Rural disability, self-reliance, and the utilization of mental health services.

Background: The intersection of rurality, disability, self-reliance values, and utilization rates of mental health services (MHS) is under-researched.

Objective: To better understand the differences between unmet need and no perceived need for MHS between noncore, micropolitan, and metropolitan adults with disabilities.

Methods: We conducted logistic regression analyses of the 2022 National Survey on Health and Disability (NSHD) to identify associations between demographic characteristics and odds of reporting unmet need for MHS or no perceived need for MHS.

"Too few, too far away, for what is paid": Consumer voices about the personal assistance worker crisis.

Background: The growing gap between demand and supply of personal assistance service (PAS) workers presents a significant burden to those who use services. The intensity and duration of hardship is growing, and consumer voices need to be heard and incorporated into the national dialogue.

Objective: This paper explores how PAS worker shortages manifest themselves in the daily lives of people with disabilities using or needing PAS services in the United States.

The hidden crisis: Long COVID's association with housing stability and home accessibility among people with disabilities.

Background: The COVID-19 pandemic has given rise to the emerging phenomenon known as Long COVID, characterized by persistent symptoms long after the acute infection has passed. However, the relationship of Long COVID on housing stability and home accessibility remains underexplored.

Objective: This manuscript aims to comprehensively examine the association of Long COVID on housing stability and accessibility, identifying challenges faced by people with Long COVID and potential strategies to address them.

Participatory curriculum development for health and independent living for disabled people: a qualitative study of participant experiences.

Participatory curriculum development is an approach that draws on participatory research philosophy by engaging members of intended audiences in the curriculum development process. This is a fairly new approach to curriculum development, which has seldom been applied in health promotion and, to our knowledge, has not previously been used to develop curriculum with disabled people. In this project, participatory curriculum development was used to both develop a new curriculum and revise an existing curriculum for in-person, web-based delivery.

Examining the effects of home modifications on perceptions of exertion and safety among people with mobility disabilities.

Background: People with mobility disabilities often have reduced stamina and limited energy, making daily activities physically demanding. Home modifications, such as installing grab bars and optimizing the environment, have the potential to reduce exertion and enhance safety in the home, enabling individuals to participate more in other activities.

Objective: The purpose of this study was to evaluate the effects of a home modification intervention on perceptions of exertion and safety among people with mobility disabilities.

Hopefulness and meaning in adults with disabilities' physical activity: A qualitative study.

Purpose/objective: The body of knowledge regarding the processes involved in changing physical activity behaviors in people with disabilities is very limited. This qualitative study is a follow-up to a pilot study on an individualized health coaching intervention for adults with any type of disabilities, titled Health My Way, that used a disability-specific health-promotion curriculum. In the original study, we found that participants in the health coaching intervention experienced improved health-promoting behavior, notably physical activity.

Transportation Patterns of Adults With Travel-Limiting Disabilities in Rural and Urban America.

Introduction: Lack of transportation is a significant barrier to community participation for many disabled adults. Living in a rural area introduces additional transportation barriers, such as having to travel long distances to access services or socialize, and limited public transit options. While the importance of transportation access is clear, the mix of different transportation options used by people with disabilities to participate in their communities is less understood, particularly among those who do not or cannot drive.

Health Coaching for People With Disabilities: An Exploratory Mixed-Methods Study.

Purpose: To expand the reach of health-promotion efforts for people with disabilities, we piloted a health-coaching intervention with a disability-specific curriculum. We evaluated the intervention's effects on health-related quality of life and health behavior change.

Design: Mixed-methods research design using pre-post measures and semi-structured interviews.

Effects of an exercise intervention on participation reported by people with disabilities: A mixed methods randomized trial.

Background: Despite a long history of research on the benefits of exercise for people with mobility impairments, little is known about how exercise affects participation in their daily activities.

Objective: This randomized mixed-methods study examined the effects of participating in a structured community-based exercise program on pain, depression, fatigue, exertion and participation in daily activities.

Method: Study participants were recruited from a population-based sample of people who returned a survey (n = 800) and indicated they would be willing to participate in another study.

Reaching people with disabilities to learn about their experiences of social connection and loneliness.

Background: People with disabilities experience higher rates of social isolation and loneliness than people without disabilities, but there is limited information about how these conditions are manifested in people with specific types of disabilities.

