Abstract
Exercise adherence among u.s. disability subgroups: A secondary analysis of the national health interview survey
Stephanie Kubiak, PhD, OTR/L
Gannon University, Erie, PA
APHA 2024 Annual Meeting and Expo
Introduction: The purpose of this study was to investigate how disability status, affecting 25% of the U.S. population, influences adherence to aerobic and strength exercise recommendations. This study analyzed how disability subtypes, including vision, hearing, cognitive, communication, and mobility impairments, influenced meeting the recommended exercise guidelines.
Methods: A secondary analysis was conducted on data from the 2022 National Health Interview Survey (N =26473), an annual national survey collecting health information from individuals living in the US. A binary logistic regression was conducted to determine if disability status predicted meeting aerobic and strength training recommendations. Results were further analyzed by disability subgroup using descriptive statistics.
Results: The regression was statistically significant, χ2(8) = 14.4, p < .001. Participants with a disability were 61% less likely to meet exercise recommendations than participants without a disability. 25% of participants without a disability met the exercise recommendations compared to 7% of participants with a disability. Of participants with a disability, the visual impairment subgroup had the highest rate of meeting exercise recommendations at 13.3% and the mobility impairment subgroup had the lowest at 4.3%.
Discussion: The study reveals a discrepancy in exercise adherence between individuals with and without disabilities. This suggests that current health promotion strategies may fail to sufficiently address the distinct challenges encountered by different disability subgroups. Additionally, it is crucial to recognize that the accessibility requirements of fitness environments may vary depending on the specific disability subtype, further highlighting the importance of targeted interventions.
Chronic disease management and prevention Diversity and culture Epidemiology Planning of health education strategies, interventions, and programs
Abstract
The hightide model: Promoting independent living and quality of lives for emerging adults with severe disabilities
George Mugoya1, Kaagendo Mutua1, Rahma Mkuu2, Amy Williamson1, Jazmin Adjei, DrPH Candidate, MPH, CNA3 and Elizabeth Jones4
(1)Tuscaloosa, AL, (2)Gainesville, FL, (3)Accokeek, MD, (4)Jackson, MS
APHA 2024 Annual Meeting and Expo
The current thinking on the achievement of adulthood point to the existence of a distinct phase called “emerging adulthood” that is characterized by identity exploration, freedom from adult roles and norms and experimentation in education, work, and love. Most individuals with significant disabilities depend on others for support to function, thus reaching markers of adulthood may not follow normative understandings of adulthood. Furthermore, most models of independent living for persons with disabilities (PWDs), such as group homes, presume that PWDs independent living needs will remain relatively static, which may promote the view of helplessness. To promote inclusivity and enhance the quality of lives for PWDs, there is need for models for independent living that are responsive to the reality of emerging adulthood as a period of exploration. This is particularly relevant now as growing numbers of emerging adults with significant disabilities are being enrolled in postsecondary education. This presentation will highlight the Hightide Model of integrated off-campus living—funded by the National Institutes of Disability and Rehabilitation Research—where students with Intellectual Disabilities attending a postsecondary program lived alongside their non-disabled undergraduate students. By living together, the students without disabilities served as mentors of their colleagues with disabilities in areas of day-to-day college living, while learning from each other on the day-to-day struggles of being an adult. The importance of interpersonal relationships in promoting independence, innovative methods of data collection from participants not usually involved in research and the challenges of implementing the program will be discussed.
Administer health education strategies, interventions and programs Diversity and culture Implementation of health education strategies, interventions and programs Social and behavioral sciences
Abstract
Paving the way to inclusive fitness: Insights from non-gym users with mobility limitations
Beth Barstow, PhD, OTR/L, SCLV, FAOTA1, Sangeetha Mohanraj, MS2 and Anushri Mandal, MPH3
(1)UAB, Birmingham, AL, (2)The University of Alabama at Birmingham, Birmingham, AL, (3)University of Alabama at Birmingham, Birmingham, AL
APHA 2024 Annual Meeting and Expo
Introduction and Objective: : Lack of physical activity among individuals with disabilities presents substantial public health challenges due to barriers in accessing fitness facilities, impacting well-being. Addressing these obstacles mitigates sedentary lifestyles, empowers healthier lives, promotes
equitable access to the benefits of an active lifestyle, underscoring the importance of exploring barriers
and facilitators to utilizing inclusive fitness centers, as well as gaining insights that could motivate and enable this population's participation in physical activity at accessible gym facilities.
