Brochure & Pretest

Brochure for social inclusion of people with disabilities: Brochure

 

Pretest results for the brochure are provided as well.

Brochure Topic: Social Inclusion of People with Disabilities

Five adults were asked to read the brochure and provide their feedback on its message, presentation, and appeal. Three women and two men were selected to participate. The participants read the brochure and were asked for their input individually as opposed to a focus group approach. The participants were asked to name the first thing about the brochure that caught their eye. Half of the participants named the photo on the cover of the brochure, while the other half mentioned the color and background design of the brochure.  The participants were asked to identify the brochure’s message; all participants said that people with disabilities should not be excluded from main society and that they are able to do things that non-disabled people are. All participants stated that the brochure did raise their interest in the subject; the majority of the participants mentioned never hearing about this topic prior to reading the brochure. Every participant claimed the wording was appropriate for the general public and was compatible for the general public’s reading level. Two participants suggested some adjustments to the brochure’s formatting (creating a new paragraph, font size) and sentence structure. One participant mentioned the order of information presented on the brochure might be confusing to some readers. All participants agreed that the brochure is a good channel to disseminate information about people with disabilities and health. Overall, this pretest of this brochure presented quantitative and qualitative data that suggest a promising outcome from using this brochure.

News Release

K.Pridgen_News.Release

FOR IMMEDIATE RELEASE:                                                                                             Contact: Kristin Pridgen

February 17, 2014                                                                                                            Email: kbadger6@liberty.edu

                                                                                                                 Website:  https://disablednotunable.wordpress.com/  

 

Disabled Doesn’t Equal Unable

Program Addresses Need for Health Promotion Programs for People with Disabilities

(Flesch-Kincaid Reading Level – 9.9)

 

(RALEIGH, NC) Wake County Human Services will work with the new program, Disabled ≠ Unable Program to bring more services for people with special needs in the county.

There are up to fifty-six million Americans who have special needs, and in North Carolina, there are around thirteen percent of citizens with special needs.  There are a large number of people in this country who have special needs, but they do not get the best health care services. In the United States, there are only sixteen programs that promote health and wellness to people with special needs. Poor health services are given to people with special needs. Studies show that people with special needs do not get check-ups to test for cancer, high blood pressure, or high cholesterol on a regular basis.

The Disabled ≠ Unable Program calls for the making of health programs for people with special needs and for them to be included in main society. This program is key, because these people receive poor health care services. Less than half of people with special needs have poor health. Health care workers have said that they do not feel at ease or educated enough to work with people with special needs. The workers’ lack of education and comfort cause many people with special needs to go to the hospital for health problems instead of seeing a regular doctor. People with special needs go to the emergency room up to nineteen times a year.

There is a big need for equal health care services, but not all health centers are able to give better care to people with special needs. The Centers for Disease Control and Prevention (CDC) held a forum about health for people with handicaps. Monika Mitra, Assistant Professor at the University of Massachusetts Medical School put stress on the importance of including people with special needs in main society: “We need to move towards a barrier free environment so that people with disabilities can access medical offices, diagnostic equipment, gyms, and the community at large.”

Mitra’s comment and the facts on poor health services show how important the need is for better health services and social acceptance for people with special needs. In the United States, only one in three adults with special needs say they join in their community’s activities, and the majority of adults with special needs say that they are pleased with their lives. Yet, minorities who have special needs are less content with their lives and do not engage in their community. Equal services are needed for all people with special needs. More health promotion programs and social inclusion for people with special needs can boost this group of people to become driven to have good health and to feel at ease in their community.

For more information on the Disabled ≠ Unable Program and ways to become involved, contact Kristin Pridgen at kbadger6@liberty.edu or visit the website at www.disablednotunable.wordpress.com.

Disabled ≠ Unable Program calls for better and equal health care services for people with special needs and their inclusion in the community activities in North Carolina. Disabled ≠ Unable Health Promotion Program is partnered by The Arc of North Carolina.

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Literature Review: Why Health Promotion Programs are Needed

Health promotion programs for people with disabilities: a literature review

Kristin Pridgen

Health 634: Health Communication & Advocacy

February 1, 2014

Introduction

Individuals with disabilities face heavy challenges with acceptance in their social environment, and they are often ostracized from main society through accessibility of infrastructure and health care services. In the disabled population, maintaining a healthy lifestyle is essential towards an increased quality of life; 39% of American adults with disabilities reported having a fair to poor health status, when 9% of adults without disabilities claim the same level of health.¹ Comorbidity due to cardiovascular issues, respiratory disease, and obesity are more likely in people with disabilities, increasing their risk of mortality.

While the statistics of risk are alarming, the number of American citizens with disabilities is even more startling; between 37 and 56 million Americans have some type of disability (physical, intellectual, developmental) with the chance of having a disability increasing along with age.² These findings emphasize the need to provide optimal health care services to this population.

