community, 2 of 5 studies directly reported on these outcomes, while increased community participation was referenced in another 2 articles, but without any data presented. The final study did not report on any post intervention in the community.Conclusions: This review demonstrates that research on health promotion interventions containing physical activity lack description about whether such interventions help reduce or prevent secondary conditions. Additionally, the review shows that further work is needed in terms of sustaining health programs effects beyond the initial proximal activity gains, with attention given toward more distal outcomes of increased participant participation in the community.Secondary analysis of a scoping review of health promotion interventions for persons with disabilities: Do health promotion interventions for people with mobility impairments address secondary condition reduction and increased community participation? - Corrected ProofGlen W. White, Chiaki Gonda, Jana J. Peterson, Charles E. Drum, the RRTC Expert Panel on Health Promotion Interventions10.1016/j.dhjo.2010.05.002Disability and Health Journal (2010)2010-07-15Disability and Health Journal2010-07-15http://www.disabilityandhealthjnl.com/article/PIIS1936657410000373/abstract?rss=yesAbstract: Background: National survey data indicate the number of individuals reporting a disability is rising. Those with disabilities experience a large number of barriers to health promotion and disease prevention programming. However, only a limited number of studies have used nationally representative data to examine the health status of individuals with disabilities in comparison to those without disabilities.Objective/Hypothesis: We used the Medical Expenditures Panel Survey (MEPS) to examine whether disability is associated with higher prevalence rates for common chronic diseases, lower use of preventive care and higher health care expenditures. Our research hypothesis was that nationally, adults with either physical disability or cognitive limitations experience significant health disparities in comparison to those with no disability.Methods: We conducted a retrospective analysis comparing the health of adults (18 and over) with physical disabilities or cognitive limitations to individuals with no disability using data from the 2006 full year consolidated data file from the Medical Expenditures Panel Survey (MEPS). We used chi-squared tests, t-tests, and logistic regression to evaluate the association.Results: Individuals with physical disabilities or cognitive limitations had significantly higher prevalence rates for 7 chronic diseases than persons with no disabilities. The disability groups were also significantly less likely than the no disability group to receive 3 types of preventive care.Conclusions: These data suggest that adults with disabilities and chronic conditions receive significantly fewer preventive services and have poorer health status than individuals without disabilities who have the same health conditions. This indicates a need for public health interventions that address the unique characteristics of adults with disabilities, many of whom are at risk for high cost, debilitating conditions that may not have as severe an effect on other population segments.Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States - Corrected ProofAmanda Reichard, Hayley Stolzle, Michael H. Fox10.1016/j.dhjo.2010.05.003Disability and Health Journal (2010)2010-07-15Disability and Health Journal2010-07-15http://www.disabilityandhealthjnl.com/article/PIIS193665741000035X/abstract?rss=yesAbstract: Background: Depression and anxiety are prevalent among adults with disabilities. However, little is known regarding the geographic variability of depression and anxiety among adults with disabilities in the United States.Objectives: We estimated prevalence of current depression, lifetime diagnoses of depression (LD), and lifetime diagnoses of anxiety (LA) among adults with disabilities by state, metropolitan and micropolitan statistical area (MMSA), and county.Methods: We analyzed Behavioral Risk Factor Surveillance System data from 2006 for 41 states and territories, 74 MMSAs, and 112 counties. Stratified analyses by sociodemographic and health status variables were performed for the 10 MMSAs with the highest estimates of current depression, LD, and LA, respectively. Current depressive symptoms were assessed with the Patient Health Questionnaire-8.Results: Estimates of current depression, LD, and LA among adults with disabilities varied substantially by state, MMSA, and county. Current depression estimates ranged from 14.7% in North Dakota to 30.1% in Mississippi; from 8.4% in San Francisco–Oakland–Fremont, CA, to 36.2% in Jacksonville, FL; and from 12.3% in Cumberland County, ME, to 44% in Orleans Parish, LA. There was major variation within some states (e.g., prevalence of current depression was 8.4% in San Francisco–Oakland–Fremont, CA