Disability and Health Journal最新文献

{"title":"Community inclusion, participation and support for people with disabilities in Zambia: a qualitative study","authors":"Nathaniel Scherer ,&nbsp;Rhoda Chabaputa ,&nbsp;Tamara Chansa-Kabali ,&nbsp;Kofi Nseibo ,&nbsp;Judith McKenzie ,&nbsp;Martha Banda-Chalwe ,&nbsp;Tracey Smythe","doi":"10.1016/j.dhjo.2025.101839","DOIUrl":"10.1016/j.dhjo.2025.101839","url":null,"abstract":"<div><h3>Background</h3><div>Recent reports, including recommendations from the United Nations Committee on the Rights of Persons with Disabilities, have highlighted failings in disability inclusion in Zambia. A recent scoping review identified need for up-to-date evidence to inform disability-inclusive policy and practice.</div></div><div><h3>Objective</h3><div>To generate new evidence on community inclusion, participation and support for people with disabilities in Zambia.</div></div><div><h3>Methods</h3><div>In-depth interviews were held with 36 participants, including 16 adults with disabilities, 16 caregivers of a child with disabilities, and four key informants from government and civil society. Participants were recruited from three districts in Lusaka Province - Lusaka, Chongwe and Kafue. Participants were purposively sampled to maximise variation by sex, age, impairment type, district and locality (rural, urban, peri-urban). Data collection was completed in November 2022.</div></div><div><h3>Results</h3><div>Key themes from the study identified stigma and discrimination towards people with disabilities, the exclusion of people with disabilities from community life, limited available support and inadequate government action on disability inclusion. There were examples of positive action on disability support, such as the Social Cash Transfer, but implementation needed improvement. Disability-awareness campaigns are widely needed across government and communities, as is funding for organisations such as the Zambia Agency For Persons With Disabilities.</div></div><div><h3>Conclusions</h3><div>Action is needed to improve disability inclusion and implementation of the United Nations Convention on the Rights of Persons with Disabilities in Zambia. This includes appropriate funding, capacity-development and meaningful engagement with people with disabilities and their representative organisations.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101839"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040623","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 disparities in cervical cancer diagnosis at the intersection of disability and sexual orientation","authors":"Amarachukwu F. Orji ,&nbsp;Carolyn Drews-Botsch ,&nbsp;Rodman Turpin ,&nbsp;Gilbert Gimm ,&nbsp;Tarang Parekh","doi":"10.1016/j.dhjo.2025.101838","DOIUrl":"10.1016/j.dhjo.2025.101838","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer risk factors are more prevalent among women with disabilities and sexual minorities, yet little is known about how these factors intersect.</div></div><div><h3>Objective</h3><div>To examine differences in cervical cancer diagnosis at the intersection of disability and sexual orientation.</div></div><div><h3>Methods</h3><div>Using a nationally representative sample (N = 80,447) obtained from 2014 to 2023 National Health Interview Survey data, we conducted logistic regressions to estimate the odds of cervical cancer diagnosis at the intersection of disability and sexual orientation among women (25–65 years). We calculated three measures of interaction: 1) relative excess risk due to interaction (RERI); 2) proportion attributable to interaction (AP); and 3) synergy index (SI).</div></div><div><h3>Results</h3><div>Heterosexual women with disabilities were more likely to receive a diagnosis of cervical cancer (aOR = 2.15, 95 % CI: 1.75–2.64) compared to heterosexual women without disabilities. This disparity was even greater among women with disabilities who identified as sexual minorities (aOR = 2.98, 95 % CI: 1.86–4.77). The interaction measures suggest a synergistic effect between disability and sexual orientation on cervical cancer risk. Specifically, women with disabilities in multiple functional areas had increased odds of a cervical cancer diagnosis, regardless of sexual orientation (Heterosexual: aOR = 2.94, 95 % CI: 2.33–3.70; Sexual minorities: aOR = 3.04, 95 % CI: 1.25–7.42).</div></div><div><h3>Conclusion</h3><div>The findings suggest that disability status plays a significant role in exacerbating the risk of cervical cancer, while the combination of disability and minority sexual orientation may further compound adverse experiences that disproportionately contribute to this risk.