Session

Health education strategies, interventions, and programs for people with disabilities

Glen White, M.S., M.A., Ph.D., Department of Applied Behavioral Science, University of Kansas, Lawrence, KS

APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)

Abstract

CDC's Disability and Health Branch: Creating A National Roadmap for Improving the Health of People with Disabilities

Shannon Griffin-Blake, PhD1, Melinda Cokley2 and Jasmine Owens, MPH2
(1)Centers for Disease Control & Prevention, Atlanta, GA, (2)CDC, Atlanta, GA

APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)

Based on the Behavioral Risk Factor Surveillance System (2013), twenty-two percent of U.S. adults (approximately 53,316,677 persons) reported having some type of disability, with mobility being the most frequent followed by cognition, independent living, vision, and self-care. Moreover, studies have shown that people with disabilities are more likely to have limited access to quality health care services (e.g., inaccessible medical equipment), higher prevalence of chronic disease risk factors (e.g., smoking, physical inactivity), and increased risk for preventable health problems (e.g., diabetes, cardiovascular disease). To ensure that the CDC's Disability and Health Branch was strategically placed to positively impact these health disparities, the Branch embarked on a multi-tiered strategic planning process in 2015. It was critical that this strategic planning process be highly participatory as well as result in a clear, concrete vision that could be easily articulated to a variety of partners. This process was achieved over 10 months and included: 1.) completing an environmental scan with key stakeholders (n=100), 2.) conducting an expert panel (n=12), 3.) engaging in internal prioritization exercises to steer Branch direction, and 4.) creating a national roadmap to frame future Branch efforts and messages. This Disability Roadmap is a pictorial description of the Branch's 10-year vision for operationalizing its core principles and accomplishing strategic areas to improve the health of and decrease health disparities for people with disabilities. This session will describe the salient steps completed during the 4-tier strategic planning process and explain the 5 core principles now used to guide Branch efforts.

Chronic disease management and prevention Planning of health education strategies, interventions, and programs Public health or related public policy Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health

Abstract

HealthMatters Program Initiative: Creating Health Friendly Environments and Services Ensuring Access for People with Intellectual and Developmental Disabilities

Beth Marks, PhD, RN1, Jasmina Sisirak, PhD, MPH1, Lindsey Mullis, MS2, Kristin Krok, C.T.R.S.3, Amanda George, MS4, George Gotto IV, PhD5, Christina Miller6 and LynneAnn Tew, MA7
(1)University of Illinois at Chicago, Chicago, IL, (2)University of Kentucky, Lexington, KY, (3)NorthPointe Resources, (4)Developmental Disability Services of Jackson County - eitas, Kansas City, MO, (5)University of Missouri - Kansas City, Kansas City, MO, (6)UMKC, Kansas City, MO, (7)University of Alaska-Anchorage, Anchorage, AK

APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)

The HealthMatters Program is a national evidence-based program for exercise, nutrition and health education tailored for people with intellectual and developmental disabilities (IDD) living in community based settings. Previous research efforts have identified the importance of engaging both local community-based organizations (CBOs) providers and fiscal and policy stakeholders as key “drivers” for effective reach and sustainability of health promoting activities for people with IDD. This study is examining the efficacy of a web-based platform to implement a health promotion program for adults with IDD in four states. The processes used to create a health promoting culture in CBOs supporting people with IDD in four states will be presented. This structure supports the inclusion of everyone in the organization to share their talents, efforts, and skill sets to ensure the successful implementation and sustainability of health friendly environments and services where people with IDD live, work, and recreate. Preliminary results demonstrate improvements in connecting CBOs with community resources and having a greater commitment to a implementing a culture that promotes health through policies and incentives in CBOs. Participants reported greater confidence in implementing health promotion initiatives within CBOs. A community academic partnership between state-level health and wellness coordinators in four states and the HealthMatters Program team is demonstrating support in being able to assist provider organizations to promote healthy lifestyles among people with IDD and their supports. Various strategies used by local service providers and state HealthMatters state coordinators engaged stakeholders to sustain health and wellness initiatives for people with IDD.

