Disability and Health Journal最新文献

{"title":"Applying NLP methods to code functional performance in electronic health records using the international classification of functioning, disability, and health.","authors":"Elizabeth Marfeo, Maryanne Sacco, Jona Camacho Maldonado, Kathleen Coale, Rafael Jimenez Silva, Rebecca Parks, Elizabeth K Rasch","doi":"10.1016/j.dhjo.2025.101888","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101888","url":null,"abstract":"<p><strong>Background: </strong>Clinical records often provide information on a person's functioning (activities), reflecting their lived experience of health. Automated extraction using clinical natural language processing (cNLP) can assist providers with clinical decision-making, treatment planning, predicting health outcomes, and informing health care policy.</p><p><strong>Objective: </strong>We aim to (1) describe the applicability of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to development of cNLP tools, (2) identify key challenges in application of the ICF, and (3) offer recommendations to improve this process.</p><p><strong>Methods: </strong>Apply the ICF as a framework to manually annotate free-text electronic health records (EHRs) from the United States (US) Social Security Administration (SSA) and the National Institutes of Health (NIH) Clinical Center using cNLP tools for each activity domain of the ICF.</p><p><strong>Results: </strong>Conceptual and content issues were encountered within four primary domains: Mobility, Self-Care and Domestic Life, Interpersonal Interactions and Relationships, and Communication and Cognition. Subsequent recommendations for ICF updates were provided.</p><p><strong>Conclusion: </strong>Overall, the ICF performed well applied to a use case for which it was not originally developed (SSA disability determination), which assessed its effectiveness, and highlighted both strengths and weaknesses between ICF conceptualizations and documented real-world functioning observations. This work provides a foundation upon which to improve the ICF and integrate it with cNLP models in order to give clinicians, researchers, and policy makers robust informatics tools that quickly identify functioning information for clinical decision and policy making purposes.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101888"},"PeriodicalIF":3.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183673","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 founding Editor's reflections.","authors":"Margaret A Turk","doi":"10.1016/j.dhjo.2025.101885","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101885","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101885"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144039","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":"Federal policy at a crossroads-Safeguarding the rights and well-being of people with disabilities.","authors":"Monika Mitra, Michael McKee, Margaret A Turk","doi":"10.1016/j.dhjo.2025.101887","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101887","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101887"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175425","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":"Community living policy: Progress, uncertainty, and research to inform paths forward.","authors":"Joseph Caldwell, Ari Ne'eman","doi":"10.1016/j.dhjo.2025.101886","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101886","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101886"},"PeriodicalIF":3.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144046","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":"Income effects on travel mode choices among people with and without disabilities: Operationalizing the capability approach.","authors":"Jaekyeong Kwon","doi":"10.1016/j.dhjo.2025.101850","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101850","url":null,"abstract":"<p><strong>Background: </strong>Income helps low-income individuals reduce their reliance on transit and walking and increase car travel. People with disabilities might face challenges in improving their private vehicle access due to disability-related extra costs.</p><p><strong>Objective: </strong>This study examines whether income has different impacts on travel mode choice based on disability status, disability type, and level of activity limitations.</p><p><strong>Methods: </strong>This study used time diary data from the nationally representative American Time Use Survey to estimate the differences in income effects on the likelihood of using public transit, walking, and traveling in private vehicles as drivers or as passengers between working-age adults with and without disabilities. Confounding variables included socioeconomic, demographic, household, and geographic characteristics.</p><p><strong>Results: </strong>Income was associated with a three-percentage-point (95 % CI: 0, 6) higher likelihood of using private vehicles as passengers for people with disabilities. In addition, people with vision disability were 10 percentage points (95 % CI: 4, 16) more likely to travel as passengers when they had more income. In contrast, people without disabilities were equally likely to travel as passengers regardless of income. Whereas people without disabilities were 10 percentage points (95 % CI: 8, 11) more likely to drive when they had more income, income was not associated with a higher likelihood of driving for people with activity-limiting disability.</p><p><strong>Conclusions: </strong>Income effectively expands transportation options for people with disabilities beyond transit and walking. Personal care assistant programs with high reimbursement rates can ease the financial burden of people with disabilities who pay others to travel as passengers.