Disability And Health Journal[JOURNAL]
Sun
200 papers
Physical activity type and duration in disabled and non-disabled adults.
Carr S, Atkin AJ, Milton K
Disabil Health J · 2025 Jul · PMID 39966017 · Publisher ↗
BACKGROUND: Disabled people are more likely to be physically inactive than non-disabled people, yet limited research has explored the types of physical activities that disabled people participate in. OBJECTIVES: This stu...
BACKGROUND: Disabled people are more likely to be physically inactive than non-disabled people, yet limited research has explored the types of physical activities that disabled people participate in. OBJECTIVES: This study describes the types of physical activities that disabled people participate in, and compares activity frequency and duration to non-disabled people. METHODS: Using cross-sectional data from the 2018/19 Sport England Active Lives survey, participants were categorised into three groups (disability - substantial effect on daily activities; disability - non-substantial effect on daily activities; no disability), and activity types were grouped into 17 categories including athletic, leisure, and swimming. Chi-squared tests and multivariable linear regression were used to compare participation in each activity category across the sub-groups. RESULTS: Of 158,995 participants, 18% (n=29,057) had a disability that had a substantial effect on daily activities, 21% (n=33,004) had a disability with a non-substantial effect on daily activities, and 61% (n=96,934) had no disability. Leisure was the most frequently reported activity type and of longest duration (median (interquartile range) mins/day: disability - substantial effect on daily activities: 315 (120-700); disability - non-substantial effect on daily activities: 390 (180-750); no disability: 375 (165-750)). Whilst activity duration was typically higher among people with no disability, artistic activities and swimming were higher for people with a disability that had a substantial effect on daily activities. CONCLUSIONS: Activity choices were similar among sub-groups, however participation rates and activity duration were typically lower among disabled people. Reducing inequalities in physical activity participation will require improved access, opportunities, and support.
Quality of life, physical activity, and social determinants in teenagers with cerebral palsy: A cross-sectional study in Sweden.
Degerstedt F, Enberg B, Ng N … +2 more , Keisu BI, Björklund M
Disabil Health J · 2025 Jul · PMID 39966016 · Publisher ↗
BACKGROUND: The associations between physical activity and various social determinants with quality of life (QoL) among teenagers with cerebral palsy (CP) are inconclusive. OBJECTIVE: To explore associations between perc...
BACKGROUND: The associations between physical activity and various social determinants with quality of life (QoL) among teenagers with cerebral palsy (CP) are inconclusive. OBJECTIVE: To explore associations between perceived QoL among teenagers with CP in Sweden and participation in physical leisure activity and physical education in school, as well as sex, gross motor function, pain and bother, caregivers' birth country and socioeconomic status. METHODS: A cross-sectional study with teenagers who have CP, aged 15-18 years. The survey, including the assessment form Cerebral Palsy Quality of Life-teenager (CP QoL-teen), was sent to all youths in the national patient registry held by the Swedish National Board of Health and Welfare (n = 900). Survey data was complemented with data from other national health registries containing information on demographics, physical leisure activity, physical education, and gross motor function. Multivariable linear- and quantile regression analyses were performed. RESULTS: The survey was answered by 149 participants. Physical leisure activity was positively associated with the QoL-domain Communication and physical health. Gross motor function was associated with domains referring to physical function and participation; more severe motor difficulties indicated lower QoL. Pain was negatively associated with all QoL domains. Low caregiver educational levels were associated with higher social well-being domain. CONCLUSION: Minimizing pain and facilitating physical activity may enhance QoL for teenagers who have CP. To improve participation for teenagers with severe disabilities, with non-Nordic caregivers, and caregivers without postgraduate education, targeted measures to facilitate participation are needed.
Assessing STI and HIV risks among autistic individuals: Implications for healthcare access and intervention.
McLean KJ, Sadowsky M, Chesnokova A … +4 more , Chvasta K, Lee WL, Ventimiglia J, Shea L
Disabil Health J · 2025 Jul · PMID 39961742 · Publisher ↗
BACKGROUND: Sexually transmitted infections (STIs) are prevalent in the general population. Autistic individuals, both with and without intellectual disability (ID), are potentially at increased risk due to gaps in sexua...