Efforts were made in the past to equalize rights and opportunities for persons with disabilities. The Americans with Disabilities Act of 1990 (ADA) protected people with disabilities against any discriminating acts in employment, public accommodations, transportation, and government services, including health and wellness programs³; however the number of health and wellness programs specifically for persons with disabilities has not increased since the 1990s. In 1999, there were 14 documented health promotion programs targeting people with disabilities; 10 years later in 2009, there were 16 programs.⁴ On the one hand, it is possible for people with disabilities to engage in non-specific health programs and health services (this is what the ADA advocated); however, data portrays the lack of utilization of non-specific health care systems by the disabled population.

An intervention is much needed in order to address the lack of health promotion and preventive services for people with disabilities, particularly not residing in supportive housing and receiving their program’s services. The proposed intervention will be the creation of a health promotion program specifically targeting individuals with disabilities. It will be initiated by including persons with disabilities as stakeholders in the program and assisting in creating a program that will meet their needs and preferences; upon the intervention’s effectiveness, a framework can be created to help produce more successful programs for people with disabilities. This review will further endorse the importance of this intervention by addressing the need for health promotion programs and services for individuals with disabilities.

This literature review is comprised of 3 sections: the introduction above briefly describing the current issue; the body of evidence (health trends of persons with disabilities, lack of health services, and healthcare costs) supporting the need for a health promotion intervention; and a summary of presented information and conclusions connecting the intervention’s purpose with the need of health promotion programs for people with disabilities.

 

 

Body of Evidence

Health needs:

As previously mentioned, the percentage of persons with disabilities who reported a poor health status is considerably high (39%) compared to persons without disabilities (9%).¹ The Healthy People 2010 Database has provided health data of American adults with and without disabilities. Physical activity is something of great importance; by engaging in physical activity, muscles are strengthened, balance and stability can increase, body weight can decrease, and risk of developing chronic diseases decreases. Data shows that 54% of adults with disabilities do not engage in any type of physical activity, compared to 32% of non-disabled adults who are consistently physically inactive.⁴ Increased body mass is associated with physical inactivity and poor diet; obesity was measured in 41% of persons with disabilities and in 33% of persons without disabilities.⁴ A study of poor healthy habits in people with intellectual disabilities determined that less than 10% of adults living in supported housing consumed a diet with recommended daily intake of fruits and vegetables.⁵ If the adults with disabilities within supportive housing are consuming unhealthy diets, it is difficult to imagine what type of dietary habits people with disabilities have who live on their own or with family.

In addition to physical inactivity and higher percentages of obesity, persons with disabilities have greater risks of developing cardiovascular disease, respiratory disease, and dental disease. People with Down syndrome and other types of intellectual disabilities have a high incidence of lung disease and injuries.⁵ Furthermore, cardiovascular health of people with disabilities is needing attention; the Healthy People 2010 Database reported 39% of individuals with disabilities and only 29% of non-disabled people having high blood pressure, but similar percentages between the two groups in measures of coronary heart disease and checking blood pressure.⁴ Although the numbers may be comparable in various measures of cardiovascular health, there is still a need to provide education and services towards the disabled population in regards to this topic. Lastly, studies have suggested an association between intellectual disabilities and poor oral health. These findings were consistent even though the participants in the study brushed their teeth daily; the study also found a higher prevalence of dental disease in people with severe intellectual disabilities and residing in deprived areas.⁵   Outside of these illnesses, people with disabilities have a greater rate of having comorbidities, or additional debilitating illnesses, such as arthritis, depression, and diabetes. Out of the 23 million individuals who reported having a disability that did not interfere with performing activities of daily living (ADLs) or instrumental activities of daily living (IADLs), around half of them reported having at least 2 chronic conditions; around 70% of people with disabilities that do affect their ADLs and IADLs reported having at least 2 chronic conditions.⁶  Overall, these statistics of chronic diseases emphasize the caliber of health care needs for people with disabilities.

Lack of services:

Despite the alarming need for addressing the health conditions of persons with disabilities, there is an overwhelming lack of services provided to this population. Several of the chronic diseases mentioned above can be averted through preventive services. Regular blood pressure checks, physical and dental exams are ways to address minor issues in advance before they become substantial debilities. Although the ADA of 1990 enforced health services to people with disabilities, a growing number of health professionals “perceive that they lack the necessary skills, resources, and training to provide adequate primary care”⁷⁽¹⁵⁶⁾ to this population. In regards to preventive services, only 38% of people with disabilities reported receiving annual dental visits.⁴ Furthermore, preventive screenings according to gender are also low; a study concluded that women with disabilities had less access to health care services than men with disabilities and women without disabilities.⁸ These services include Pap smears and mammograms, two preventive services that can detect abnormal or cancerous cells before they can progress. A particular study used the Behavioral Risk Factor Surveillance System (BRFSS), a randomized telephone survey, to compare women with disabilities’ access to health care to the access of men with disabilities and women without disabilities; while women from both groups reported to have had a mammogram, women with disabilities were less likely to have had a mammogram within the last year (59.5%) compared to women without disabilities (65.1%).  Similar results were measured for Pap smear tests between the women with and without disabilities. (64.3% and 71.4% respectively).⁸