compared to 25.5% in Los Angeles–Long Beach–Glendale, CA). In the 10 MMSAs with the highest estimates, estimates varied by age, gender, socioeconomic status, and health status.Conclusions: Public and mental health agencies may find these estimates useful for program planning purposes to address depression and anxiety among adults with disabilities.State and local area estimates of depression and anxiety among adults with disabilities in 2006 - Corrected ProofCatherine A. Okoro, Lela R. McKnight-Eily, Tara W. Strine, John E. Crews, James B. Holt, Lina S. Balluz10.1016/j.dhjo.2010.05.001Disability and Health Journal (2010)2010-07-05Disability and Health Journal2010-07-05http://www.disabilityandhealthjnl.com/article/PIIS1936657410000348/abstract?rss=yesAbstract: Background: This study explored workplace disability accommodations and their benefits. The participants were employers and human resource professionals who had not used the services of the Job Accommodation Network (JAN). The companies included large businesses (more than 499 employees) and small businesses (fewer than 500 employees).Objective/Hypothesis: The intent of this investigation was to assess the disability accommodations and benefits for the employers.Methods: The study used responses to online survey from194 employers to discuss disability-related accommodations for an employee or potential employee. The survey included 128 employers who reported having had a person with a disability who requested an accommodation.Results: As reported by the employers, the most frequently mentioned direct benefits from implementing workplace accommodations were (a) retained a qualified employee, (b) increased worker productivity, and (c) eliminated the cost of training a new employee. The most frequently mentioned indirect benefits from accommodations were (a) improved interactions with coworkers, (b) increased overall company morale, and (c) increased overall company productivity. The most frequently reported types of implemented accommodations were buying equipment and changing work schedules. Most of the respondents estimated the direct benefits of having made an accommodation at more than $1000.Conclusions: The findings heighten awareness of benefits associated with making accommodations for people with disabilities in the workplace. These benefits signify value for business, coworkers, and individuals with disabilities for whom accommodations are critical for successful employment.Employer benefits from making workplace accommodations - Corrected ProofTatiana I. Solovieva, Denetta L. Dowler, Richard T. Walls10.1016/j.dhjo.2010.03.001Disability and Health Journal (2010)2010-04-26Disability and Health Journal2010-04-26http://www.disabilityandhealthjnl.com/article/PIIS1936657410000154/abstract?rss=yesAbstract: Background: Adults with disabilities experience a variety of secondary health conditions that have a negative association with employment. Vocational rehabilitation (VR) provides one possible access point for providing health promotion activities to help clients manage these conditions.Objective: To build the case for providing health promotion services in the VR setting, this research assesses how secondary health conditions impact employment closures over time for VR clients. Specifically, we hypothesize that higher rates of secondary conditions will be negatively associated with employment outcomes at 18 months.Methods: VR clients with physical disability (n = 162) provided longitudinal data at baseline and at 6, 12, and 18 months. Two binary logistic regression models used self-report data to predict employment outcomes. The first model used explanatory variables measured at baseline or prior to receiving VR services, and the second model measured variables after 18 months in the VR program. Both models included variables to control for demographic characteristics, disability severity, baseline employment, and receipt of social insurance payments. The second model also included variables to account for VR services received.Results: Both models showed that higher reported rates of secondary conditions were associated with lower probabilities of employment (p = .012; p = .022). The expanded model also showed that receipt of counseling services through VR increased the probability of employment (p = .04) and that receipt of medical services through VR reduced the probability of employment (p = .02).Conclusions: VR can improve client employment outcomes through expanded counseling and guidance services or possibly through improved access to health promotion programming that helps clients manage secondary health conditions.A prospective study to examine the influence of secondary health conditions on vocational rehabilitation client employment outcomes - Corrected ProofCatherine Ipsen, Tom Seekins, Nancy Arnold10.1016/j.dhjo.2010.02.001Disability and Health Journal (2010)2010-04-15Disability and Health