BACKGROUND: Sexually transmitted infections (STIs) are prevalent in the general population. Autistic individuals, both with and without intellectual disability (ID), are potentially at increased risk due to gaps in sexual health education, increased vulnerability to sexual abuse, victimization, and disparities in access to primary and reproductive health care. OBJECTIVE: This study aims to identify the prevalence of STIs and HIV among a national sample of Medicaid-enrolled autistic individuals and their peers, identifying opportunities for intervention. METHODS: Characteristics of autistic Medicaid beneficiaries with and without ID were stratified to compare individuals with and without chlamydia, gonorrhea, syphilis, and HIV. Period prevalence of outcomes among Medicaid enrollees with autism spectrum disorder (ASD) only, ID only, and both (ASD and ID) were compared. RESULTS: Among autistic individuals, the prevalence of STIs and HIV was highest in the 22-30 age group and among Black enrollees, underscoring the importance of prioritizing their care through screening and preventive health measures. CONCLUSIONS: The results emphasize gaps in addressing the sexual and reproductive health needs of autistic individuals. Policymakers should prioritize funding for clinician training and increased healthcare access to address the sexual health needs of this population, especially those from additionally marginalized communities. It is vital to provide inclusive care that addresses the unique challenges faced by autistic individuals in accessing appropriate sexual health resources.
Internal medicine residents' self-described knowledge of general medical versus disability-focused concerns: An exploratory study.
Stillman M, Capron M, Peterson J … +3 more , Partha I, Barker H, Hong M
Disabil Health J · 2025 Jul · PMID 39956754 · Publisher ↗
BACKGROUND: The dearth of disability-focused education in United States residency programs fuels health care disparities faced by persons with disabilities (PWD). However, it has yet to be demonstrated that physicians-in...
BACKGROUND: The dearth of disability-focused education in United States residency programs fuels health care disparities faced by persons with disabilities (PWD). However, it has yet to be demonstrated that physicians-in-training feel less comfortable managing disability-specific health concerns than they do other medical conditions. OBJECTIVE OR HYPOTHESIS: To assess Internal Medicine (IM) residents' level of comfort in managing disability-specific versus general internal medical (GIM) concerns. We hypothesized that: 1) IM residents are less comfortable managing disability-specific health conditions than other GIM conditions; 2) IM residents feel increasingly comfortable handling GIM conditions over the course of their training, but not in addressing disability-specific concerns, and; 3) prior exposure to PWD improves IM residents' comfort in managing disability-specific conditions. METHODS: An exploratory study utilizing a Likert Scale-based survey assessing IM residents' level of comfort in managing GIM and disability-focused conditions was developed then distributed through 3 IM programs. Main measures included residents' level of comfort in managing a variety of medical conditions, including those pertaining to the care of PWD. Data analysis included descriptive statistics, ANOVAs, and independent sample t-tests. RESULTS: The survey was distributed to 298 residents and 127 completed it (response rate of 42.6 %). Participants were less comfortable providing disability-focused care than GIM care. Upper-level residents were more comfortable than first-year residents in managing GIM conditions, but not in providing disability-focused care. CONCLUSIONS: Internal medicine residents are inadequately trained to provide care for PWD. There is a need to incorporate disability-specific learning objectives into graduate medical program requirements and curricula.
Prognostic comparison between GMFCS and WCI for 5-year risks of 22 relevant health outcomes for adults with cerebral palsy: Expanding the methodological menu for prognostic model research.
Whitney DG
Disabil Health J · 2025 Jul · PMID 39955248 · Publisher ↗
BACKGROUND: The gross motor function classification system (GMFCS) is a well-established measurement of function specific to cerebral palsy (CP) and likely offers prognostic ability for disease trajectories. However, oth...
BACKGROUND: The gross motor function classification system (GMFCS) is a well-established measurement of function specific to cerebral palsy (CP) and likely offers prognostic ability for disease trajectories. However, other emerging measurements may be more directly aligned with assessing disease risk for adults with CP, such as the Whitney Comorbidity Index (WCI). OBJECTIVE: To expand the methodological menu for prognostic model research, this study assessed whether GMFCS or WCI served as a better prognostic factor of 5-year risks of mortality and 21 relevant morbidity outcomes among adults with CP. METHODS: This retrospective cohort study used medical records from 01/01/2012-06/01/2024 from adults ≥18 years old with CP. A 1-year baseline ascertained the WCI score. Logistic regression estimated and compared the c-statistic of each outcome between: (1) base model (age, sex, race, smoking status, insurance, year of start date) + GMFCS and (2) base model + WCI. Multiple imputation was used for missing GMFCS data to address sample selection bias. RESULTS: In the complete case analysis with no missing GMFCS data (n = 923), 14 of 21 morbidity outcomes were similarly predicted by base + GMFCS and base + WCI models and 7 were predicted better by base + WCI model, while the mortality outcome was predicted better by base + GMFCS. Using the full cohort after multiple imputation (n = 2601), 18 morbidity outcomes were similarly predicted by both models and 3 were predicted better by base + WCI model, while the mortality outcome was predicted better by base + GMFCS. CONCLUSIONS: This study suggests that while GMFCS was superior for mortality prediction, the WCI had similar-to-superior prediction for most morbidity outcomes.
