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Chen MZ, Lee L, Fellinghauer C, Cieza A, Chatterji S. Demographic and environmental factors associated with disability in India, Laos, and Tajikistan: a population-based cross-sectional study. BMC Public Health 2022; 22:607. [PMID: 35351052 PMCID: PMC8962048 DOI: 10.1186/s12889-022-12846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background The number of people experiencing functional limitations due to health conditions (capacity) is expected to increase in low and middle-income countries as populations age and rates of non-communicable disease rise. This trend could raise the prevalence and levels of disability worldwide. Understanding the demographic and environmental factors associated with disability can inform the design of policy interventions to make societies more accessible and inclusive for all. Methods Approximately 2,500–3,000 participants in each of India, Laos, and Tajikistan responded to the Gallup World Poll and the World Health Organization’s Brief Model Disability Survey through face-to-face interviews. For each country, random forest regression was performed to explore the associations of demographic and environmental factors with disability while controlling for capacity. Using the variable importance measures generated by the random forest models, linear regression models were built in a stepwise manner for each country to predict disability level based on these contextual factors. Results Capacity was strongly associated with disability in all three countries. Most of the variance in disability was explained by minimally adjusted linear models that included only capacity, sex, and age. Inclusion of additional demographic factors and environmental factors explained slightly more of the variance in disability score. Across all three countries, the level of basic infrastructure, public services, and financial stability were moderately associated with disability. Age, sex, employment status, the use of assistive technologies, and other factors had associations with disability that were highly variable across countries. Conclusion While capacity was the main determinant of disability, individual demographic and environmental factors were associated with disability in a country-specific manner while controlling for the effects of capacity. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12846-1.
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Affiliation(s)
- Michael Zhu Chen
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Lindsay Lee
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Carolina Fellinghauer
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Somnath Chatterji
- Department of Data and Analytics, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
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Sabariego C, Fellinghauer C, Lee L, Posarac A, Bickenbach J, Kostanjsek N, Chatterji S, Kamenov K, Cieza A. Measuring functioning and disability using household surveys: metric properties of the brief version of the WHO and World Bank model disability survey. ACTA ACUST UNITED AC 2021; 79:128. [PMID: 34253263 PMCID: PMC8273944 DOI: 10.1186/s13690-021-00654-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/06/2021] [Indexed: 12/01/2022]
Abstract
Background The Model Disability Survey (MDS) is the current standard recommended by WHO to collect functioning and disability data. Answering calls from countries requesting a version to be implemented as a module that could be integrated into existing surveys and be used for monitoring disability trends and for data disaggregation, WHO developed the brief MDS. The objectives of this paper are to evaluate the metric properties of the disability metrics generated with the Brief MDS and the precision of the Brief MDS in comparison with the full MDS. Results The partial credit model, a unidimensional model for polytomous data from the Rasch family, was applied to evaluate psychometric properties using data from national MDS implementations in Chile (N = 12,265) and in Sri Lanka (N = 3000). The Brief MDS generates valid metrics for measuring disability, from the perspectives of capacity and performance, thereby achieving good levels of measurement precision in comparison with its full counterpart. Conclusion Given the scarcity of valid functioning and disability modules for household surveys, the Brief MDS represents a milestone in disability measurement. The Brief MDS is currently used by countries to monitor disability trends over time, which is especially important to evaluate the impact of health policies and public health interventions, to disaggregate indicators of the Sustainable Development Goals, and to monitor the implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD). Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00654-9.
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Affiliation(s)
- Carla Sabariego
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Carolina Fellinghauer
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Lindsay Lee
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | | | - Jerome Bickenbach
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Nenad Kostanjsek
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- Department of Data and Analytics, World Health Organization, Geneva, Switzerland
| | - Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
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Lee L, Mou F, Um Boock A, Fellinghauer C, Kohls M, Cieza A, Sabariego C. Identifying key environmental barriers experienced by persons with mild, moderate, or severe disability in Bankim Health District, Cameroon: a policy-targeted secondary analysis of data obtained with the World Bank and WHO model disability survey. Arch Public Health 2021; 79:95. [PMID: 34099049 PMCID: PMC8183069 DOI: 10.1186/s13690-021-00619-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/24/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Comprehensive data is key for evidence-informed policy aiming to improve the lives of persons experiencing different levels of disability. The objective of this paper was to identify the environmental barriers - including physical, social, attitudinal, and political barriers - that might become priorities for cross-cutting policies and policies tailored to the needs of persons experiencing severe disability in Cameroon. METHODS A secondary analysis of data obtained with the WHO Model Disability Survey was completed in the Bankim Health District (N = 559) using random forest regression to determine and compare the impact of the environmental factors on the experience of disability. RESULTS The physical environment had by far the highest influence on disability, with transportation, toilet of the dwelling, and the dwelling itself being the most important factors. Factors inside one's own home (toilet of the dwelling, and the dwelling itself) were the most important for persons with moderate and severe disability, followed by attitudes of others and issues with accessing health care. CONCLUSION Our study provides country policy makers with evidence for setting priorities and for the development of evidence-informed policies for the Bankim Health District in Cameroon.