Method: A phenomenological approach involving semi-structured online interviews of 12 individuals (4 males, 8 females) with mobility limitations, who do not currently utilize fitness centers, recruited through purposive sampling. Open-ended questions guided by the Social Ecological Model framework explored barriers and facilitators at different levels. Verbatim transcripts underwent inductive analysis and concept-driven coding using NVivo, with researcher triangulation and validation strategies.
Findings: Participants identified insufficient space as the primary barrier to gym access, followed by lack of accessible equipment, untrained staff, and non-inclusive programming. Personal factors like concerns over personal care, lack of perceived benefits, viewing gyms as social spheres, lack of motivation, transportation issues, and health conditions also deterred gym utilization, adversely affecting physical activity participation and well-being.
Conclusion: Overcoming spatial constraints and creating an inclusive environment through universal design, adaptive facilities, and tailored programming is crucial. A collaborative, multi-stakeholder approach uniting policymakers, fitness centers, advocates, and healthcare professionals is vital to dismantle barriers, ensure equitable access to physical activity, and enhance public health and quality of life for individuals with disabilities.
Diversity and culture Public health or related organizational policy, standards, or other guidelines
Abstract
Health promotion for people with lupus disabilities and their caregivers in Ohio
Angela Dawson1, Elizabeth Talbot, MSW, Ph.D.2, Nathan Nysether, M.S.1, Fatima Perkins, MSLIS, MNO1 and Manoj Sharma, MBBS, Ph.D., MCHES3
(1)Ohio Commission on Minority Health, Columbus, OH, (2)Dayton, OH, (3)Las Vegas, NV
APHA 2024 Annual Meeting and Expo
Background: The Ohio Commission on Minority Health (OCMH) funded six programs throughout Ohio from 2021-2023 for improving the lives of people with lupus and their caregivers. These included the Community Recreation Council, Lorain Urban Minority Alcoholism and Drug, Lupus Foundation of America, Greater Ohio Chapter, Inc. Nuestra Gente Community Projects, Inc., UMADAOP of Dayton, and WESFLC Optimal Lupus Health Group. The projects promoted support groups intended to increase awareness around lupus and promote health literacy along with conducting lupus screening, especially among minorities. The purpose of this presentation is to summarize the health promotion efforts undertaken for people with lupus disabilities and their caregivers in Ohio.
Methods: Descriptive data and reports were gathered from the six projects funded by the OCMH in this evaluation. The Research and Evaluation Enhancement Program (REEP) panel of OCMH analyzed the reports and conducted a qualitative thematic analysis.
Results: The thematic analysis revealed that the lupus awareness month was a great success and was celebrated like a festival by the participants that helped in health promotion. Virtual support groups and social media efforts were successful and will be part of the ongoing strategy. Promotion via flyers, public service announcements, bulletin boards, and mailers were useful strategies.
Conclusions: The lupus projects met or exceeded all their goals. Lupus awareness month and the distribution of symptom checklists were successful strategies and are important for the future. Enhanced insurance coverage, health literacy efforts, and reduction of emergency room use were identified targets for the future.
Administer health education strategies, interventions and programs Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Program planning Social and behavioral sciences
Abstract
A coffee club connection for people with disabilities: Incorporating new methodologies and initiatives recommended by participants makes for better connections and days lived.
Stephanie Ward1, Robin Lanzi, PhD, MPH1, Robert (Bob) Lujano, UAB/Expert Inclusion Specialist1 and James Rimmer, PhD2
(1)Birmingham, AL, (2)University of Alabama at Birmingham, Birmingham, AL
APHA 2024 Annual Meeting and Expo
The proposed submission seeks to share new methodologies and strategies recommended by participants for the "Coffee Club" program for people living with a disability that is an extension of NCHPAD's eHealth/mHealth telewellness program for people with disabilities: Mindfulness, Exercise and Nutrition to Optimize Resilience (MENTOR) featuring mind, body and spirit wellness domain. The NCHPAD Coffee Club seeks to provide an inclusive and welcoming setting for people living with a disability to stay connected over coffee and conversations, learn about health and wellness and have an opportunity to share there health journey and challenges, and opportunities to engage in wellness. The coffee club members are able to engage with others in the group to build authentic friendships through the coffee club group and coffee club Facebook Chats platform. The Coffee Club was developed during the pandemic as a mechanism to extend gatherings for NCHPAD MENTOR participants that wanted to stay connected to their NCHPAD MENTOR community, since its inception in August 2021. Since then there have been 240 members to join the coffee club. The coffee club sessions are facilitated by a NCHPAD Community Health Educator, who is the epitome of peace, love and calmness by sharing and providing health and wellness information and inviting professionals to lead conversations that that could be applied to an individuals life living with a physical disability. Members often co-facilitate based on their own coping strategies which provides opportunities for engagement and Connections.