Lack of preventive services and access to a personal doctor can increase the number of ambulatory visits by persons with disabilities. One particular study on access to health services for people with disabilities and chronic conditions measured 11 to 19 emergency care visits for individuals with disabilities within the sample, while people without disabilities had around 4 ambulatory visits.⁶ Additionally, preventive screenings and annual visits can educate patients on knowing key symptoms of illnesses such as a lump in a breast, chest pain, or slurred speech. The Healthy People 2010 Database lists 37% of American adults (regardless of disability) recognizing a heart attack and the importance of immediately calling for help, and 49% of people with disabilities are aware of early warning signs of a stroke.⁴ These percentages emphasize the need to not only provide preventive services to the disabled population but to also provide education to promote self-advocacy in health.

Cost of healthcare services:

Numerous surveys and focus groups have indicated that healthcare costs and limited insurances are hindrances to people with disabilities seeking health care services. The Surgeon General priced the annual costs of disability to be more than $300 billion dollars.³ While federal and state monies do fund the bulk of the costs, people with disabilities and their families typically pay $34 billion dollars for health services.³ These numbers are generally startling, but they are a significant problem to many people with disabilities who only have a high school education and are unemployed or underemployed. One study compared the health care expenditures of people with and without physical disabilities; the average health care spending of people with disabilities was 6 times higher than people without disabilities.⁹ Health insurance (private and Medicaid) does provide for most health services and can allow people with disabilities to spend less money out of pocket—Medicaid paid $72.7 billion dollars in 2011,³ particularly to help fill prescriptions and address behavioral health.¹⁰ Despite these initiatives to provide affordable healthcare, accessing healthcare is difficult, as the rate of unmet physical health needs was 41% in one study.¹⁰ For this reason, 27.5% of adults with disabilities claim health care costs to be a barrier to receiving health care services.¹¹ Overall, affordability to all health care services needs to be addressed.

 

 

Summary & Conclusions

The body of evidence addressed the poor health status associated with disability, lack of health services and the expensive nature of such services. Rates of obesity, physical inactivity, comorbidity, and lack of preventive screenings illustrate the health disparity this population suffers. Despite the large disparity, health professionals do not target educating this population on healthy living, and there are only 16 reported health promotion programs for this group in the US.

All the studies mentioned in this literature review do have limitations, such as sample size, source of the samples (people living at home), and methods used to collect data (telephone and mail surveys). Additionally, there is not a large health database on persons with disabilities, a limitation towards creating an effective intervention.

People with disabilities are people and deserve equal services as the rest of the US population. The ADA of 1990 initiated the nationwide acceptance and accommodations for the disabled population, but more work is needed, particularly in the health care sector. This intervention of creating a health promotion program tailored to people with disabilities will aim to effectively educate and promote healthy living among this population and produce a framework for future programs.

 

References

1. CDC. Disability and Health Data System (DHDS). CDC. Available at http://dhds.cdc.gov. Published 2010. Accessed January 31, 2014.
2. CDC. Disability and health: data and statistics. CDC. http://www.cdc.gov/ncbddd/disabilityandhealth/data.html. Published December 16, 2011. Accessed January 31, 2014.
3. Surgeon General. The Surgeon General’s call to action to improve the health and wellness of persons with disabilities. Surgeon General. http://www.surgeongeneral.gov/library/calls/disabilities/understanding.html. Updated January 10, 2008. Accessed January 31, 2014.
4. Centers for Disease Control and Prevention (CDC). DATA 2010. http://wonder.cdc.gov/data2010/focus.htm. Accessed January 31, 2014.
5. McCarthy J, O’Hara J. Ill-health and intellectual disabilities. Curr Opin Psychiatry. 2011;24(5):382-386.
6. Gulley SP, Rasch EK, Chan L. The complex web of health: relationships among chronic conditions, disability, and health services. Public Health Reports. 2011;126(4):495-507.
7. Iacono T, Sutherland G. Health screening and developmental disabilities. Journal of Policy and Practice in Intellectual Disabilities. 2006;3(3):155-163.
8. Smith DL, Ruiz MS. Perceived disparities in access to health care due to cost for women with disabilities. Journal of Rehabilitation. 2009;75(4):3-10.
9. Pumkam C, Probst JC, Bennett KJ, Hardin J, Xirasagar S. Health care expenditures among working-age adults with physical disabilities: variations by disability spans. Disability and Health Journal. 2013;6(4):287-296.

10. Henry AD, Long-Bellil L, Zhang J, Himmelstein J. Unmet need for disability-related health care services and employment status among adults with disabilities in the Massachusetts Medicaid program. Disability and Health Journal. 2011;4(4):209-218.

11. CDC. Cost as a barrier to care for people with disabilities. CDC. http://www.cdc.gov/ncbddd/documents/cost_barrier-tip-sheet–_phpa_1.pdf. Accessed January 31, 2014.