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101850"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163378","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":"Exploring yoga attitudes and social influences among mothers of autistic children through the theory of planned behavior.","authors":"Gayatri Swarup, Susan Andreae, Kristen Pickett, Luis Columna","doi":"10.1016/j.dhjo.2025.101852","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101852","url":null,"abstract":"<p><strong>Background: </strong>Mothers of autistic children face physiological and psychological health concerns and encounter significant barriers to engaging in health-enhancing behaviors. While yoga may improve physical and emotional well-being in parents with children with disabilities, research on yoga programs designed specifically for mothers of autistic children remains limited. Developing accessible and motivating yoga interventions requires an understanding of attitudes toward yoga within this population.</p><p><strong>Objective: </strong>The purpose of this study was to explore the attitudes of mothers of autistic children toward yoga and investigate how yoga was perceived within their social environment.</p><p><strong>Methods: </strong>The Theory of Planned Behavior guided this descriptive-qualitative study, in which participants were mothers (N = 12) of autistic children aged 3-22 years. Data were collected through semi-structured interviews, transcribed verbatim, and analyzed using line-by-line thematic analysis.</p><p><strong>Results: </strong>Three major themes were constructed: (1) Positive beginnings with yoga; (2) Yoga's impact on holistic well-being; and (3) Influence of social circles on yoga attitudes.</p><p><strong>Conclusions: </strong>Mothers expressed positive attitudes towards yoga, influenced by their past experiences and perceived benefits. Yoga was positively regarded within mothers' social networks, which reinforced their attitudes. Despite positive attitudes and supportive subjective norms, most mothers were not actively practicing yoga. This suggests the need to explore potential barriers, which may restrict mothers' participation in yoga.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101852"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129187","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":"Examine a factor structure for the World Health Organization quality of life measure among adults with ADL limitations in underserved neighborhoods in the United States.","authors":"Rie Suzuki, Woojong Kim, Shan Parker, Michelle A Meade","doi":"10.1016/j.dhjo.2025.101853","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101853","url":null,"abstract":"<p><strong>Background: </strong>The extent of the impact of Activity of daily living (ADL) limitations on Quality of Life is well documented. However, the validity of the World Health Organization's Quality of Life-BREF (WHOQOL-BREF) rarely focuses of residents living in underserved settings and on minority inclusion.</p><p><strong>Objective: </strong>to examine the structural validity of WHOQOL-BREF among adults with long-term ADL limitations residing in underserved communities.</p><p><strong>Methods: </strong>A cross-sectional survey of patients from underserved communities in the Midwestern United States was conducted between March 2019 and February 2021. Inclusion criteria included a minimum age of 19 years, ADL limitations for more than 5 years, English proficiency, and residence in the targeted zip code areas. A confirmatory factor analysis was conducted to determine the factor structure of the WHOQOL-BREF. The International Statistical Classification of Diseases and Related Health Problems 10 was used to identify individuals with ADL limitations.</p><p><strong>Results: </strong>A total of 290 people met the criteria. Four latent factors were extracted. However, compared to the original conceptual relationships between variables and latent factors, Physical health to leisure activities, social relationships to self-satisfaction, and environmental health to acceptance of body appearance were additional leadings beyond their conceptual group. This CFA final model fit the data well (ꭓ2 (df = 228) = 320.30, p < 0.001; RMSEA = 0.06; CFI = 0.95; TLI = 0.94).</p><p><strong>Conclusions: </strong>These findings underscored the need for accessible environments in their communities. In addition, supportive intra- and interpersonal relationships are needed to improve the QOL for adults with long-term ADL limitations.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101853"},"PeriodicalIF":3.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120211","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":"Use of the International Classification of Functioning, Disability and Health (ICF) in integrated care for people with disabilities: A scoping review using the SELFIE framework.","authors":"Hye-Jin Kim, Bokyoung Choi, Eunhee Choi, Haesong Kim, Soong-Nang Jang, Jae-Young Lim, Kim Bulkeley, Jennifer Smith-Merry","doi":"10.1016/j.dhjo.2025.101854","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101854","url":null,"abstract":"<p><strong>Background: </strong>Integrated care addresses system fragmentation, especially for people with disabilities who require support across multiple domains. Most models focus on healthcare, overlooking social and environmental factors that hinder health management for people with disabilities. The International Classification of Functioning, Disability and Health (ICF)'s biopsychosocial approach integrates these broader factors, but its application in integrated care remains underexplored.</p><p><strong>Objective: </strong>This scoping review aimed to explore the application of the ICF in research on integrated care, informed by the SELFIE framework, within the context of disability.</p><p><strong>Methods: </strong>Following Joanna Briggs Institute's guidance and the PRISMA extension for scoping reviews, seven databases were searched from January 2011 to September 2023. Independent screening, selection, and data extraction were performed, with key findings related to integrated care identified deductively using the SELFIE framework.