Administer health education strategies, interventions and programs Advocacy for health and health education Communication and informatics Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Public health or related education
Abstract
A needs analysis to develop an adaptive sport, and exercise data repository
Sangeetha Mohanraj, MS1, Mohanraj Thirumalai, PhD2 and Christen Mendonca, PhD2
(1)University of Alabama at Birmingham, Hoover, AL, (2)The University of Alabama at Birmingham, Birmingham, AL
APHA 2024 Annual Meeting and Expo
Introduction and Objective: Data sharing has become integral to the decision making made by athletes, coaches, and organizations; however, there is no data repository specific to the unique needs of adaptive athletes. These athletes are healthier and perform better with guidance; however, professionals lack the necessary tools for evaluating the training, strategies, and activities that may improve outcomes. The purpose of this study was to assess the data needs of researchers and professionals in adaptive sports. Methods: Semi-structured interviews were conducted with 10 individuals either involved in research, or as a professional in adaptive sports. Interviews were transcribed from audio recordings, and the transcripts were coded by two members of the research team. Cohen’s Kappa was used to assess Inter-coder agreement. Thematic analysis was used to extract themes. Results: Several themes emerged including data use, variables, and interaction preferences. Participants expressed interest in raw data and value executive summaries and reports. Variables of interest included dimensions such as sport performance and competitive outcomes, and demographic variables such as social determinants of health. Sorting and filtering options were important; however, several ethical concerns were expressed regarding the intersection of deidentified sport data and identifiable disability and demographic information. Conclusions: The results of this needs analysis have laid a rich foundation to develop a future adaptive sports and exercise data repository. Future research will concentrate on building the technology and creating a strategy to ethically house and present data that will enrich decision making for athletes with disabilities.
Assessment of individual and community needs for health education Biostatistics, economics Communication and informatics Conduct evaluation related to programs, research, and other areas of practice Planning of health education strategies, interventions, and programs Program planning
Abstract
Examine a factor structure for the World Health Organization quality of life measure among older adults with the ADL limitations in underserved neighborhoods.
Rie Suzuki, PhD1, Woojong Kim, PhD, MSW1 and Michelle Meade, Ph.D.2
(1)University of Michigan-Flint, Flint, MI, (2)Ann Arbor, MI
APHA 2024 Annual Meeting and Expo
Introduction and Objective: Psychometric properties of WHOQOL-BREF measure for people with disabilities have been examined across countries. However, few studies have assessed them for older adults living in low-resource US communities. Hence, this study aimed to explore whether the four domains of WHOQOL-BREF fit the cross-sectional data from them. Methods: The Michigan Medicine patients who were at least 65 years old, had activities of daily living (ADL) limitations, and lived in the Detroit-Metro and Greater-Flint communities were recruited through various strategies in 2021-2022. Participants received $100 to complete study. Factor analysis (FA) was performed with the WLSMV estimator and the Eigenvalue of 1.0. on Mplus. Findings: Of 280, a majority were female, African American, single (including divorced or widowed), and educated in some college. The results indicated that, like the original domains, the four-factor structures were merged. Although the reliabilities of each domain were adequate, the loading from medical treatment needs for the function in their daily life to physical health and the loading from the satisfaction of one’s sex life to social relationship were low in the Exploratory FA. The confirmatory FA could not prove the model fit for the original structure. Conclusions. Findings suggest that overall underlying patterns were like the original domains except for two loadings, indicating that participants may use assisted devices or social support to perform the ADL activities and that intimate activity may not represent their social relationships. Additional study is needed to understand the complexity of QOL scores to improve their health outcomes.