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Affiliation(s)
- Lindsay Lee
- Sensory Functions, Disability and Rehabilitation (SDR), World Health Organization, Geneva, Switzerland
| | | | | | - Carolina Fellinghauer
- Sensory Functions, Disability and Rehabilitation (SDR), World Health Organization, Geneva, Switzerland.
| | - Mirjam Kohls
- Sensory Functions, Disability and Rehabilitation (SDR), World Health Organization, Geneva, Switzerland
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation (SDR), World Health Organization, Geneva, Switzerland
| | - Carla Sabariego
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
- Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
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Mental health assessment in rehabilitation: a descriptive study through an international internet survey. Int J Rehabil Res 2018; 41:368-372. [PMID: 29912785 DOI: 10.1097/mrr.0000000000000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This cross-sectional study assessed international rehabilitation practitioners' views of mental health assessment (MHA), related specifically to assessment tools and needs in the field. We delivered an anonymous web-based survey capturing rehabilitation practioners' perspectives on MHA practices, assessment tools, and needs through the American Congress of Rehabilitation Medicine in the USA and through national rehabilitation networks in Finland and Norway. Altogether, 355 rehabilitation professionals answered the survey. Unmet MHA needs, most often attributed to insufficient time (112/269 responders), were recognized among rehabilitation professionals irrespective of the country of practice. When professional experience was weighed against barriers to conducting MHA, cost was statistically significantly linked to professional experience, with those with less experience viewing cost more as a barrier (P=0.019). Rehabilitation professionals from different professions, in different countries, and working with a variety of clinical populations recognize defined barriers to MHA in rehabilitation.
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Ivandic I, Kamenov K, Rojas D, Cerón G, Nowak D, Sabariego C. Determinants of Work Performance in Workers with Depression and Anxiety: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050466. [PMID: 28445433 PMCID: PMC5451917 DOI: 10.3390/ijerph14050466] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 04/17/2017] [Accepted: 04/22/2017] [Indexed: 12/21/2022]
Abstract
Depression and anxiety are highly prevalent disorders with an impact on existential aspects of person’s life, including employment i.e., work performance (WP). In order to develop appropriate strategies, it is essential to identify determinants of WP. The objective of this study was to identify the built, social, attitudinal and health system-related environmental determinants of WP in workers with anxiety or depression in total (N = 1211) and regarding the level of disability. Hierarchical binary logistic regression was performed on data obtained from implementation of the WHO Model Disability Survey (MDS) in Chile in 2015. Hindering aspects of means of transportation and workplace, and the use of personal assistance were determinants of WP for all workers with anxiety or depression. Results differed with level of disability. Hindering aspects of means of transportation and workplace, and discrimination were determinants of WP for persons with mild to moderate disability, while hindering aspects of the workplace and dwelling, and the use of personal assistance were determinants of WP for persons with severe disability. Our results emphasize the need for a broader understanding of determinants of WP and the requirement for an integrative approach in developing both universal and specific strategies that go beyond workplace settings.
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Affiliation(s)
- Ivana Ivandic
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377 Munich, Germany.
| | - Kaloyan Kamenov
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Diego de León 62, 28006 Madrid, Spain.
| | - Diego Rojas
- Departamento de Estudios, Servicio Nacional de la Discapacidad (Senadis), Ministerio de Desarrollo Social, Catedral 1575, 8340309 Santiago, Chile.
| | - Gloria Cerón
- Departamento de Estudios, Servicio Nacional de la Discapacidad (Senadis), Ministerio de Desarrollo Social, Catedral 1575, 8340309 Santiago, Chile.
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, 80336 Munich, Germany.
| | - Carla Sabariego
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU), Marchioninistr. 17, 81377 Munich, Germany.
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