</p><p><strong>Results: </strong>Twenty-six studies were included. These focused on populations with visual impairments, hearing loss, intellectual or developmental disabilities, spinal cord injuries, brain injuries, physical and learning disabilities, psychological impairment, and wheelchair users. Most studies applied the ICF as a conceptual framework rather than a coding system. Key elements of integrated care, such as holistic assessment, service delivery, leadership, governance, and workforce, were emphasized, while components like financing, technology, and research received limited attention.</p><p><strong>Conclusions: </strong>Traditional integrated care models, focusing on disease management, fall short for people with disabilities, who have diverse, often cross-system needs and social barriers. This review highlights the importance of integrating the context of disability, with the ICF's biopsychosocial model playing a crucial role in addressing environmental factors impacting body functions, activities, and participation.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101854"},"PeriodicalIF":3.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120379","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":"Cancer inequalities experienced by people with disability: a systematic review.","authors":"Yi Yang, Nina Afshar, Joanna Butchart, Alex Sully, Rebecca J Bergin, Anne Kavanagh, George Disney","doi":"10.1016/j.dhjo.2025.101851","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101851","url":null,"abstract":"<p><strong>Background: </strong>People with disability experience worse cancer outcomes than people without disability. One potential pathway is through low screening participation leading to delayed cancer diagnosis and late disease presentation.</p><p><strong>Objective: </strong>To summarise and evaluate evidence quantifying disability-related inequalities in (1) cancer mortality, (2) fatality among cancer patients; and for cervical, breast, colorectal and lung cancers: (3) screening participation and (4) stage at diagnosis.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, PsycInfo and Scopus up to November 2023 for studies that quantified disability-related inequalities in the four outcomes. Studies were evaluated using the Risk Of Bias In Non-randomized Studies - of Exposures tool.</p><p><strong>Results: </strong>We found 73 eligible articles globally. People with disability had higher cancer mortality compared to those without. This inequality was most pronounced among people with intellectual disability. Evidence showed substantially higher fatality among cancer patients with disability compared to those without consistently across disability groups and cancer types. Screening uptake for breast, cervical and colorectal cancers was consistently lower for people with various disability types in multiple countries. Evidence regarding inequalities in stage at diagnosis for people with disability was limited and inconsistent. The main methodological challenges for future research are: complexity in defining disability, underestimation of inequalities due to over-adjustment of mediating factors, under-representation of people with severe disability in data, and reporting inequalities on relative scales only.</p><p><strong>Conclusions: </strong>Existing evidence reinforces the need for high-quality cancer inequality research for this population, and a multi-pronged, inclusive approach to prioritise people with disability in the whole cancer control pathway.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101851"},"PeriodicalIF":3.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121453","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 educational accommodation needs and mental health outcomes in adults with disabilities: A machine learning approach.","authors":"Bryan R Christ, Lucie Adams, Benjamin Ertman, Paul B Perrin","doi":"10.1016/j.dhjo.2025.101849","DOIUrl":"https://doi.org/10.1016/j.dhjo.2025.101849","url":null,"abstract":"<p><strong>Background: </strong>No research has yet determined exactly what accommodation needs are unmet for disabled students and how those needs being unmet predict psychosocial outcomes many years later.</p><p><strong>Objective: </strong>To address this research gap, we seek to explore the potentially long-term associations of unmet educational accommodation needs and demographic characteristics with the mental health of adults with disabilities (n = 409).</p><p><strong>Methods: </strong>To explore these associations, we use modern the machine learning technique of Random Forest feature importance.</p><p><strong>Results: </strong>While 52.3 % of the sample reported having had one or more unmet accommodation needs while going to school, 57.2 % displayed current clinically elevated symptoms of depression and 48.4 % clinically elevated symptoms of anxiety. The machine learning approaches had 65.9 % and 60.0 % accuracy in correctly classifying clinically elevated depression and anxiety symptoms, respectively. For the models predicting clinically elevated depression symptoms using mean decrease in impurity (MDI) and permutation importance, unmet accommodation needs ranked fifth and fourth, respectively, in feature importance after age, disability severity, high school GPA, and individual income (for MDI). For the MDI model predicting clinically elevated anxiety symptoms, unmet academic accommodation ranked third in feature importance behind disability severity and age, while for permutation importance, unmet academic accommodation need ranked fourth behind age, urbanicity, and disability severity.</p><p><strong>Conclusion: </strong>Unmet academic accommodations may result in reduced psychological adjustment and quality of life potentially many years into adulthood.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"101849"},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086607","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}