Environmental Modifications for People With Intellectual and Developmental Disabilities: A Policy Analysis of Medicaid Home- and Community-Based Services.

Importance: Environmental modifications are targets for occupational therapy intervention because they support activities of daily living, self-efficacy, personal control, independence, and community living for people with intellectual and developmental disabilities (IDDs).

Objective: To examine how environmental modifications were provided to people with IDDs through Medicaid home- and community-based services (HCBS) waivers across the United States in fiscal year (FY) 2021.

Design: Using a mixed-methods policy analysis, we examined FY 2021 Medicaid HCBS 1915(c) waivers from across the United States to examine whether, and how, states provided environmental modifications to people with IDDs.

Developing Client Self-Advocacy in Occupational Therapy: Are We Practicing What We Preach?

Background: Developing client self-advocacy is in occupational therapy's (OT) scope of practice; however, there is limited understanding of if, or how, occupational therapists learn about self-advocacy interventions as well as implement self-advocacy into clinical practice.

Objective: This study sought to identify if and how therapists learn about self-advocacy intervention approaches and identify if and how therapists implement self-advocacy into their work with clients.

Method: A survey was distributed via email to academic and professional listservs in the United States, and data were collected using REDCap survey software.

'Not seeing people as capable': Disability professionals' mis/understandings of ableism.

Background: Knowledge about how disability professionals understand ableism may provide insight into the production of inequalities. The aim of this study was to examine how disability professionals understand ableism.

Methods: We asked 347 disability professionals, all of whom worked with people with intellectual and developmental disabilities, among other populations, to define ableism and then analysed those definitions using content analysis.

People with Disabilities' Access to Medical Care During the COVID-19 Pandemic.

Delaying and forgoing medical care intensifies the health disparities and unmet needs people with disabilities already face. While many people with disabilities were at high risk for COVID-19, less is known about their access to medical care during the pandemic. This study explored people with disabilities' access to medical care during the COVID-19 pandemic.

Early Career Occupational Therapists' Experiences during the COVID-19 Pandemic.

Occupational therapists entering the clinical workforce during the COVID-19 pandemic experienced levels of uncertainty and stress. This study's aim was to explore the clinical experiences and concerns of early-career occupational therapists entering the workforce during the COVID-19 pandemic ( = 27). We administered an open-ended online survey and analyzed the data using inductive thematic analysis.

Telehealth Use By Persons with Disabilities During the COVID-19 Pandemic.

Telehealth use rapidly expanded during the COVID-19 pandemic. Understanding if, and how, persons with disabilities (PWDS) used telehealth during the pandemic is vital to assuring that this evolving and increasingly common form of health care is equitably developed and delivered to avoid reproducing the health disparities PWDS already face. Our aim was to explore the use of telehealth among PWDS during the pandemic.

Disability Studies and Occupational Therapy: Renewing the Call for Change.

Disability studies (DS) is an interdisciplinary field grounded in a minority studies philosophy that approaches disability as a socially constructed phenomenon. The first special issue of the American Journal of Occupational Therapy on DS was published in 2005. The present issue serves as a follow-up to highlight opportunities for and examples of DS integration into occupational therapy education, research, and practice.

"A Legitimate Place in the Profession": Author Reflections on the 2005 Disability Studies Special Issue.

Importance: In 2005, the American Journal of Occupational Therapy published a special issue focused on disability studies. Contributing authors challenged readers to reflect on their practices and recommended ways to change the field, yet literature on the current state of the integration of disability studies into occupational therapy is scarce.

Objective: To engage the original authors of the 2005 special issue in an examination of perspectives on how disability studies perspectives have contributed to changes within occupational therapy and what work remains.

Recognizing Inequity: A Critical Step of Health Literacy for People With Disability.

Importance: Receiving accommodations may require a person with physical disability (PWPD) to recognize and address disparate care when it occurs.

Objective: To explore whether PWPDs recognize disparate health care and how their experiences contribute to the development of strategies to access care.

Design: In this qualitative study, we used grounded theory methods to explore perceptions of PWPDs regarding access to health care.

Impact of Occupational Therapy Education on Students' Disability Attitudes: A Longitudinal Study.