Aging with a disability: A call for research, policy, and practice.
Mitra M, Turk M
Disabil Health J · 2025 Apr · PMID 39947982 · Publisher ↗
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Exploring the increased prevalence of autism in the fee-for-service Medicare population with open data, 2007 to 2018.
Yoo EM
Disabil Health J · 2025 Jul · PMID 39904651 · Publisher ↗
BACKGROUND: The Autism and Developmental Disabilities Monitoring (ADDM) Network continues to report increases in the percentage of U.S. children identified with autism spectrum disorder (ASD). Few studies, however, have...
BACKGROUND: The Autism and Developmental Disabilities Monitoring (ADDM) Network continues to report increases in the percentage of U.S. children identified with autism spectrum disorder (ASD). Few studies, however, have examined prevalence among U.S. adults. OBJECTIVE: To use open data on ASD prevalence among fee-for-service Medicare beneficiaries, considering trends in the context of sociodemographic factors and dual enrollment in Medicaid. METHODS: Administrative prevalence estimates from the Centers for Medicare and Medicaid Services (CMS) were used to explore changes in ASD prevalence among fee-for-service Medicare beneficiaries. These rates were compared with corresponding childhood prevalence estimates from the ADDM Network. RESULTS: In 2018, there were 87,108 fee-for-service Medicare beneficiaries with autism diagnoses, representing a 236.1% increase from 2008. For 8-year-old children in the ADDM Network, the 2008-2018 change was 32.41%. National ASD prevalence increased in the fee-for-service Medicare population every year from 2007 through 2018, most substantially for beneficiaries under the age of 65. While only 10 states had a prevalence at or above 1 in 1000 beneficiaries in 2007, 48 states and the District of Columbia had a prevalence above that value in 2018. Prevalence in the Medicare population also increased from 2016 to 2018, a period in which program enrollment declined. CONCLUSIONS: Even more so than among children, autism prevalence increased in the fee-for-service Medicare population from 2007 through 2018. While geographic and sociodemographic differences in ASD identification existed, prevalence grew across states and most subgroups. Further research is needed to address questions involving the identification and support of autistic adults.
Daily physical activity and cardiorespiratory fitness in adults with Down syndrome with and without congenital heart disease.
Clina JG, White DA, Sherman JR … +6 more , Danon JC, Forsha DE, Helsel BC, Washburn RA, Donnelly JE, Ptomey LT
Disabil Health J · 2025 Jul · PMID 39894685 · Full text
BACKGROUND: Individuals with Down syndrome (DS) typically exhibit lower cardiorespiratory fitness and reduced moderate-to-vigorous physical activity (MVPA) compared to persons without disability. Approximately 50-55 % of...
BACKGROUND: Individuals with Down syndrome (DS) typically exhibit lower cardiorespiratory fitness and reduced moderate-to-vigorous physical activity (MVPA) compared to persons without disability. Approximately 50-55 % of individuals with DS have congenital heart disease (CHD), which is associated with cardiopulmonary deficiencies and reduced MVPA participation in non-DS populations. It is unknown if CHD related comorbidities compound with DS associated deficits in physical activity and fitness. OBJECTIVE: To compare physical activity, cardiorespiratory fitness, and cardiovascular function, of persons with DS with and without CHD. METHODS: Baseline data were used from a 12-month randomized controlled physical activity intervention of adults with DS. Participants with DS were age and sex matched based on presence of CHD. Measures of physical activity through accelerometry (n = 42; CHD, n = 21), cardiorespiratory fitness (VO; n = 34, CHD n = 17), and cardiovascular function (anaerobic threshold, chronotropic index, O pulse; n = 34, CHD n = 17) were compared by CHD status using Wilcoxon rank sum tests. RESULTS: There were no differences in VO between those with and without CHD (CHD 20.3 ml/kg/min; no CHD 21.3 ml/kg/min, p = 0.44). MVPA was lower for those with CHD vs. without CHD (10.0 vs 13.3 min/week, p = 0.05). There were no differences in cardiovascular function by group. CONCLUSION: Fitness and physical activity were low regardless of CHD status. Adults with DS and CHD may engage in less physical activity than those without CHD, however fitness and cardiovascular function were not further impaired by CHD. Given the prevalence of CHD in DS, it is important to include those with CHD in work increasing physical activity and fitness.