Journal2010-04-15http://www.disabilityandhealthjnl.com/article/PIIS1936657410000282/abstract?rss=yesAbstract: Background: Pedometers serve as one of the most feasible and cost-effective methods for frontline practitioners to measure moderate-to-vigorous physical activity (MVPA) of youth with an intellectual disability (YwID) but, historically, pedometers have been unable to measure MVPA. Technological advancements now allow pedometers to measure MVPA via step frequency (steps per minute). Translating the output of this technology into practical information that frontline practitioners and families can use, however, will require accurate step frequency guidelines.Objective: The purpose of this study was to identify steps per minute thresholds corresponding to MVPA for YwID.Methods: Thirty-eight children and adolescents (10 girls, 11.8 ± 1.8 years) attending a summer camp for youth with an ID walked on a treadmill starting at 2.0 mph and increasing every 2 minutes by 0.5 mph until they reached 4.0 mph. Youth were affixed with a heart rate (HR) monitor. Steps were counted by trained observers using hand-tally counters. Data were collected during the final minute of each speed. HR at each speed was transformed into percentage of heart rate reserve (%HRR), using each participant's resting HR. Percentage of HRR corresponding to 40%HRR or higher was used to define MVPA. Random effects models were constructed to predict steps per minute from %HRR and participant characteristics.Results: The results indicated that, on average, 122 steps·min−1 was the minimal threshold for MVPA. Height- and age-specific steps·min−1 ranged from 135 steps·min−1 to 112 steps·min−1.Conclusions: These findings provide preliminary thresholds for steps per minute that frontline practitioners working with YwID can use to promote and evaluate MVPA in this population.Using pedometers to measure moderate-to-vigorous physical activity for youth with an intellectual disability - Corrected ProofMichael W. Beets, Kenneth H. Pitetti10.1016/j.dhjo.2010.02.002Disability and Health Journal (2010)2010-04-09Disability and Health Journal2010-04-09http://www.disabilityandhealthjnl.com/article/PIIS1936657410000294/abstract?rss=yesAbstract: Background: Accurate measurement is required by researchers and clinicians who are interested in the physical activity behavior of individuals with multiple sclerosis (MS). Advances in technology have resulted in an increased number of motion sensors such as pedometers and accelerometers that are worn on the body and that measure bodily movement. Accelerometers are becoming less expensive and more user-friendly, but there is limited evidence regarding the accuracy of measurement in persons with MS.Objective: The present study examined the accuracy of an ActiGraph accelerometer for measuring steps taken during controlled conditions in persons with MS compared with a sample of individuals without MS.Methods: The participants were 24 adults with mild MS and 24 adults without MS who undertook three 6-minute periods of walking at 54, 80, and 107 m·min−1 on a motor-driven treadmill. We measured steps taken through observation and an ActiGraph model 7164 accelerometer worn around the waist above the right hip.Results: The accelerometer accurately measured steps during moderate (80 m·min−1) and fast (107 m·min−1) walking in both persons with MS and control subjects. There was a small degree of underestimation of step counts (≈4% error) for the accelerometer during slower walking (54 m·min−1) in both persons with MS and control subjects.Conclusions: Such findings support the accuracy of a waist worn ActiGraph accelerometer for the measurement of steps in persons with MS and control subjects.Does an accelerometer accurately measure steps taken under controlled conditions in adults with mild multiple sclerosis? - Corrected ProofRobert W. Motl, Erin M. Snook, Stamatis Agiovlasitis10.1016/j.dhjo.2010.02.003Disability and Health Journal (2010)2010-04-05Disability and Health Journal2010-04-05http://www.disabilityandhealthjnl.com/article/PIIS1936657410000038/abstract?rss=yesAbstract: Background: Disability affects health status and quality of life; however, insufficient research has been done in developing countries using internationally accepted measurements.Objective: We investigated disabilities, sociodemographics, health indicators, and health behaviors using a sample of rural residents in northern China. We reported disability prevalence by age for our study sample and for a sample of rural residents who participated in the 1999-2002 Colorado Disability Survey.Methods: Face-to-face interviews were conducted in 2008, and complete questionnaires were obtained from 2199 individuals 15 years old or older. The definition of disability was conceptually based on the International Classification of Functioning, Disability and Health.Results: Of those who completed the survey, 154 (7.0%) reported having disabilities. The prevalence was 2.3% for limitations in