Assessment of individual and community needs for health education Diversity and culture Environmental health sciences Social and behavioral sciences
Abstract
Building a specialized behavioral health model for adults with intellectual/ developmental disabilities
Christine Gadbois, DNP, RN, PHNA-BC, PMH-BC
CareLink, East Providence, RI
APHA 2024 Annual Meeting and Expo
Adults with Intellectual/ Developmental Disabilities experience behavioral health challenges at higher rates than the general population. Behavioral Health clinicians often report they are ill-equipped to properly care for individuals with IDD due to lack of training and/ or clinical exposure. Communication challenges, behavioral manifestations and complex medical and physical co-morbidities may make complicate treatment. Additionally, the US (varies state to state) IDD and BH service provision systems and funding methodology may further complicate access to behavioral healthcare.
Our program was developed based on community needs assessment and involved multiple stakeholders including IDD and BH providers, advocates and state health and human service departments. Lack of access to qualified behavioral health professionals, insufficient levels of care for emergency intervention, and challenges to family and caregiver education and support were primary problems identified. Advocacy led to a new funding opportunity which could be leveraged to fund program development informed by national evidence-based models. Engaging stakeholders was critical to overcoming silos and building a model that is fully integrated with both our state’s IDD provider system and our state’s Behavioral Health Organization system. A multidisciplinary team built a comprehensive model for community based, patient and family/ caregiver centered care for high risk adults with IDD and BH challenges. The program was launched with a 100 patient pilot and early outcomes and next steps will be discussed.
Administer health education strategies, interventions and programs Advocacy for health and health education Chronic disease management and prevention Planning of health education strategies, interventions, and programs Provision of health care to the public Social and behavioral sciences
Abstract
Revamping systems: Missouri's department of mental health positive behavioral support approach to enhancing the quality of life for its diagnosed developmental disabilities population.
Carl Hoeninger
Florissant, MO
APHA 2024 Annual Meeting and Expo
Individuals with developmental disabilities experience situations that impact their lives. Often these are system related issues such as access to healthcare, housing, direct care staff, etc. To address this issue the Missouri Department of Mental Health is investing in a Positive Behavioral Support Multi-Tiered System of Support approach as a solution. Following a public health framework in conjunction with Positive Behavior Support approach, the department is actively consulting with contracted serve providers to enhance their systems within a 3 tiered framework to address care across the lifespan. The tiered framework encompasses Tier 1, Tier 2, & Tier 3. Tier 1 establishes universal supports or supports everyone needs to have a quality life. Tier 2 addresses individuals approaching or at risk for their quality of life being disrupted i.e. in hospital setting, homelessness, criminal justice system, etc... and provides specific interventions to help individuals and teams return to their universal baseline levels. Tier 3 focuses on individuals currently in crisis and approaches cases through a behavioral analysis clinical lens with the hope of returning individuals to universal baseline, similar to Tier 2. Missouri is leading the way in this approach as no other state has established a similar model as of yet. By incorporating this tiered model Missouri is actively attempting to address chronic quality life issues individuals with developmental disabilities face by investing in them and the providers who support them. The ultimate goal being greater quality of life for Missouri’s population diagnosed with developmental disabilities.
Administer health education strategies, interventions and programs Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Program planning Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Title: Minority caregivers voice; Towards better understanding of families living with disabilities: In person presentation
Tanisha Tyler Graves
Williamsburg, VA
APHA 2024 Annual Meeting and Expo
When the Trumpet Sounds, is a nonprofit, located in rural Virginia which provides minority health services to families at high risk for chronic health diseases. The organization was funded based upon a sound community development within the context of faith based principles such keen spirituality, hope, collaboration and teamwork. The founders is comprised of Mr. and Mrs. Bobby Graves of Mattaponi, VA , just outside of Historic Williamsburg, VA. This area is also known as the Golden Crescent is also just a few miles from Tidewater, Norfolk, Portsmouth, rural Western Tidewater where we partner with various agencies to help fill significant health gaps in minority and underserved communities. This abstract focuses attention capacity gaps which continue to stand in the way of improved health, especially black families living with disabilities . this abstract explores the multiple challenging minority families through the lenses of the caregiver and support systems such churches, extended family, both medical and allied health professionals. the unique senses through which stores are told to help unpack new pathways to craft new solution toward health and healing. The intent will be to help bring focus to the unmet needs of the caregivers who require more assistance with the following, Respite care, Education and awareness around epilepsy, social support to help reduce depression and anxiety related to social isolation and create friendship teams and talk therapy. We will share story outcomes using qualitative approach of storytelling which is cultural competent.
Advocacy for health and health education