The prevalence of disability among adolescents and young adults in low and middle-income countries: A cross-sectional comparison of two measures.
Emerson E, Llewellyn G
Disabil Health J · 2025 Jul · PMID 39884917 · Publisher ↗
BACKGROUND: The Washington Group Short Set on Functioning (WG-SS) is frequently used to identify disability among adults in national surveys. Concerns have been raised about the utility of the WG-SS given that it fails t...
BACKGROUND: The Washington Group Short Set on Functioning (WG-SS) is frequently used to identify disability among adults in national surveys. Concerns have been raised about the utility of the WG-SS given that it fails to include any items relating to psychosocial disability. OBJECTIVE: To compare prevalence estimates for adolescents and young adults derived from the Washington Group's Child Functioning Module (WG-CFM; age 15-17) and the WG-SS (age 18-25). To estimate the prevalence of impairments among adolescents who were not categorised as having a disability based on the six WG-SS domains. To investigate the association between disability and relative household wealth among adolescents with disabilities who were/were not categorised as having a disability based on the six WG-SS domains. METHODS: Secondary analysis of 40 nationally representative surveys collected in low- and middle-income countries. RESULTS: Prevalence estimates for disability were significantly higher among adolescents (15.1 % 95 % 14.8-15.4) than young adults (3.2 % 95 % 3.1-3.3). The WG-SS only identified 21%-23 % of young adults who are likely to have a disability. Among adolescents, those identified as having a disability by the WG-CFM, but as not having a disability by the items in the WG-CFM similar to the six domains of the WG-SS primarily had functional limitations related to anxiety and depression. Household wealth was unrelated to disability based on the six WG-SS domains but was strongly related to disability identified by the WG-CFM. CONCLUSIONS: The WG-SS, as it stands, should not be used to identify disability in young adult populations.
The importance of Ombudsman programs in supporting the transition from medicare-medicaid plans to dual special needs plans.
Basnet F, Killick C, Diaz L … +1 more , Felteau S
Disabil Health J · 2025 Jul · PMID 39863480 · Publisher ↗
In this paper, we examine the critical role of Ombudsman programs in facilitating the transition from Medicare-Medicaid Plans (MMPs) to Dual Special Needs Plans (D-SNPS) for dual-eligible members. As states implement thi...
In this paper, we examine the critical role of Ombudsman programs in facilitating the transition from Medicare-Medicaid Plans (MMPs) to Dual Special Needs Plans (D-SNPS) for dual-eligible members. As states implement this federally mandated transition, Ombudsman programs serve as essential supports for the dual-eligible population who are navigating complex healthcare changes. Through analysis of Ombudsman programs in California, Massachusetts, Rhode Island, and Michigan, we highlight how these services address beneficiary concerns, resolve access issues, and provide valuable insights to policymakers. We emphasize the importance of maintaining and potentially expanding Ombudsman programs during and after the transition to ensure person-centric, high-quality care for dual-eligible members.
Diverse perspectives on supporting the health and wellness of people with intellectual and developmental disabilities.
Nicholson J, Faughnan K, Silverman AF … +6 more , Lesser V, Andresen ML, Bahr M, Corey T, Benevides TW, Pham H
Disabil Health J · 2025 Jul · PMID 39818503 · Publisher ↗
BACKGROUND: Persons with intellectual and/or developmental disabilities (IDD) are a growing population, frequently living with complex health conditions and unmet healthcare needs. Traditional clinical practice and resea...