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101838"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046664","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":"Inclusivity in Design: Integrating human-centered methodologies in disability research","authors":"Shanee Abouzaglo ,&nbsp;Devika Patel ,&nbsp;Thiru Annaswamy","doi":"10.1016/j.dhjo.2025.101840","DOIUrl":"10.1016/j.dhjo.2025.101840","url":null,"abstract":"<div><div><span>To achieve equity in health and research, the inclusion and active participation of people with disabilities (PWD) is critical. Our commentary posits that human-centered design (HCD) is essential in medical research's equity efforts. Eliciting issues from end-users directly and implementing an iterative problem-solving process, HCD is a framework well-suited to capture the </span>lived experiences of PWD, better understand their unique needs, and work towards addressing them. Disability research in healthcare is frequently not conducted in equal partnership with its end-users, PWD. Current practices, like inclusive design, though well-intentioned, may overlook the complex experiences of PWD, leading to ineffective interventions. Medical research must centralize PWD to uncover outcomes resonant with the disability community. Integrating HCD frameworks of “Inspiration”, “Ideation”, “Implementation” and the “Investment” required to conduct HCD in disability research represents a shift towards research methodologies collaboratively created with and by PWD, embracing inclusivity and respect in person-centered care.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101840"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053453","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":"Assessing unmet need for dental care from the perspective of adults with disabilities: A mixed methods approach","authors":"Marissa Andréah Diaz ,&nbsp;Elizabeth Geneva Wood ,&nbsp;Weili Yuan ,&nbsp;Gilbert Gimm ,&nbsp;Jae Kennedy","doi":"10.1016/j.dhjo.2025.101835","DOIUrl":"10.1016/j.dhjo.2025.101835","url":null,"abstract":"<div><h3>Background</h3><div>Adults with disabilities face multiple barriers in accessing health care and experience a variety of unmet needs, including dental care. However, few U.S. studies have assessed unmet need for dental care from the perspective of adults with disabilities.</div></div><div><h3>Objective</h3><div>We sought to assess unmet need for dental care services from the perspective of adults with disabilities using a mixed methods approach.</div></div><div><h3>Methods</h3><div>Using individual-level data from the 2022 National Survey on Health and Disability, we conducted a descriptive analysis of participant characteristics, unmet need for dental care, and reasons for unmet need. Using content analysis, we analyzed open-ended text responses from the survey.</div></div><div><h3>Results</h3><div>While participants most commonly cited underinsurance as a barrier to services, they also highlighted lack of accommodation, dental anxiety, and difficulty securing appointments as issues resulting in unmet dental care needs.</div></div><div><h3>Conclusion</h3><div>This study illustrates not only the rate of unmet need for dental care for adults with disabilities, but also the reasons driving this phenomenon. Future research is needed to delve further into the reasons cited by participants, namely dental anxiety and the perception that dental providers are unwilling to serve disabled people, neither of which has been explored in-depth quantitatively or qualitatively.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101835"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796888","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":"Applying NLP methods to code functional performance in electronic health records using the international classification of functioning, disability, and health","authors":"Elizabeth Marfeo ,&nbsp;Maryanne Sacco ,&nbsp;Jona Camacho Maldonado ,&nbsp;Kathleen Coale ,&nbsp;Rafael Jimenez Silva ,&nbsp;Rebecca Parks ,&nbsp;Elizabeth K. Rasch","doi":"10.1016/j.dhjo.2025.101888","DOIUrl":"10.1016/j.dhjo.2025.101888","url":null,"abstract":"<div><h3>Background</h3><div><span>Clinical records often provide information on a person's functioning (activities), reflecting their lived experience of health. Automated extraction using clinical </span>natural language processing<span> (cNLP) can assist providers with clinical decision-making, treatment planning, predicting health outcomes, and informing health care policy.</span></div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>Apply the ICF as a framework to manually annotate free-text electronic health records<span> (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.