Objectives: Using data collected as part of the second administration of the National Survey on Health and Disability (n = 2,132), our objectives were to determine if disability type and recruitment method added explanatory power to observed levels of social connectedness, after controlling for socio-demographic and environmental indicators.

Methods: We used hierarchical regression to evaluate how socio-demographic, disability, environmental, and recruitment type explained four outcome variables for different dimensions of social connectedness, including satisfaction with social activity, quantity of social connections, quality of social connections, and loneliness.

A usable home: A qualitative investigation of the relationship between home usability and community participation for people with disabilities.

Background: People with mobility disabilities frequently have unmet needs in their home environment, which can lead to difficulties completing daily living activities. Therefore, it is important that homes are not just accessible, but rather useable, meaning that the home complements an individual's functional, social, and psychological needs. Although previous research has shown the importance of home usability for people with mobility disabilities on health outcomes, this research explores the relationship between home usability and community participation both inside and outside the home.

Effects of a consumer driven home modification intervention on community participation for people with mobility disabilities.

Background: Community participation has become a key outcome measure for people with disabilities. This has resulted in a shift in researchers focus from the individual to the environment. However, research has focused primarily on participation barriers in the community with limited research examining the role of the home environment.

Is the presence of home entrance steps associated with community participation of people with mobility impairments?

Background: Little is known about how home entrances are related to community participation for people with mobility impairments.

Objective: This investigation explored how the need to navigate steps at the entrance of a home affects the community participation levels of people with mobility impairments.

Methods: This survey study used pre-measure data collected from three different samples.

Transitory and Enduring Disability Among Urban and Rural People.

Background: Disabilities are not evenly distributed across geography or age, yet few studies on disability have considered these factors. The purpose of this study was to explore rural-urban differences in disability rates, particularly related to gender and race, and what other rural-urban disparities help explain these differences.

Methods: Utilizing the 2008-2016 Current Population Survey (CPS), we first examined rural and urban disability trends by gender and race, estimating means and rural-urban percentage differences for men and women by race and conducting t test analysis to test group differences by age cohort (eg, comparing white, non-Hispanic, rural 15- to 24-year-old women to white, non-Hispanic, urban 15- to 24-year-old women).

Disability Items From the Current Population Survey (2008-2015) and Permanent Versus Temporary Disability Status.

Objectives: To examine longitudinal responses to the disability indicator questions that have been adopted as the standard across national surveys sponsored by the US Department of Health and Human Services.

Methods: Data from the Current Population Survey between 2008 and 2015 were linked to create a longitudinal sample of 721 178 individual respondents.

Results: Responses to the disability questions fluctuated significantly.

A comparative analysis of Center for Independent Living staff and board of directors regarding CIL services and consumer participation.

Community living of people with disabilities spans independent living and community engagement. Consumer choice and control of their level of community participation requires community accessibility, resources and supports. Some people with disabilities have difficulties procuring and maintaining these resources.

Can people catastrophize barriers? An exploratory analysis of the association between pain catastrophizing and perceptions of environmental factors.

Background: Measurement of the environment is taking on increased importance for understanding variability in participation. Most measures of the environment use subjective ratings, yet little is known about how people appraise the environment.

Objective: /Hypothesis: We conducted this post-hoc study to examine whether or not catastrophizing, an important variable for understanding how pain contributes to disability, may be related to ratings of the environment.

Participatory action research designs in applied disability and rehabilitation science: protecting against threats to social validity.

Researchers and disability advocates have been debating consumer involvement in disability and rehabilitation science since at least 1972. Despite the length of this debate, much confusion remains. Consumer involvement may represent a spirit of democracy or even empowerment, but as a tool of science, it is necessary to understand how to judge its application.

Disability and health behavior change.

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.

Nutrition education and support program for community-dwelling adults with intellectual disabilities.

To test the efficacy, acceptability, and appropriateness of a nutrition education and support program, 4 community-based group homes for adults with intellectual or developmental disabilities participated in a pilot intervention with extended baseline period and pre-post-test design. Adults (N = 32) with intellectual or developmental disabilities, 20 direct service staff, 4 managers of group homes, and 2 health specialists at private service providers participated in the intervention, consisting of a system of nutrition supports in nutrition education and guidelines, menu and meal planning, grocery shopping, and cooking designed for the special needs of this population. Positive impacts were found using the program, including fidelity measures, food systems changes and acceptability to users, planned and served foods, and cost changes associated with implementation.