BACKGROUND: Persons with intellectual and/or developmental disabilities (IDD) are a growing population, frequently living with complex health conditions and unmet healthcare needs. Traditional clinical practice and research methods and measures may require adaptation to reflect their preferences. OBJECTIVE: The perspectives of people with IDD, caregivers/partners, and clinicians were obtained to provide insight into factors contributing to the health and wellness of people with IDD. These, in turn, suggest opportunities for improvements in clinical training and care, and considerations for enhancing research methods and measures. METHODS: An exploratory design, participatory methods, abductive qualitative approach and thematic analysis were employed. Interview data were obtained in twelve focus groups with people with IDD (n = 25), caregivers/partners (n = 21), and clinicians (n = 27). Particular attention was paid to supporting attendees in focus group participation, with adaptations and accommodations made for communication preferences, and graphic illustrations were provided. RESULTS: Themes emerging across attendee categories that reflect factors contributing to health and wellness for people with IDD include: (1) making healthy choices; (2) participating in everyday activities; (3) benefitting from natural supports (e.g., family, friends, peers); and (4) accessing skilled professional supports (e.g., healthcare provision and payment). CONCLUSIONS: Study findings underscore factors related to supporting health and wellness for people with IDD and suggest the importance of autonomy, accessibility, healthy relationships, self-advocacy, and tailored clinical care. People with IDD can be actively engaged throughout the research enterprise to ensure the relevance, acceptability, and accessibility of research methods and measures; promote inclusiveness; and address health disparities.
Housing stability for households with LTSS needs in America: Contrasting pre-pandemic housing data from 2017 with data from 2021.
Trivedi K, Pickern S, Nguyen T
Disabil Health J · 2025 Jul · PMID 39809693 · Publisher ↗
BACKGROUND: Economically insecure people with disabilities are often forced to choose between health and housing. Housing instability in the form of mortgage, rent delinquency, or missing utility payments can adversely a...
BACKGROUND: Economically insecure people with disabilities are often forced to choose between health and housing. Housing instability in the form of mortgage, rent delinquency, or missing utility payments can adversely affect the health and well-being of people with disabilities and, specifically, people with LTSS needs. OBJECTIVE: Our study investigates the disparity in housing stability for LTSS households and non-LTSS disability households in comparison to non-disability households. We also investigate the differences in housing stability indicators between 2017 and 2021 (during COVID-19) to assess the potential impact of the COVID-19 crisis on housing instability. Finally, we conducted a stratified analysis to investigate the intricate relationship between LTSS needs and aging. METHODS: We used data from the American Housing Survey (AHS) from 2017 to 2021 to conduct a logistic regression analysis to examine housing instability for households with members with LTSS needs. We also conducted a stratified logistic regression analysis, with data stratified by age groups, to investigate whether this relationship varied across different age groups. RESULTS: LTSS households faced housing instability in 2017 and 2021, with higher odds of missing mortgage, rent, and utility payments. Compared to 2017, LTSS households in 2021 face marginally lower odds of missing mortgage and utility payments but higher odds of missing rent. CONCLUSION: We need sustained policy intervention to reduce housing instability for LTSS and non-LTSS households. Some policies employed during the COVID-19 crisis at both federal and state levels may have reduced housing instability for the LTSS and non-LTSS disability households.
Understanding HCBS utilization: The role of disability onset age and length of disability.
Chiri G, Howard JN, Palmer L … +2 more , Robinson K, Rafiuddin S
Disabil Health J · 2025 Jul · PMID 39809692 · Publisher ↗
BACKGROUND: Younger adults aging with and older adults aging into disability often need support to remain in their homes and communities. However, researchers and policymakers lack sufficient understanding of their diffe...
BACKGROUND: Younger adults aging with and older adults aging into disability often need support to remain in their homes and communities. However, researchers and policymakers lack sufficient understanding of their differing needs for home and community-based services (HCBS), largely due to limitations in existing data. OBJECTIVES: This study addresses this gap by exploring select HCBS utilization among adults with disability onset before age 60 and those with onset after age 60, focusing on how aging and disability intersect. METHODS: We used data from multiple waves of the Health and Retirement Study (HRS), the HCBS HRS module and the Health Care Mail Survey. Using these data, we identified individuals by their disability onset (before and after age 60) and measured the duration of their disability. We then examined the use of select HCBS and its association with the onset and duration of disability. RESULTS: Multivariate regression analysis found no significant differences in service utilization based on the timing of disability onset. Instead, a longer disability duration was associated with increased odds of utilizing HCBS, regardless of when the disability began. CONCLUSION: As the population continues to age, more individuals will live with disabilities, including both those who acquire them earlier in life and older adults who develop them in later years. This analysis emphasizes the critical role of disability duration in understanding service needs and resource allocation. By combining perspectives from aging and disability research, this study underscores the need for integrated policies and programs that address shared challenges. Such an approach can bridge existing gaps, leading to better outcomes for all individuals living with disabilities.