</span></div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101888"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","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":"Exploring yoga attitudes and social influences among mothers of autistic children through the theory of planned behavior","authors":"Gayatri Swarup,&nbsp;Susan Andreae,&nbsp;Kristen Pickett,&nbsp;Luis Columna","doi":"10.1016/j.dhjo.2025.101852","DOIUrl":"10.1016/j.dhjo.2025.101852","url":null,"abstract":"<div><h3>Background</h3><div><span>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 </span>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101852"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","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":"Healthcare access by disability and race among United States Adults: Behavioral Risk Factor Surveillance System 2019 to 2021","authors":"Jennifer Choi,&nbsp;Franz Castro,&nbsp;Bonnielin Swenor,&nbsp;Varshini Varadaraj","doi":"10.1016/j.dhjo.2025.101908","DOIUrl":"10.1016/j.dhjo.2025.101908","url":null,"abstract":"<div><h3>Background</h3><div>National data on ongoing inequities in healthcare access is crucial for setting priorities and ensuring that all individuals, regardless of disability or race, have access to adequate care.</div></div><div><h3>Objective</h3><div>To examine healthcare access by disability and race in the United States.</div></div><div><h3>Methods</h3><div>Using 2019–2021 Behavioral Risk Factor Surveillance System data, multivariable logistic regression assessed the association of disability with healthcare access outcomes (absence of healthcare coverage, absence of healthcare provider, &gt;1 year since last checkup, and forgoing healthcare due to cost).</div></div><div><h3>Results</h3><div>Among 1,258,919 adults surveyed, most were female (51.0 %) and non-Hispanic (NH) white (61.0 %), and 28.9 % had a disability. Regression analysis indicated that disabled adults were less likely to lack a healthcare provider (OR = 0.89, 95 % CI = 0.86, 0.91) and less likely to have gone without a recent checkup (OR = 0.90; 95 % CI = 0.88, 0.93), but more likely to forgo healthcare due to cost (OR = 2.33, 95 % CI = 2.26, 2.41), than non-disabled adults. There was no difference in healthcare coverage prevalence by disability status (OR = 1.02, 95 % CI = 0.98, 1.06). When further stratifying by race, difficulties accessing healthcare were most prevalent among those who identified as Hispanic and disabled across all measures.</div></div><div><h3>Conclusion</h3><div>Individuals with disabilities, especially those from racial or ethnic minorities, encounter greater barriers to accessing healthcare.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101908"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250534","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":"Effect of tailored cardiopulmonary resuscitation training for middle-aged and older adults with visual impairment: A cluster-randomized controlled trial","authors":"Eunjin Yang ,&nbsp;Kyung Hee Lee ,&nbsp;Youngshin Joo","doi":"10.1016/j.dhjo.2025.101909","DOIUrl":"10.1016/j.dhjo.2025.101909","url":null,"abstract":"<div><h3>Background</h3><div>Despite the widespread dissemination of cardiopulmonary resuscitation (CPR) training, CPR training for individuals with visual impairment is lacking.</div></div><div><h3>Objective</h3><div>This study aimed to provide tailored CPR training for older adults with visual impairment and verify its effectiveness.</div></div><div><h3>Methods</h3><div>A cluster-randomized controlled trial involving six clusters and 35 participants was conducted in February 2023. The intervention group received tailored CPR training with several considerations for visual characteristics, such as video-based training with descriptive video service, a higher instructor-to-participant ratio, braille stickers, educational materials of choice, and booster education two weeks later. The control group received standard video-based training designed for laypeople. CPR knowledge, self-efficacy, and actual performance were evaluated at three time points, and generalized estimating equations were used for statistical analysis.</div></div><div><h3>Results</h3><div>The intervention and control groups exhibited significant improvements over time in CPR knowledge, self-efficacy, overall CPR quality, and quality of compression, including depth, rate, and accuracy. However, a significant interaction effect between the groups and time was observed in the overall CPR quality, with the intervention group demonstrating more improvement than the control group over time.</div></div><div><h3>Conclusions</h3><div>This study demonstrated the positive effects of tailored CPR training for older adults with visual impairment, underscoring the importance of developing tailored training that considers disability characteristics. The findings also emphasize that CPR training designed for laypeople can help address educational disparities among individuals with visual impairment.