Disability and Health Journal最新文献

{"title":"Accessibility and utilisation of reproductive healthcare services among women with disabilities in Lithuania: Insights from a mixed-methods study.","authors":"Ugnė Grigaitė, Simona Aginskaitė, Rokas Uscila","doi":"10.1016/j.dhjo.2025.101928","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101928","url":null,"abstract":"<p><strong>Background: </strong>Women with disabilities worldwide face barriers to reproductive healthcare, including accessibility challenges and negative attitudes from medical professionals. These issues reflect multiple intersecting forms of discrimination.</p><p><strong>Objective: </strong>This study aims to examine how women with various disabilities in Lithuania access reproductive healthcare services, evaluate their experiences with these services, and explore the related attitudes of clinicians.</p><p><strong>Methods: </strong>This cross-sectional study employs a mixed-methods convergent design. Quantitative and qualitative data were collected through an online survey (n = 154) and two focus groups with medical professionals (n = 12). Statistical and thematic analyses were performed using SPSS and MAXQDA.</p><p><strong>Results: </strong>Over half of the women rated their reproductive healthcare experiences as average to very bad. Issues spanned preventive, general, pregnancy, labour, childbirth, and postpartum care. Participants with hearing, mobility, physical disabilities, and autism reported more issues, often citing inaccessible infrastructure, lack of Sign language interpretation, written consultations, or Easy-to-Read materials. Intellectual disabilities were also associated with reports of negative attitudes from medical professionals, highlighting widespread communication and support inadequacies.</p><p><strong>Conclusions: </strong>Improving reproductive healthcare for women with disabilities in Lithuania and globally requires educating medical professionals on the human rights-based model of disability and accessibility. Implementing individual accommodations in healthcare is essential and should involve medical staff, administrators, and policymakers. Ensuring access to sex education for women with disabilities and addressing societal stereotypes about their sexuality and motherhood are also vital. Further research with larger sample sizes is needed to evaluate and enhance the accessibility and quality of reproductive healthcare services for women with disabilities.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101928"},"PeriodicalIF":3.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental barriers to participation for people with spinal cord injury. The case of Ecuador.","authors":"Ana Oña, Andrea Pacheco Barzallo, Jaime Toaquiza, Diana Pacheco Barzallo","doi":"10.1016/j.dhjo.2025.101929","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101929","url":null,"abstract":"<p><p>This study assesses the environmental barriers faced by people with spinal cord injury (SCI) in Ecuador. Using cross-sectional data from the International Spinal Cord Injury Survey (InSCI), we analyzed responses from 510 participants across 23 provinces. We calculated the total environmental barrier index using the Nottwil Environmental Factor Inventory (NEFI) and applied regression analysis to identify key influencing factors. We also examined the severity of barriers by region, comparing rural and urban areas. Our findings reveal significant disparities. Individuals with lower incomes, those with tetraplegia, and those without a partner reported higher levels of environmental barriers. Rural residents were disproportionately affected. While both urban and rural participants cited long-distance travel and limited public access as top barriers, finances ranked higher in urban settings, whereas home access was more critical in rural areas. This is the first national study to map modifiable environmental barriers for people with SCI in Ecuador. The results point to clear spatial and economic inequalities, highlighting the need for targeted policies that improve public infrastructure to promote social inclusion.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101929"},"PeriodicalIF":3.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment is associated with manual ability in adults with cerebral palsy - a population-based study.","authors":"Jenny Hedberg-Graff, Elisabet Rodby-Bousquet, Anna Lindgren, Evgenia Manousaki, Erika Cloodt, Katina Pettersson","doi":"10.1016/j.dhjo.2025.101926","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101926","url":null,"abstract":"<p><strong>Background: </strong>Employment rates are lower in adults with cerebral palsy (CP). Even though reduced manual ability is associated with limitations in daily activities, it is unclear whether employment rates are associated with manual ability in adults with CP.</p><p><strong>Objective: </strong>To analyze regular employment and employment rates (hours/week) in adults with CP and estimate their associations with manual ability relative to age and sex.</p><p><strong>Methods: </strong>This was a cross-sectional study of adults with CP, aged 20-64 years, from the combined Swedish CP follow-up program and registry. Manual ability was classified as levels I-V using the Manual Ability Classification System (MACS). Logistic regression analysis was used.