Development of guidelines for health promotion for people with disabilities: Ideals and reality

Background and Importance. Approximately one in five Americans experiences a disability. Disability does not have to be equivalent to ill health and people with disabilities (PWD) benefit from HP. Historically, there were no implementation guidelines for HP programs for PWD. Recently developed guidelines for HP programs for PWD will be described and contrasted with results from a scoping review of HP interventions for PWD. Although the guidelines target programs and the scoping review focuses on HP interventions, each contributes to the other from a translational perspective. Methods & Results. An expert panel (including persons with disabilities and family members) with more than 175 years of experience and more than 500 publications developed operational, participation, and access guidelines through facilitated discussion. Operational guidelines include having an underlying framework, and conducting process and outcome evaluation with appropriate measures. Participation guidelines include involving constituents in HP development and implementation and considering participant values. Access guidelines include accessibility and affordability. Concurrently, a scoping review of HP interventions for PWD was conducted, identifying 79 HP interventions for PWD in publications dated 1996 to 2006. Comparison of the scoping review findings with the guidelines revealed many inconsistencies: only 11 interventions reported a theoretical basis; over 200 different outcome measures were used; only 12 interventions involved constituents in design/implementation; only four reported on cost; and 17 reported on accessibility features. Conclusions. Guidelines for HP programs for people with disabilities are promising but may not reflect current research practice. Translation from research to practice may require more homogeneity.