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101909"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295193","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":"The inclusion of people with disabilities in COVID-19 preventive measures: Qualitative research from Vietnam","authors":"Luong-Anh Ngoc ,&nbsp;Nguyen Thi Hue ,&nbsp;Nguyen Thi Kim Dung ,&nbsp;Xanthe Hunt ,&nbsp;Tom Shakespeare ,&nbsp;Shaffa Hameed ,&nbsp;Vu Quynh Mai ,&nbsp;Minh Van Hoang ,&nbsp;Lena Morgon Banks","doi":"10.1016/j.dhjo.2025.101910","DOIUrl":"10.1016/j.dhjo.2025.101910","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has posed unique challenges for people with disabilities, highlighting significant structural disparities in access to essential health information and services. In Vietnam, these challenges are pronounced, necessitating an investigation into the experiences of people with disabilities during the pandemic.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the experiences of people with disabilities in three major cities in Vietnam in accessing COVID-19 information and adhering to preventive measures.</div></div><div><h3>Methods</h3><div>In-depth interviews were conducted with 23 adults with disabilities from Hanoi, Da Nang, and Ho Chi Minh City. Participants were purposively selected from government registers based on age, gender, residence location, and disability type. Data were analysed thematically.</div></div><div><h3>Results</h3><div>Respondents revealed significant barriers to accessing information on COVID-19 prevention. Key issues included the use of technical language, combined with low literacy among respondents, poor access to assistive and information-communication technology, and lack of accessible information formats or unsuitable adaptations. Difficulties in implementing preventive measures and heightened anxiety were common among participants, leading some to be unable to adequately protect themselves, while others undertook additional, unconventional measures.</div></div><div><h3>Conclusions</h3><div>This research emphasizes the urgency of redefining disability inclusion in public health responses, particularly during crises like the COVID-19 pandemic. Tailored guidance and resources are essential to address the unique challenges faced by people with disabilities to ensure equitable health outcomes.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101910"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486682","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":"Igniting the fire within: An innovative residential rehabilitation program for people with spinal cord injury","authors":"Lori Hochman ,&nbsp;Anita Santasier","doi":"10.1016/j.dhjo.2025.101913","DOIUrl":"10.1016/j.dhjo.2025.101913","url":null,"abstract":"<div><h3>Background</h3><div>Shortened rehabilitation stays following spinal cord injury<span> (SCI) limits rehabilitation potential and adversely impacts psychosocial health, functional goal capacity, and quality of life. Designed to fill this healthcare gap, Empower SCI (ESCI) was established to provide a second chance at rehabilitation using a short-term residential rehabilitation model shaped by participant-driven goals through physical and occupational therapy, adaptive recreation, rehabilitation counseling, and education sessions. A volunteer staff of multidisciplinary healthcare professionals and health professional students provides the supportive environment.</span></div></div><div><h3>Objective</h3><div>This qualitative inquiry aimed to reveal the outcomes and subsequent impact of the ESCI 2023 programs on the participants' physical, emotional, and psychosocial development.</div></div><div><h3>Methods</h3><div>Nine participants from the ESCI 2023 programs volunteered to participate in semi-structured interviews. The interviews were analyzed using a grounded theory approach, and themes and subthemes were established. Methodological rigor was established through multiple means.</div></div><div><h3>Results</h3><div>Three themes, each with subthemes, emerged from the data: 1. Positive participant change, 2. Positive life changing perspective shift, and 3. Integral ESCI program ingredients.</div></div><div><h3>Conclusion</h3><div><span>The comprehensive nature of the impactful changes on participant's physical, emotional, and psychosocial development are well aligned with the International Classification of Functioning, Disability, and Health, a </span>biopsychosocial model of disability. Additionally, the motivation for the participants' perspective shift is consistent with Maslow's Hierarchy of Needs. The evidence from this study supports the value of short-term residential rehabilitation programs that are driven by participant centered goals and occur in the SCI healthcare continuum when individuals can maximize their potential to live more meaningful lives.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101913"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530685","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}