</p><p><strong>Results: </strong>The study included 2304 adults with CP (1271 men; median age 28 years, interquartile range 20-64 years). Fewer than one in five (19 %) were employed, and about half (52 %) of these worked full time. The probability of employment in adults with MACS level II was almost half that of those with level I (OR 0.44; 95 % CI 0.34-0.57) and decreased with each MACS level to OR 0.01 (95 % CI 0.00-0.03) for MACS V. Limited manual ability was associated with a lower probability of working full time: ORs of 0.46 (95 % CI 0.30-0.72) for MACS II and 0.29 (95 % CI 0.16-0.56) for MACS III-V.</p><p><strong>Conclusion: </strong>Limited manual ability in adults with CP impacts both their likelihood of employment and employment rate. Greater manual ability is associated with a higher probability of regular employment and working full time.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101926"},"PeriodicalIF":3.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing the relationship between ableist microaggressions and well-being in a cross-sectional sample of adults with varied disabilities.","authors":"Whitney M Morean, Abigail Hayden, Angela Maccarrone, Jacob A Bentley","doi":"10.1016/j.dhjo.2025.101925","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101925","url":null,"abstract":"<p><strong>Background: </strong>In prior research ableist microaggressions have correlated with higher measures of psychological distress. However, research has not yet examined the relationship between ableist microaggressions and well-being as measured not merely by the absence of distressing mental health symptoms, but rather about effective functioning and flourishing.</p><p><strong>Objective: </strong>The present study addressed this gap by analyzing the relationship between ableist microaggressions and well-being and assessing if different coping strategies moderate the relationship in a sample of adults with varied disabilities.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted with (n = 132) adults who self-identified as having a health condition that significantly impacts one or more major life activities. Participants were recruited online to complete a Qualtrics survey of measures of well-being, ableist microaggressions, coping, and depression symptoms.</p><p><strong>Results: </strong>Ableist microaggression scores did not significantly predict well-being. Depression scores and disability visibility predicted well-being. In planned exploratory post-hoc analyses, those who endorsed having a more visible disabilities reported experiencing statistically significant more ableist microaggressions and statistically significant higher well-being scores than those endorsing less visible disabilities.</p><p><strong>Conclusions: </strong>Consistent with prior literature, depression scores predicted lower well-being. Participants with more visible disabilities reported experiencing more ableist microaggressions and also endorsed higher well-being. This research supports that depression and well-being are independent constructs. Further research needs to examine factors such as, positive disability identity, connection to the disability community, and disability pride, that might contribute to why those with more visible disabilities experience more ableist microaggression while also endorsing higher levels of well-being.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101925"},"PeriodicalIF":3.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersecting disability and race implicit attitudes of health care professionals.","authors":"Carli Friedman","doi":"10.1016/j.dhjo.2025.101924","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101924","url":null,"abstract":"<p><strong>Background: </strong>Focusing on intersectionality is necessary not only to better understand how oppression impacts people, but also to reduce the harmful impacts of discrimination. While past research has separately found most health care professionals are implicitly (unconsciously) biased against disability, and implicitly biased against people of color, and some also self-report explicit (conscious) biases, to our knowledge, there is little to no research about health care professionals' intersectional attitudes. Yet, we do know that health care professionals' attitudes and biases impact the quality of care they provide and the outcomes of those they serve. Thus, it is critical to uncover more information about their explicit and implicit attitudes, especially intersectional attitudes.</p><p><strong>Objective: </strong>The aim of this study was to examine the intersecting disability and race attitudes of health care professionals.</p><p><strong>Methods: </strong>We had 784 health care professionals complete the Intersecting Disability and Race Attitudes Implicit Association Test (IDRA-IAT) and an explicit measure (January-March 2025).</p><p><strong>Results: </strong>Health care professionals implicitly preferred nondisabled white people (M = 0.18) the most, then disabled white people (M = 0.08), and then disabled (M = -0.12) and nondisabled people of color (M = -0.14) the least. There was a significant gap between participants' explicit and implicit attitudes, with self-report explicit attitudes showing an opposite pattern as implicit attitudes, suggesting health care professionals may be unaware of the scope of their implicit biases.