Experiences of siblings of individuals with developmental disabilities: A meta-synthesis of qualitative studies.
Lee H, Kim K, Kim H … +1 more , Choi EK
Disabil Health J · 2025 Apr · PMID 39799090 · Publisher ↗
BACKGROUND: While the impact of developmental disabilities (DD) on the entire family is increasingly recognized, the experiences of typically developing (TD) siblings often remain overlooked. Recently, an understanding o...
BACKGROUND: While the impact of developmental disabilities (DD) on the entire family is increasingly recognized, the experiences of typically developing (TD) siblings often remain overlooked. Recently, an understanding of siblings' experiences has been developed through qualitative studies. OBJECTIVE: This review aims to synthesize existing qualitative evidence regarding the experiences of TD siblings of individuals with DD. METHODS: A systematic search across four databases (PubMed, CINAHL, PsycINFO, and Web of Science) identified studies reporting empirical qualitative data on the experiences of TD siblings of adolescents and young adults with DD, including English studies from 2014 to 2023. A quality appraisal was performed using the Critical Appraisal Skill Programme (CASP) checklist. The data were synthesized using thematic synthesis. RESULTS: Nine studies met the inclusion criteria. Six key themes and 13 subthemes were identified from the included articles. These themes included (i) encountered difficulties, (ii) intrapersonal response, (iii) interpersonal interaction, (iv) challenging family dynamics, (v) strategies and support, and (vi) accepting and adapting to my reality. CONCLUSIONS: This review synthesizes qualitative evidence on the experiences of TD siblings, highlighting how their situation shapes their lives. The findings suggest that TD siblings of individuals with DD experience difficulty due to their sibling's disability. These experiences influence various aspects of their lives, including personal, school/work, and family dynamics, ultimately affecting TD siblings' adaptation processes. Our findings emphasize the need for targeted interventions to support the psychological well-being of TD siblings of individuals with DD.
Perinatal mental health and risk of severe maternal morbidity in women with physical disabilities, Massachusetts 2003-2015.
Valentine A, Akobirshoev I, Zhang J … +2 more , Moore Simas TA, Mitra M
Disabil Health J · 2025 Jul · PMID 39794218 · Full text
BACKGROUND: Perinatal mental health and substance use disorders contribute to adverse maternal outcomes. Women with disabilities experience increased risk for severe maternal morbidity (SMM). No studies have examined the...
BACKGROUND: Perinatal mental health and substance use disorders contribute to adverse maternal outcomes. Women with disabilities experience increased risk for severe maternal morbidity (SMM). No studies have examined the association between perinatal mental health and SMM risk in women with physical disabilities. OBJECTIVE: To examine the association between perinatal mental health and substance use disorders and SMM risk in women with physical disabilities. METHODS: We analyzed delivery hospitalizations from 2003 to 2015 from the Massachusetts Pregnancy to Early Life Longitudinal (PELL) data system. We identified physical disability using International Classification of Diseases, Ninth Revision codes. Perinatal mental health status was based on the presence of at least one emergency department visit, observational, or in-patient stay attributed to a mental health or substance use disorder anytime from gestation to delivery. We used modified Poisson regressions to obtain risk ratios (RR) for SMM in women with either a physical disability or no disability by perinatal mental health status. Non-disabled women with no perinatal mental health or substance use disorder visit served as the referent group. RESULTS: Deliveries in women with no physical disability and a perinatal mental health visit were not associated with risk of SMM. Compared to the referent group, women with a physical disability and a perinatal mental health or substance use disorder visit had greater risk of both SMM (RR = 1.84, 95 % CI:1.32-2.56), and nontransfusion SMM (RR = 2.35 1.52, 3.64), after adjusting for demographic and socioeconomic characteristics. CONCLUSIONS: Increased attention should be paid to perinatal mental health status in women with physical disabilities.
Prevalence of food and housing insecurity among direct support professionals in New York.
Cohen J, van der Meulen Rodgers Y
Disabil Health J · 2025 Apr · PMID 39753380 · Publisher ↗
BACKGROUND: Low earnings are associated with household insecurity. Direct Support Professionals (DSPs) provide support for people with intellectual and developmental disabilities, typically for wages close to state minim...