activities of daily living (ADL) and 3.1% for limitations in instrumental activities of daily living (IADL). Significant differences in the disability prevalence were found across the categories of education, age, and marital status. Among individuals with disabilities, 54.6% rated their health status as poor or very poor compared to 13.4% of people without a disability. A strong association was seen between disability status and injury. A large proportion (79.9%) of persons with disabilities, as well as 82.2% of persons without disabilities, reported paying for their medical expenses out-of-pocket. The age pattern of disabilities (ADL and IADL) was similar to that seen in a rural Colorado population.Conclusions: Many rural Chinese individuals with disabilities report poor general health and may face further limitations in their daily activities and social participation without accessible and affordable health care.Prevalence of disability among adolescents and adults in rural China - Corrected ProofTala Alhajj, Limin Wang, Krista Wheeler, Weiyan Zhao, Yaowu Sun, Lorann Stallones, Huiyun Xiang10.1016/j.dhjo.2010.01.002Disability and Health Journal (2010)2010-02-22Disability and Health Journal2010-02-22http://www.disabilityandhealthjnl.com/article/PIIS1936657409001964/abstract?rss=yesAbstract: Background: Obtaining comprehensive health outcomes and health services utilization data on stroke patients has been difficult. This research grew out of a memorandum of understanding between the National Institutes of Health and the Istituto Superiore di Sanità (its Italian equivalent) to foster collaborative research on rehabilitation.Objective: The purpose of this study was to pilot a methodology using administrative data to monitor and improve health outcomes for stroke survivors in Tuscany.Methods: This study used qualitative and quantitative methods to study health resources available to and used by stroke survivors during the first 12 months poststroke in two Italian health authorities (AUSLs 10 and 11). Mortality rates were used as an outcome measure.Results: Number of inpatient days, number of prescriptions, and prescription costs were significantly higher for patients in AUSL 10 compared with AUSL 11. There was no significant difference between mortality rates.Conclusion: Using administrative data to monitor process and outcomes for chronic stroke has the potential to save money and improve outcomes. However, measures of functional impairment and more sensitive outcome measures than mortality are important. Additional recommendations for enhanced data collection and reporting are discussed.Methodological issues in monitoring health services and outcomes for stroke survivors: A case study - Corrected ProofMary Stuart, Donato Papini, Francesco Benvenuti, Marco Nerattini, Enrico Roccato, Velio Macellari, Steven Stanhope, Richard Macko, Michael Weinrich10.1016/j.dhjo.2009.11.003Disability and Health Journal (2010)2010-01-08Disability and Health Journal2010-01-08http://www.disabilityandhealthjnl.com/article/PIIS1936657409000880/abstract?rss=yesAbstract: Background: Although multiple sclerosis (MS) is the most common neurologic disease disabling younger adults, very little is known about the characteristics of young adults with MS and the impact of MS on their lives.Objectives: To conduct a pilot study of the demographic, disease, treatment, and psychosocial characteristics of young adults with MS (aged 18 and 31 years).Methods: We solicited participation from all 452 members of the Registry of the North American Research Committee On Multiple Sclerosis (NARCOMS) Project aged 18 to 31 years, collecting data from 100 of these young adults (22%) by computer-assisted telephone interviews. Data included basic demographic, disease, and treatment characteristics, ratings of satisfaction with access to and quality of MS and mental health care, and beliefs about the impact of MS on their current and future lives.Results: Participants were 93% female and averaged 28.6 years of age, and 88% had relapsing-remitting MS. Forty-three percent received the majority of their MS-focused care at an MS clinic and 94% had seen a neurologist in the previous 12 months. More than 40% reported depressive symptoms at the time of the survey. These young adults with MS had relatively low rates of concern about the impact of MS in the present but higher rates of worry about their future.Conclusions: These findings suggest the need for a study with a larger, representative sample of young adults with MS to guide development of programs, interventions, and services tailored to meet their needs.A pilot study of young adults with multiple sclerosis: Demographic, disease, treatment, and psychosocial characteristics - Corrected ProofRobert J. Buchanan, Sarah L. Minden, Bonnie J. Chakravorty, William Hatcher, Tuula Tyry, Timothy Vollmer10.1016/j.dhjo.2009.09.003Disability and Health Journal (2009)2009-11-30Disability and Health Journal2009-11-30