</p><p><strong>Conclusions: </strong>Everyone deserves high quality healthcare; until we reduce health care professionals' biases, health equity will not be possible.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101924"},"PeriodicalIF":3.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A shared journey and a call for action for persons living with inherited retinal diseases.","authors":"Qin Xiang Ng, Hwei Wuen Chan, Gerald Choon Huat Koh","doi":"10.1016/j.dhjo.2025.101921","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101921","url":null,"abstract":"<p><p>Two recently published qualitative studies-conducted in Australia and Singapore-coincided with Rare Disease Day 2025, and they delved into the profound psychosocial impacts of inherited retinal diseases (IRDs) among working-age adults. Both studies independently identified similar themes related to identity disruption, social invisibility, emotional turbulence and the significant challenges of adapting to progressive vision loss. This serendipitous alignment highlights the universal challenges and struggles of IRD across distinct cultures, and the findings illuminate how IRDs transcend medical diagnoses, demanding coordinated psychosocial support and policy-level interventions. This commentary reflects upon the implications for healthcare and society at large, and urges a clarion call to action. Improving psychosocial support, enhancing public awareness and advocating for empathetic care models and inclusive policies for persons affected by IRDs are imperatives. In doing so, we can build more equitable systems that address the realities of IRDs and empower individuals to lead fulfilling lives despite their vision impairment.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101921"},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influences on bone mineral density among adults with mobility Limitations: Results from a national survey.","authors":"Joy Haizelden, Linda Knol, Lori Turner","doi":"10.1016/j.dhjo.2025.101923","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101923","url":null,"abstract":"<p><strong>Background: </strong>Risk factors for low bone mineral density (BMD) are widely recognized in the general population; however, influences on BMD in people with mobility limitations is not well understood.</p><p><strong>Objective: </strong>To examine factors that influence BMD in US adults with mobility limitations, including demographic, anthropometric, and physical activity measures.</p><p><strong>Methods: </strong>Cross-sectional analysis of NHANES 2013-2018 data, including 421 adults aged ≥20 years with self-reported walking difficulties. Risk factors for low bone mineral density were used including physical activity. Physical activity was assessed using the Global Physical Activity Questionnaire and recoded as meeting or not meeting the guidelines. Total BMD was measured with a dual-energy X-ray absorptiometry scan. Multiple linear regression was used to assess for differences in total BMD.</p><p><strong>Results: </strong>BMD was significantly higher for males versus females (p < .001), Non-Hispanic blacks versus Non-Hispanic whites (p = .004), individuals who were overweight or obese compared to a people with healthy weights (p = .02, p < .001, respectively). As age increased, BMD decreased. No significant difference in BMD was found between participants meeting physical activity guidelines (1.084 ± 0.012 g/cm²) and those who did not meet guidelines (1.076 ± 0.011 g/cm²; p = .99).</p><p><strong>Conclusion: </strong>In adults with mobility limitations, traditional demographic and anthropometric risk factors significantly influenced BMD. Calcium intake, vitamin D intake and physical activity guideline adherence were not significant. These findings suggest the need for targeted research to more fully understand bone health determinants in this population.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101923"},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet needs for long-term services and supports and associations with health outcomes","authors":"Joseph Caldwell,&nbsp;Elad Daniels,&nbsp;Kaitlin Stober","doi":"10.1016/j.dhjo.2024.101678","DOIUrl":"10.1016/j.dhjo.2024.101678","url":null,"abstract":"<div><h3>Background</h3><div>The availability of population-level data on unmet needs for long-term services and supports (LTSS) is limited at state and national levels. Data on unmet LTSS needs can improve our understanding of disparities and relationships with health outcomes.</div></div><div><h3>Objective</h3><div>1) Explore differences in unmet LTSS needs by socio-demographic characteristics, including age, sex, race/ethnicity, metropolitan status, sexual orientation, and socio-economic status; and 2) Examine associations between unmet LTSS needs and health/preventative healthcare outcomes.</div></div><div><h3>Methods</h3><div>We used the 2021 Behavioral Risk Factor Surveillance System (BRFSS) core survey and state-added LTSS questions to analyze a sample of adults with LTSS needs in Texas (N = 1232). We compared socio-demographic characteristics between adults with and without unmet LTSS needs. We conducted modified-Poisson regressions to estimate unadjusted and adjusted risk ratios (with 95 % confidence intervals) for each health/preventative healthcare outcome among adults with unmet LTSS needs. Health outcomes included health status, healthy days-physical health, healthy days-mental health, suicide ideation, and multiple chronic conditions. Preventative healthcare outcomes included routine check-up and flu vaccine.