Administer health education strategies, interventions and programs Advocacy for health and health education Program planning

Abstract

Even if we build it, equitable care might not come: Differences in care receipt and satisfaction for patients with disabilities

Allysha C. Maragh-Bass, PhD, MPH1, Sean Phelan, PhD2, Joan Griffin, PhD2, Lila Rutten, PhD2, W. Austin Davis, BS3, Ashley Pitzer, BS2 and Megan Morris, PhD, MPH, CCC-SLP3
(1)Brigham and Women's Hospital, Harvard School of Medicine, Boston, MA, (2)Mayo Clinic, Rochester, MN, (3)Brigham and Women's Hospital, Boston, MA

APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)

Introduction: Creating accessible medical environments is advocated as one way to provide equitable care to patients with disabilities. Consequently, healthcare organizations are investing in accessible medical equipment, including height-adjustable examination tables. Our study objective was to describe the effects of height-adjustable exam tables on patients' receipt and perceptions of care in two primary care clinics. Methods: We surveyed primary care patients following their appointments at two Midwestern clinics. All examination tables in Clinic A were height-adjustable; none were height-adjustable in Clinic B. Survey questions inquired about their healthcare examination, perceived quality of care, and demographics. Results: A total of 399 (199 in Clinic A and 200 in Clinic B) completed the survey. Patient demographics at each clinic were similar: 70% female, 95% white, and 21% patients with disabilities. There were no differences between the two clinics in the likelihood of patients being evaluated on an examination table (Clinic A: 63%, Clinic B: 62%, p<0.97). Patients with disabilities, however, were 27% less likely to be evaluated on an examination table than patients without disabilities (p<0.01). No differences in perceptions of quality of care were found by clinic site or demographics. However, compared to patients without disabilities, patients with disabilities were less likely to rate their providers' communication and bedside manner favorably. Discussion: While accessible physical environments are necessary and legally required, providing accessible equipment alone might not be sufficient to address disparities in care. Comprehensive approaches by healthcare systems, including understanding providers' attitudes and behaviors towards patients with disabilities, are needed.

Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Implementation of health education strategies, interventions and programs Provision of health care to the public Public health or related organizational policy, standards, or other guidelines

Abstract

Montana's Shelter 2020 Project: Improving accessibility to disaster shelters in a frontier state

Ian Thigpen, MA EM1, Helen Russette, MPH2 and Meg Traci, PhD3
(1)Public Health Emergency Preparedness, Helena, MT, (2)Unviersity of Montana, Missoula, MT, (3)University of Montana Rural Institute, Missoula, MT

APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)

People with disabilities are at increased risk of death and injury during disasters (White et al., 2007) and were among the populations most negatively affected during Hurricane Katrina (Flanagan et al., 2011). In September 2013 a federal court found New York City's disaster shelters inadequate for including Access and Functional Needs (A&FN) populations. This court decision spurred the Federal Emergency Management Agency (FEMA) to issue a purse-strings directive to the American Red Cross (ARC) to overhaul their National Shelter System (NSS) and include parts of the 2010 Americans with Disabilities Act (ADA) criteria as part of its NSS Data. Montana recognized the NSS overhaul as a limited opportunity to improve accessibility to shelter locations across the state. In collaboration with Montana Department of Public Health and Human Services, ARC of Montana/Idaho, Montana Disability and Health Accessibility Ambassadors, county/tribal Disaster Emergency Services, jurisdictional Public Health, and other partners, the 5-year Shelter 2020 Project has in its first year substantially increased ADA and A&FN awareness across the state. Montana originally had 444 shelters in the NSS. In the past year several shelters were removed from this list sighting A&FN inadequacies; while new shelters have been added in order to improve accessibility for A&FN populations in frontier areas of Montana. The project has 3 phases. Phase 1: Identify shelter representatives and conduct a collaborative paper assessment of county/tribal shelters. 2: train shelter representatives and conduct collaborative in-person survey of each shelter. 3: Identify county/tribal “go to” shelters and improve infrastructure for A&FN populations.

Conduct evaluation related to programs, research, and other areas of practice Ethics, professional and legal requirements Other professions or practice related to public health Protection of the public in relation to communicable diseases including prevention or control