BACKGROUND: Low earnings are associated with household insecurity. Direct Support Professionals (DSPs) provide support for people with intellectual and developmental disabilities, typically for wages close to state minimums, and may experience insecurity. OBJECTIVE: The purpose of the study was to evaluate the prevalence of food and housing insecurity among DSPs. METHODS: We conducted a statewide, cross-sectional survey of DSPs in New York State (2022-2023). Measures included detailed questions about food and housing insecurity. We used chi-square analyses and logistic regressions to examine relationships between insecurity and demographic characteristics as proxies for social determinants of health. A total of 4503 DSPs responded to the survey. The analytic sample contained 2766 respondents with complete data for all relevant variables. RESULTS: Overall, 62.6 % experienced food and/or housing insecurity, with over half of those respondents experiencing both. Insecurity was highest among DSPs with a disability (76.2 %), DSPs of color (75.7 %), and those with lower income (72.4 %), but over 50 % of DSPs across demographic groups experienced insecurity. CONCLUSIONS: The widespread insecurity this study demonstrates is an occupational hazard that reduces worker welfare. At the macro-level, household insecurity is a critical threat to the stability of the care and support delivery system. The human services sector is projected to grow rapidly in the future. If growth continues along low wage lines, it implies an equally rapid expansion of worker insecurity. Government action to raise pay and interventions that enhance food and housing security are needed to support workers in the care delivery system for people with intellectual and developmental disabilities.
Chronic conditions among transgender Medicare beneficiaries: Variation by race, ethnicity, and Medicaid dual-enrollment.
Babbs G, Mulcahy A, Ellison J … +6 more , Varma H, Pletta DR, Yee K, Hughes LD, Shireman TI, Hughto JMW
Disabil Health J · 2025 Apr · PMID 39701841 · Full text
BACKGROUND: Transgender and gender diverse (TGD) adults experience disability at twice the rate of cisgender (non-TGD) adults in the US. TGD people of color and low-income TGD people experience intersecting discriminatio...
BACKGROUND: Transgender and gender diverse (TGD) adults experience disability at twice the rate of cisgender (non-TGD) adults in the US. TGD people of color and low-income TGD people experience intersecting discrimination that may compound chronic conditions and disability. To our knowledge, no research has focused on chronic conditions among TGD Medicare beneficiaries with disabilities. OBJECTIVE: We compared the probability of chronic conditions among TGD adults with disability-based eligibility for Medicare across race, ethnicity, and dual Medicaid-Medicare enrollment. METHODS: We used cross-sectional Medicare enrollment and claims data between 2008 and 2017 for fee-for-service beneficiaries eligible based on disability. We applied a claims-based algorithm to identify TGD beneficiaries. We assessed differences in beneficiaries' age-adjusted predicted probability of chronic conditions across race, ethnicity, and dual eligibility. RESULTS: Dual-eligible TGD beneficiaries (N = 8041) had a higher predicted probability of nine out of ten health condition categories relative to Medicare-only TGD beneficiaries (N = 6237). For each race and ethnicity category, the most prevalent condition categories were mental health, cardiovascular conditions, and non-cardiovascular-related physical health conditions. Hispanic and non-Hispanic Black TGD beneficiaries had over two and three times the probability of infectious disease as non-Hispanic White TGD beneficiaries, respectively. CONCLUSIONS: TGD adults with disabilities have high rates of chronic conditions with additional disparities by race, ethnicity, and dual eligibility status. Our findings offer potential directions for mixed-methods and intervention research aimed at identifying and ameliorating the drivers of these disparities among TGD Medicare beneficiaries with disabilities.
Needs beyond coverage: Health care inequities among children with disabilities of parents with disabilities.
Pu C, Shih SF, Chou YJ
Disabil Health J · 2025 Apr · PMID 39694784 · Publisher ↗
BACKGROUND: Family aggregation of disability is not uncommon. Research on children with disabilities has often overlooked a specific group facing health disparities: children with disabilities of parents with disabilitie...
BACKGROUND: Family aggregation of disability is not uncommon. Research on children with disabilities has often overlooked a specific group facing health disparities: children with disabilities of parents with disabilities. OBJECTIVE: To determine whether children with disabilities, whose parents also have disabilities, experience limited access to health care. METHODS: This is a dynamic cohort study. The data used in this study were the 2017-2021 Taiwan's National Disability Registry and the National Health Insurance claims data. All children were matched to their biological fathers and mothers using a unique anonymous identification number to identify the disability status of the children and their parents and the receipt of health care services by the children. RESULTS: In 2021, a total of 2 834 870 pairs of children and parents were identified, of whom 53,419 were children with disabilities. Of these, 5188 had at least one parent with disabilities. Compared with children whose parents did not have disabilities, those whose parents both had disabilities had 1.71 fewer outpatient visits per year (P = .013). Compared with children whose parents had no disabilities, those whose parents had disabilities had 5.0 and 4.2 fewer general outpatient visits at birth (P < .001) and at the age of 2 years (P < .001), respectively. The magnitude of this effect decreased as the children's age increased. CONCLUSIONS: Children with disabilities whose parents also have disabilities may underutilize health care even in settings such as Taiwan, where universal health coverage is available. Standard health programs do not eliminate health care utilization disparities for such children.
The adaptation of the GameSquad exergaming intervention for young adults with Down syndrome: A pilot feasibility study.
Suire K, Helsel BC, Bowling A … +4 more , Staiano AE, Sherman JR, Rice A, Ptomey LT
Disabil Health J · 2025 Apr · PMID 39668064 · Full text
BACKGROUND: Exergames may be a feasible alternative to in-person exercise that is adaptable for adults with Down Syndrome (DS). OBJECTIVE: The purpose of this study was to conduct a 12-week pilot trial to assess the feas...
BACKGROUND: Exergames may be a feasible alternative to in-person exercise that is adaptable for adults with Down Syndrome (DS). OBJECTIVE: The purpose of this study was to conduct a 12-week pilot trial to assess the feasibility of exergames for adults with DS. METHODS: Adults with DS were provided Ring Fit Adventure™ which uses a resistance ring and body weight to perform cardiovascular and strength exercises. Participants were instructed to play Ring Fit Adventure™ for 120 min/week and attend 30-min weekly virtual coaching sessions where a health educator encouraged gameplay via goal setting, helped troubleshoot technological issues, and collected self-reported minutes of gameplay. Intervention outcomes included attendance, adherence to weekly gameplay goals, retention, safety, and exercise intensity captured via heart rate and indirect calorimetry. RESULTS: Twenty adults with DS (age 23.5 years, 89 % non-Hispanic white, 61 % female) enrolled and 19 participants completed the trial. Participants attended 93 % of coaching sessions and 90 % met the weekly gameplay goals. The average gameplay duration was 39 min/session and 123 min/week at 67.3 % of the participants' estimated maximum heart rate. Both the average heart rate during the intervention and metabolic equivalents (3.4 ± 1.0) during the indirect calorimetry assessment were suggestive of moderate intensity exercise. CONCLUSIONS: Attendance and adherence to the weekly gameplay goal were high among adults with DS who were able to reach and sustain moderate intensity during the exergame sessions. Exergaming represents a home-based option for accumulating minutes of moderate-to-vigorous physical activity that is feasible for and acceptable to adults with DS.
Social validity of Research Ethics for All: Social-behavioral research ethics education for community research partners with developmental disabilities.
Schwartz AE, McDonald K, Research Ethics for All Consortium
Disabil Health J · 2025 Apr · PMID 39658478 · Publisher ↗
BACKGROUND: Training in research ethics supports community research partners with developmental disabilities to take on additional research responsibilities. We worked with an academic-community partnership to develop an...
BACKGROUND: Training in research ethics supports community research partners with developmental disabilities to take on additional research responsibilities. We worked with an academic-community partnership to develop an accessible research ethics training tailored to the roles of community research partners with developmental disabilities that leads to certification: Research Ethics for All. OBJECTIVE: We evaluated the social validity of the educational activities and certification process. METHODS: We shared the training via a webinar and gathered feedback from attendees using polls (138 attendees; 92 respondents). In addition, four research teams composed of academic researchers and community research partners with developmental disabilities completed Research Ethics for All. Teams provided feedback on a series of surveys as they prepared to use the training, completed each of the 5 learning units, and after completing the training. We calculated descriptive statistics and used a pragmatic content analysis approach to analyze open-ended data. RESULTS: Teams were satisfied with the training and felt it supported learning. They endorsed the videos and learning activities but thought videos should be shorter. 68.5% of webinar attendees felt that Research Ethics for All covers essential information in social-behavioral research ethics. Several IRBs have approved the use of Research Ethics for All. CONCLUSIONS: Research Ethics for All is an acceptable research ethics training that may support community research partners with developmental disabilities to take on important research responsibilities in social-behavioral research.
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