</div></div><div><h3>Results</h3><div>Among adults with LTSS needs, those with unmet LTSS needs were statistically significantly more likely to be younger (age&lt;65), female, higher educational attainment, and non-straight sexual orientation. After controlling for socio-demographic variables, having unmet needs for LTSS was significantly associated with poorer physical and mental health outcomes and suicide ideation.</div></div><div><h3>Conclusions</h3><div>Improved data collection on unmet needs LTSS can assist policymakers, particularly at the state level in guiding reforms to reduce disparities in access to home and community-based services (HCBS) and improve health outcomes.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 3","pages":"Article 101678"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transportation for people with intellectual and developmental disabilities in Home- and Community-Based Services","authors":"Carli Friedman","doi":"10.1016/j.dhjo.2024.101708","DOIUrl":"10.1016/j.dhjo.2024.101708","url":null,"abstract":"<div><h3>Background</h3><div>Transportation can help improve the health, quality of life, and community integration of people with intellectual and developmental disabilities (IDD). Yet, transportation is one of people with IDD's most common unmet needs.</div></div><div><h3>Objective</h3><div>The aim of this study was to examine if, and, how, states provide non-medical transportation to people with IDD in their Medicaid HCBS programs.</div></div><div><h3>Methods</h3><div>Using content analysis and descriptive statistics, this study analyzed fiscal year (FY) 2021 Medicaid HCBS 1915(c) waivers for people with IDD from across the nation to examine how they allocated transportation.</div></div><div><h3>Results</h3><div>In FY 2021, all 44 states and the District of Columbia with HCBS waivers for people with IDD provided transportation services. Transportation was included either by providing a stand-alone service that exclusively provided transportation, or by being embedded within another service. Transportation was embedded within 896 different HCBS services for people with IDD, most commonly within residential habilitation services (26.70 %), supported employment services (19.44 %), and day habilitation (18.44 %). Thirty-three states (73.33 %) also provided 145 different stand-alone transportation services in their programs for people with IDD, to increase community integration and help people gain access to waiver services. A total of $781.78 million of spending was projected for stand-alone transportation services for 261,109 people with IDD (30.32 % of waiver recipients).</div></div><div><h3>Conclusions</h3><div>HCBS waivers are an important resource for providing transportation for people with IDD. However, significant variation in how states do so may result in disparities or unmet needs.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 3","pages":"Article 101708"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the effects of home modifications on perceptions of exertion and safety among people with mobility disabilities","authors":"Kelsey S. Goddard ,&nbsp;Jean P. Hall ,&nbsp;Lillie Greiman ,&nbsp;Lyndsie M. Koon ,&nbsp;Randi C. Gray","doi":"10.1016/j.dhjo.2024.101590","DOIUrl":"10.1016/j.dhjo.2024.101590","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>The study utilized the Home Usability Program (HUP), which aims to improve accessibility, safety, and independence in participants' homes. Participants were recruited from four Centers for Independent Living (CILs) across the US and underwent a comprehensive assessment to identify consumer-directed, individualized home modifications. Surveys examining safety and exertion, in addition to qualitative interviews, were conducted to explore the impact of the intervention on participants’ energy levels and feelings of safety.</div></div><div><h3>Results</h3><div>Analysis of pre-post measures and participant interviews revealed that the HUP intervention resulted in decreased exertion. Decreased exertion had positive outcomes, including increased time for other activities, improved socialization, enhanced independence, and the potential for engaging in activities outside the home. Additionally, the HUP intervention led to increased safety, which positively affected mental well-being and independence.</div></div><div><h3>Conclusions</h3><div>Findings highlight the need for useable living environments that minimize physical strain and reduce exertion. Policy recommendations include prioritizing accessibility standards for housing, implementing individualized assessments for funding home modifications, providing financial assistance options, and allocating research funding for innovative solutions and technologies.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 3","pages":"Article 101590"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139877027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}