Importance: Discrimination based on disability-ableism-is pervasive and affects the opportunities of people with disabilities to fully engage in society.

Objective: The aim of this study was to explore the impact of occupational therapy graduate education on students' explicit and implicit disability attitudes throughout their graduate education.

Design: Longitudinal observational study, measuring occupational therapy students' attitudes on an annual basis.

Explicit and implicit disability attitudes of occupational and physical therapy assistants.

Background: Reduction of explicit and implicit bias in healthcare providers is a critical issue faced by our society in moving toward more equitable and culturally appropriate health and rehabilitation care. Because resources for OT and PT services are limited and shortages in these professions exist, direct care provision by occupational and physical therapist assistants (OTA/PTA) is on the rise and valued in comprehensive rehabilitation practice. It is important to consider attitudes and biases of OTA/PTA, as they are directly involved in provision of rehabilitation services for people with disabilities.

Anti-Fat Biases of Occupational and Physical Therapy Assistants.

Fat people are highly stigmatized, and anti-fat bias is pervasive resulting in stigma, prejudice, and discrimination, including in health care. The aim of this study was to explore occupational and physical therapy assistants' anti-fat biases. We analyzed secondary weight implicit association tests from 5,671 occupational/physical therapy assistants.

Explicit and implicit disability attitudes of healthcare providers.

Purpose/objective: Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers' clinical decision making, less research has focused on providers' attitudes about disability. The aim of this study was to examine providers' explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias.

ScreenABLE: Breast Cancer Screening among Women with Disabilities from Community Identified Challenges to Community-Based Programs.

Background: Women with disabilities are an unrecognized cancer disparities population who experience well-documented barriers to breast cancer screening. There is a critical need for targeted, community-directed programing to address these disparities.

Objectives: To describe the trajectory of a long-term community-academic partnership aimed at understanding and addressing breast cancer screening disparities among women with disabilities.

Our Peers-Empowerment and Navigational Support (OP-ENS): Development of a Peer Health Navigator Intervention to Support Medicaid Beneficiaries With Physical Disabilities.

People with disabilities (PWD) are a health disparities population who experience well-documented physical, structural, attitudinal, and financial barriers to health care. The disability rights community is deeply engaged in advocacy to promote health care justice for all PWD. As the community continues to work toward systems change, there is a critical need for community-directed interventions that ensure individuals with disabilities are able to access the health care services they need and are entitled to.

Relationships between occupational therapy students' understandings of disability and disability attitudes.

Entering occupational therapy (OT) students have established beliefs, informed by sociocultural backgrounds. Understanding how students define and understand disability, and the relationships these understandings have to disability bias, can guide curriculum design decisions to integrate meso and macro level perspectives of disability into clinical reasoning. This study's aim was to explore incoming occupational therapy students' ( = 67) understandings of disability and their attitudes towards it.

"The Bigger Picture": Occupational Therapy Practitioners' Perspectives on Disability Studies.

Objective: This qualitative study explored occupational therapy practitioners' perspectives about integrating principles from the field of disability studies (DS) into clinical education and practice.

Methods: After a conference presentation about DS, three simultaneous focus groups were conducted with 27 occupational therapy practitioners. A constant comparative, grounded-theory approach was used to identify themes across groups.

The relationship between disability prejudice and medicaid home and community-based services spending.

Background: Medicaid is one of the most important health care safety nets for people with disabilities in the United States. Yet, from the beginning Medicaid only covered long-term services and supports (LTSS) through institutional care. In 1981 changes to Medicaid allowed states to provide home and community-based services (HCBS) instead so people with disabilities could receive LTSS in their own homes or in the community.

The impact of people with disabilities choosing their services on quality of life outcomes.

Background: In recognition of the importance of services and supports that are defined and chosen by the recipient with disabilities, there has been a shift toward person-centered services. Quality person-centered services not only aim to ensure people have control over their own lives, but also to improve individually defined outcomes.

Objective: The aim of this study was to explore the relationships between people with disabilities (PWD) choosing their services and their quality of life (QOL).

Occupational Therapy in Medicaid Home and Community-Based Services Waivers.

Objective: Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015.

Method: Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization.