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Carlson SR, Munandar V, Thompson JR. Outcomes for Adults With Intellectual and Developmental Disabilities Receiving Long-Term Services and Supports: A Systematic Review of the Literature. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 62:137-150. [PMID: 38545817 DOI: 10.1352/1934-9556-62.2.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/10/2023] [Indexed: 04/05/2024]
Abstract
The impact of long-term services and supports on the quality of life of adults with intellectual and developmental disabilities (IDD) is not well understood given the highly complex nature of researching this topic. To support future research addressing this topic, we conducted a systematic literature review of studies addressing outcomes of adults with IDD receiving long-term services and supports. Results of this review describe current outcomes for adults with IDD who receive long-term services and supports and can be used to inform program evaluation, policy development, and future research.
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Affiliation(s)
- Sarah R Carlson
- Sarah R. Carlson, University of New Mexico; Vidya Munandar, Kennesaw State University; and James R. Thompson, University of Kansas
| | - Vidya Munandar
- Sarah R. Carlson, University of New Mexico; Vidya Munandar, Kennesaw State University; and James R. Thompson, University of Kansas
| | - James R Thompson
- Sarah R. Carlson, University of New Mexico; Vidya Munandar, Kennesaw State University; and James R. Thompson, University of Kansas
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2
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Stokes JE, Waldron DA, Hartford EG, Sauer J. Preventive Healthcare Screening Completion Among Midlife and Older Adults With Intellectual and Developmental Disabilities. J Appl Gerontol 2023; 42:2288-2293. [PMID: 37525892 DOI: 10.1177/07334648231191663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
Individuals with intellectual and developmental disabilities (IDD) face several barriers to healthcare, making them less likely to receive numerous routine preventive health screenings. Preventive healthcare is a critical aspect to maintaining health and wellness, particularly for people with complex health needs. This study examines individual- and state-level factors associated with mammogram and colonoscopy screenings in mid- and later-life foradults with IDD receiving state services. Multilevel logistic regression models analyzed data from the 2012-2013 and 2018-2019 waves of the National Core Indicators In-Person Survey (NCI-IPS). Results indicated that factors such as age, living situation, transportation access, and community involvement were associated with completion of both preventive screenings. Medicaid expansion was associated with a significantly greater likelihood of completing a colonoscopy screening only among younger persons in the sample (i.e., in their 50s). These findings may have implications for completion of preventive health screenings for adults with IDD.
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Affiliation(s)
- Jeffrey E Stokes
- Gerontology, University of Massachusetts Boston, Boston, MA, USA
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Lineberry S, Bogenschutz M, Dinora P, Ayers K. The Role of Information and Knowledge in COVID-19 Vaccination Among People With Intellectual and Developmental Disabilities and Their Families. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:16-30. [PMID: 36706004 DOI: 10.1352/1934-9556-61.1.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 05/16/2023]
Abstract
People with intellectual and developmental disabilities (IDD) may be at an increased risk of severe illness and death from COVID-19. This article examines the role of information and knowledge in COVID-19 vaccine uptake for people with IDD and their families. We developed a survey about COVID-19 vaccine uptake, confidence, and knowledge for people with IDD and their families. COVID-19 vaccine uptake was associated with higher self-reported knowledge about the vaccine, learning about the vaccine from one's doctor, and social media use. Qualitative results reflected the importance of trusted relationships with medical providers in vaccination.
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Affiliation(s)
- Sarah Lineberry
- Sarah Lineberry, Matthew Bogenschutz, and Parthenia Dinora, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Sarah Lineberry, Matthew Bogenschutz, and Parthenia Dinora, Virginia Commonwealth University
| | - Parthenia Dinora
- Sarah Lineberry, Matthew Bogenschutz, and Parthenia Dinora, Virginia Commonwealth University
| | - Kara Ayers
- Kara Ayers, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine
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King E, Brangan J, McCarron M, McCallion P, Bavussantakath FR, O’Donovan MA. Predictors of Productivity and Leisure for People Aging with Intellectual Disability. Can J Occup Ther 2022; 89:135-146. [PMID: 35037768 PMCID: PMC9136372 DOI: 10.1177/00084174211073257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background. Adults aging with intellectual disability (ID) face barriers to engagement in occupation. Greater understanding of factors that affect engagement in work and leisure occupations is required to support occupational engagement in this population. Purpose. Identify predictors of engagement in work and leisure occupations for adults aging with an ID, and consider implications for occupational therapy practice. Method. Data from wave 2 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Aging (IDS-TILDA) was analyzed using regression analysis to identify predictors of engagement in work and leisure occupations for adults aging with an ID. Findings. Adults who had difficulty getting around their home environment, poor physical health, or older age were less likely to engage in work and leisure activities. Implications. Occupational therapists can support adults aging with ID to age in place. Occupation-focused health promotion could enhance well-being through engagement in occupation.
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Affiliation(s)
- Eilish King
- Eilish King, Discipline of Occupational Therapy, Trinity College Dublin, D08 W9RT, Dublin, Ireland.
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Chan DNS, Law BMH, Au DWH, So WKW, Fan N. A systematic review of the barriers and facilitators influencing the cancer screening behaviour among people with intellectual disabilities. Cancer Epidemiol 2021; 76:102084. [PMID: 34920342 DOI: 10.1016/j.canep.2021.102084] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022]
Abstract
Individuals with intellectual disabilities (ID) may require assistance in accessing healthcare services, including cancer screening. A better understanding of the factors affecting cancer screening utilisation among these individuals is needed for the development of strategies to promote screening uptake in them. This review aimed to explore the facilitators of and barriers to cancer screening utilisation among people with ID. A literature search was conducted using five databases, and an additional snowball search yielded 16 studies for inclusion in the review. Overall, the methodological quality of these studies was good (43-100%). In this review, we noted barriers to screening among individuals with ID, including perceptions of fear, distress, and embarrassment; unpreparedness for screening; negative interactions with healthcare professionals; a lack of knowledge about cancer screening; mobility issues; a high severity of ID; and a lack of ability to provide consent and communicate verbally. Facilitators to screening among these individuals were also identified, including living in a supervised setting, prior use of other healthcare services, being educated about screening via social media, having carers accompany them to screening appointments, and having dual insurance coverage or a higher income. Our review highlights the current needs of individuals with ID undergoing cancer screening. Strategies should be developed to address these needs, such as the provision of training to healthcare professionals on how to conduct screening for people with ID.
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Affiliation(s)
- Dorothy N S Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Bernard M H Law
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Doreen W H Au
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ning Fan
- Yan Chai Hospital, Hospital Authority, Hong Kong SAR, China.
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Zandam H, Mitra M, Akobirshoev I, Li FS, Ne'eman A. Infectious Diseases-Related Emergency Department Visits Among Non-Elderly Adults with Intellectual and Developmental Disabilities in the United States: Results from the National Emergency Department Sample, 2016. Popul Health Manag 2021; 25:335-342. [PMID: 34665664 DOI: 10.1089/pop.2021.0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Emerging evidence on the disproportionate impact of COVID-19 on people with intellectual and developmental disabilities (IDD) points to the underlying risk and burden of infectious diseases (IDs) in this population. The objective of this study was to examine the risk of ID-related emergency department (ED) visits, subsequent hospitalizations, and hospital-based mortality during ID-related visits among adults with IDD compared to those without IDD. The authors conducted a retrospective study using data from the 2016 Nationwide Emergency Department Sample. The sample included 94,928 adults with IDD identified using ICD-10-CM codes, and age- and sex-matched 284,763 non-IDD adults in a 1:3 case-control ratio. A Poisson regression model was used to compare the risk of ID-related ED visits, subsequent hospitalizations, and hospital-based mortality during ID-related visits between adults with and without IDD. Covariates included sociodemographic and hospital characteristics. Results showed that adults with IDD are at a higher risk for ID-related ED visits, subsequent hospitalization, and mortality during ID-related ED visits compared to non-IDD adults. Adults with IDD continued to experience higher risks even after accounting for sociodemographic, hospital, and clinical characteristics. Septicemia and respiratory tract infections are the leading causes of ED visits, hospitalization, and mortality. This study found substantial disparities in ID-related ED visits, subsequent hospitalization, and mortality among the burdens for adults with IDD. These observations underscore the importance of integrated strategies to reduce ID-related morbidity among adults with IDD.
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Affiliation(s)
- Hussaini Zandam
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Monika Mitra
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Ilhom Akobirshoev
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Frank S Li
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Ari Ne'eman
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
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Salzberg D, Zhang W, Moran M, Hardin J, McDermott S, Okoro C, Hollis N. Helpers help people with intellectual and developmental disabilities and hypertension to understand their condition and the need to adhere to anti-hypertensive medication. Disabil Health J 2021; 15:101219. [PMID: 34625396 DOI: 10.1016/j.dhjo.2021.101219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/09/2021] [Accepted: 09/20/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Recent evidence suggests that many adults with intellectual and developmental disabilities (IDD) do not adequately manage hypertension (HTN) medication. Known risk factors for insufficient prescription filling include age, residential placement, and lack of caregiver support. This is a first report of a randomized intervention trial designed to analyze the relationship of a brief educational intervention with increased knowledge about HTN and improvement in prescription filling for anti-hypertensive medication. OBJECTIVE/HYPOTHESIS The objective was to test whether an educational flyer and regular messages about HTN and the importance of refilling medication would improve scores on knowledge surveys. Participants were Medicaid members with HTN and IDD (Member) or caregivers (Helpers) who chose to participate on behalf of a Member. METHODS Recruitment letters explained that either the Member or their Helper could participate (not both). Participants were randomly assigned to the Case or Comparison group, and both were comprised of Members and Helpers. Only Case participants received a flyer and monthly HTN education messages for one year, but all participants completed knowledge surveys at baseline, six, and 12 months. Linear regression and log-binomial models were used to compare responses between groups. RESULTS Case Helpers had statistically significant improvements on HTN knowledge from baseline through the first year, compared to Comparison Members and Comparison Helpers. Regardless of group assignment, Helpers scored better on surveys than did Members. CONCLUSIONS This study suggests that it is beneficial to explicitly include Helpers in health care instruction and in management of chronic disease for adults with IDD.
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Affiliation(s)
- Deborah Salzberg
- Department of Epidemiology & Biostatistics, Discovery 1 Building, University of South Carolina, Columbia, SC, USA.
| | - Wanfang Zhang
- Department of Epidemiology & Biostatistics, Discovery 1 Building, University of South Carolina, Columbia, SC, USA
| | - Madeline Moran
- Department of Epidemiology & Biostatistics, Discovery 1 Building, University of South Carolina, Columbia, SC, USA
| | - James Hardin
- Department of Epidemiology & Biostatistics, Discovery 1 Building, University of South Carolina, Columbia, SC, USA
| | - Suzanne McDermott
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Catherine Okoro
- National Center on Birth Defects and Developmental Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - NaTasha Hollis
- National Center on Birth Defects and Developmental Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA; Commissioned Corps, US Public Health Service, USA
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Niemeier BS, Wetzlmair LC, Bock K, Schoenbrodt M, Roach KJ. Improvements in biometric health measures among individuals with intellectual disabilities: A controlled evaluation of the Fit 5 program. Disabil Health J 2020; 14:100979. [PMID: 32900653 DOI: 10.1016/j.dhjo.2020.100979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Individuals with intellectual disabilities (ID) have poorer health statuses compared to the general population. Actions are needed to address health disparities and promote healthy lifestyles among individuals with ID. Moreover, studies that consider program settings for this population are needed. OBJECTIVE The Special Olympics health program, Fit 5, was evaluated to assess effectiveness in improving health measures for individuals with ID. The settings of programs' implementation were also considered. METHODS Four Special Olympics basketball teams participated as an intervention group, and three teams as a control group, in a study of the Fit 5 program that was implemented during, and as part of, a regular 8-week basketball season. Resting heart rate (RHR) and blood pressure, and height and weight to calculate Body Mass Index (BMI), were measured before and after the program. Differences in pre- and post-measures were compared between the two groups with paired samples t-tests and ANCOVA. RESULTS Participants in the intervention group had significantly greater improvements in resting systolic and diastolic blood pressures (p = 0.02 and 0.03, respectively) and RHR (p = 0.003). BMI increased for both groups; however, the increase in the intervention group was significantly less (p = 0.006). The Special Olympics setting was considered familiar and supportive and effectively reached individuals with ID. CONCLUSION The Fit 5 program positively impacts RHR and blood pressure, and could help reduce extents of BMI increases, in individuals with ID when implemented in a common setting. Further investigation of the impact of Fit 5 and similar programs in additional settings is warranted.
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Affiliation(s)
- Brandi S Niemeier
- Department of Kinesiology, University of Wisconsin-Whitewater, 800 West Main Street, Whitewater, WI, 53190, USA.
| | - Lisa-Christin Wetzlmair
- Department of Kinesiology, University of Wisconsin-Whitewater, 800 West Main Street, Whitewater, WI, 53190, USA
| | - Karla Bock
- Special Olympics Wisconsin, 2310 Crossroads Dr, Suite 1000, Madison, WI, 53718, USA
| | - Melissa Schoenbrodt
- Special Olympics Wisconsin, 2310 Crossroads Dr, Suite 1000, Madison, WI, 53718, USA
| | - Kathleen J Roach
- Special Olympics Wisconsin, 2310 Crossroads Dr, Suite 1000, Madison, WI, 53718, USA
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Dinora P, Bogenschutz M, Broda M. Identifying Predictors for Enhanced Outcomes for People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:139-157. [PMID: 32240047 DOI: 10.1352/1934-9556-58.2.139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
People with intellectual and developmental disabilities (IDD) often rely on Medicaid-funded services and supports to facilitate their daily living. The financial investment for these services is significant, yet little work has been conducted to understand how these investments affect life outcomes. This pilot study used a novel data integration approach to offer initial insights about how Medicaid expenditures relate to outcomes using Medicaid claims data, results of the National Core Indicators consumer survey, and data from the Supports Intensity Scale (SIS). Findings suggested that subpopulations of people with IDD who also had high behavioral needs or high medical needs had significantly higher expenditures than individuals with more typical SIS-assessed support needs. Regression analyses suggested mixed outcomes based on the factors we considered, including a finding that people with IDD who lived in sponsored residential care homes were more likely to engage in inclusive activities in the community than those who lived in larger congregate settings, or those who lived in a family home. Results of this pilot, when brought to scale, will be useful in examining the performance of state IDD service systems over time.
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Affiliation(s)
- Parthenia Dinora
- Parthenia Dinora, Matthew Bogenschutz, and Michael Broda, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Parthenia Dinora, Matthew Bogenschutz, and Michael Broda, Virginia Commonwealth University
| | - Michael Broda
- Parthenia Dinora, Matthew Bogenschutz, and Michael Broda, Virginia Commonwealth University
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10
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Akobirshoev I, Mitra M, Parish SL, Valentine A, Simas TAM. Racial and Ethnic Disparities in Birth Outcomes and Labor and Delivery Charges Among Massachusetts Women With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:126-138. [PMID: 32240049 DOI: 10.1352/1934-9556-58.2.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Understanding the pregnancy experiences of racial and ethnic minority women with intellectual and developmental disabilities (IDD) is critical to ensuring that policies can effectively support these women. This research analyzed data from the 1998-2013 Massachusetts Pregnancy to Early Life Longitudinal (PELL) data system to examine the racial and ethnic disparities in birth outcomes and labor and delivery charges of U.S. women with IDD. There was significant preterm birth disparity among non-Hispanic Black women with IDD compared to their non-Hispanic White peers. There were also significant racial and ethnic differences in associated labor and delivery-related charges. Further research, examining potential mechanisms behind the observed racial and ethnic differences in labor and delivery-related charges in Massachusetts' women with IDD is needed.
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Affiliation(s)
- Ilhom Akobirshoev
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Monika Mitra
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Susan L Parish
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Anne Valentine
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Tiffany A Moore Simas
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
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Arana E, Carroll-Scott A, Massey PM, Lee NL, Klassen AC, Yudell M. Racial/Ethnic Disparities in Mammogram Frequency Among Women With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:177-187. [PMID: 31120403 PMCID: PMC8363066 DOI: 10.1352/1934-9556-57.3.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Little information exists on the associations between intellectual disability (ID) and race/ethnicity on mammogram frequency. This study collected survey and medical record data to examine this relationship. Results indicated that Hispanic and Black women with ID were more likely than White women with ID to have mammograms every 2 years. Participants who live in a state-funded residence, were aged 50+, and had a mild or moderate level of ID impairment were more likely to undergo mammography compared to participants living with family or alone, were <50, and had severe ID impairment. Further research is needed to understand the mechanisms explaining disparities in mammograms between these racial/ethnic groups.
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Affiliation(s)
- Evelyn Arana
- Evelyn Arana, Cancer Disparities Center, Hackensack University Medical Center; and Amy Carroll-Scott, Philip Massey, Nora L. Lee, Ann C. Klassen, and Michael Yudell, Drexel University Dornsife School of Public Health
| | - Amy Carroll-Scott
- Evelyn Arana, Cancer Disparities Center, Hackensack University Medical Center; and Amy Carroll-Scott, Philip Massey, Nora L. Lee, Ann C. Klassen, and Michael Yudell, Drexel University Dornsife School of Public Health
| | - Philip M Massey
- Evelyn Arana, Cancer Disparities Center, Hackensack University Medical Center; and Amy Carroll-Scott, Philip Massey, Nora L. Lee, Ann C. Klassen, and Michael Yudell, Drexel University Dornsife School of Public Health
| | - Nora L Lee
- Evelyn Arana, Cancer Disparities Center, Hackensack University Medical Center; and Amy Carroll-Scott, Philip Massey, Nora L. Lee, Ann C. Klassen, and Michael Yudell, Drexel University Dornsife School of Public Health
| | - Ann C Klassen
- Evelyn Arana, Cancer Disparities Center, Hackensack University Medical Center; and Amy Carroll-Scott, Philip Massey, Nora L. Lee, Ann C. Klassen, and Michael Yudell, Drexel University Dornsife School of Public Health
| | - Michael Yudell
- Evelyn Arana, Cancer Disparities Center, Hackensack University Medical Center; and Amy Carroll-Scott, Philip Massey, Nora L. Lee, Ann C. Klassen, and Michael Yudell, Drexel University Dornsife School of Public Health
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Mitra M, Parish SL, Clements KM, Zhang J, Simas TAM. Antenatal Hospitalization Among U.S. Women With Intellectual and Developmental Disabilities: A Retrospective Cohort Study. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:399-411. [PMID: 30198766 PMCID: PMC9014374 DOI: 10.1352/1944-7558-123.5.399] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This population-based retrospective cohort study examines the prevalence of hospital utilization during pregnancy and the primary reason for antenatal hospital utilization among women with intellectual and developmental disabilities (IDD). Massachusetts residents with in-state deliveries that were ≥ 20 weeks gestational age were included via data from the 2002-2009 Massachusetts Pregnancy to Early Life Longitudinal Data System. Among women with IDD, 54.8% had at least one emergency department (ED) visit during pregnancy, compared to 23% of women without IDD. Women with IDD were more likely to have an antenatal ED visit, observational stays, and non-delivery hospital stays. This study highlights the need for further understanding of the health care needs of women with IDD during pregnancy.
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Tichá R, Qian X, Stancliffe RJ, Larson SA, Bonardi A. Alignment between the Convention on the Rights of Persons with Disabilities and the National Core Indicators Adult Consumer Survey. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jppi.12260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Renáta Tichá
- Research and Training Center on Community Living, University of Minnesota; Minneapolis MN USA
| | - Xueqin Qian
- Research and Training Center on Community Living, University of Minnesota; Minneapolis MN USA
| | - Roger J. Stancliffe
- Centre for Disability Research and Policy, The University of Sydney; Sydney Australia
| | - Sheryl A. Larson
- Research and Training Center on Community Living, University of Minnesota; Minneapolis MN USA
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Long-term condition management in adults with intellectual disability in primary care: a systematic review. BJGP Open 2018; 2:bjgpopen18X101445. [PMID: 30564710 PMCID: PMC6181081 DOI: 10.3399/bjgpopen18x101445] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/02/2018] [Indexed: 11/05/2022] Open
Abstract
Background Adults with intellectual disabilities have higher morbidity and earlier mortality than the general population. Access to primary health care is lower, despite a higher prevalence of many long-term conditions. Aim To synthesise the evidence for the management of long-term conditions in adults with intellectual disabilities and identify barriers and facilitators to management in primary care. Design & setting Mixed-methods systematic review. Method Seven electronic databases were searched to identify both quantitative and qualitative studies concerning identification and management of long-term conditions in adults with intellectual disability in primary care. Both the screening of titles, abstracts, and full texts, and the quality assessment were carried out in duplicate. Findings were combined in a narrative synthesis. Results Fifty-two studies were identified. Adults with intellectual disabilities are less likely than the general population to receive screening and health promotion interventions. Annual health checks may improve screening, identification of health needs, and management of long-term conditions. Health checks have been implemented in various primary care contexts, but the long-term impact on outcomes has not been investigated. Qualitative findings highlighted barriers and facilitators to primary care access, communication, and disease management. Accounts of experiences of adults with intellectual disabilities reveal a dilemma between promoting self-care and ensuring access to services, while avoiding paternalistic care. Conclusion Adults with intellectual disabilities face numerous barriers to managing long-term conditions. Reasonable adjustments, based on the experience of adults with intellectual disability, in addition to intervention such as health checks, may improve access and management, but longer-term evaluation of their effectiveness is required.
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A longitudinal assessment of adherence to breast and cervical cancer screening recommendations among women with and without intellectual disability. Prev Med 2017; 100:167-172. [PMID: 28455223 PMCID: PMC5675015 DOI: 10.1016/j.ypmed.2017.04.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/04/2017] [Accepted: 04/23/2017] [Indexed: 11/20/2022]
Abstract
Each year in the United States, about 4000 deaths are attributed to cervical cancer, and over 40,000 deaths are attributed to breast cancer (U.S. Cancer Statistics Working Group, 2015). The purpose of this study was to identify predictors of full, partial, and no screening for breast and cervical cancer among women with and without intellectual disability (ID) who are within the age group for screening recommended by the U.S. Preventive Service Task Force (USPSTF), while accounting for changes in recommendations over the study period. Women with ID and an age matched comparison group of women without ID were identified using merged South Carolina Medicaid and Medicare files from 2000 to 2010. The sample consisted of 9406 and 16,806 women for mammography screening and Papanicolaou (Pap) testing adherence, respectively. We estimated multinomial logistic regression models and determined that women with ID were significantly less likely than women without ID to be fully adherent compared to no screening with mammography recommendations (adjusted odds ratio [AOR]: 0.63, 95% confidence interval [CI] 0.55-0.72), and Pap testing recommendations (AOR: 0.17, 95% CI 0.16-0.19). For the 70% of women with ID for whom we had residential information, those who lived in a group home, medical facility, or supervised community living setting were more likely to be fully adherent with both preventive services than those living alone or with family members. For both outcomes, women residing in a supervised nonmedical community living setting had the highest odds of full adherence, adjusting for other covariates.
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Axmon A, Björne P, Nylander L, Ahlström G. Psychiatric care utilization among older people with intellectual disability in comparison with the general population: a register study. BMC Psychiatry 2016; 16:389. [PMID: 27829383 PMCID: PMC5103447 DOI: 10.1186/s12888-016-1094-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with intellectual disability have been found to have higher prevalence of psychiatric disorders than the general population. However, they do not seem to have a corresponding increase in psychiatric care utilization. The aim of the present study was to investigate psychiatric care utilization among older people with intellectual disability. METHODS We used a cohort of people with intellectual disability, 55+ years in 2012 (n = 7936), and an equally sized age and sex matched reference cohort from the general population. Psychiatric care utilization was measured using registrations in the Swedish National Patient register during 2002-2012, where each registration corresponds to a psychiatric care occasion. RESULTS About 20 % of those with intellectual disability had at least one registration during the study period, compared to some 6 % in the general population sample. In the whole cohort as well as stratified by sex, people with intellectual disability were 3-4 times more likely than those in the general population sample to have had at least one registration during the study period. The effect was, however, only consistent in age groups comprising people younger than 65 years. Among people with intellectual disability, men were more likely than women to have had at least one registration, and people living in special housing (group home or service home) during the entire study period were less likely than those who only lived in special housing for parts of the study or not at all. People with intellectual disability had longer stays per inpatient registration compared with the general population sample. When stratifying on sex, the effect was found only among men, although there were no sex differences within the cohort of people with intellectual disability. Among people with intellectual disability, living in special housing during the entire study period was associated with shorter stays per inpatient registration. CONCLUSIONS Although people with intellectual disability had higher psychiatric care utilization than the general population during the 11 year study period, it does not correspond to the high prevalence of psychiatric disorders in this population. Future research is required to establish if the level of care utilization is appropriate among older people with intellectual disability.
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Affiliation(s)
- A. Axmon
- Department of Occupational and Environmental Medicine, Lund University, SE-221 00 Lund, Sweden
| | - P. Björne
- Research and Development Unit, City Office, City of Malmö, SE-205 80 Malmö, Sweden
| | - L. Nylander
- Department of Clinical Sciences/Psychiatry, Lund University, SE-221 00 Lund, Sweden ,Gillberg Neuropsychiatry Centre, University of Gothenburg, SE-411 19 Göteborg, Sweden
| | - G. Ahlström
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden
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Horner-Johnson W, Dobbertin K, Beilstein-Wedel E. Disparities in dental care associated with disability and race and ethnicity. J Am Dent Assoc 2015; 146:366-74. [DOI: 10.1016/j.adaj.2015.01.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/20/2014] [Accepted: 01/18/2015] [Indexed: 12/13/2022]
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Blick RN, Saad AE, Goreczny AJ, Roman K, Sorensen CH. Effects of declared levels of physical activity on quality of life of individuals with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 37:223-229. [PMID: 25528082 DOI: 10.1016/j.ridd.2014.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/28/2014] [Indexed: 06/04/2023]
Abstract
Routine physical fitness improves health and psychosocial well-being of individuals with intellectual and developmental disabilities. The current study investigated impact of physical fitness on quality of life by comparing individuals who maintain a physically active lifestyle with those who do not report exercising. We assessed several indicators of quality of life, including inclusion and community participation; satisfaction with professional services, home life, and day activities; dignity, rights, and respect received from others; fear; choice and control; and family satisfaction. Our data suggested that individuals who regularly exercise reported having more frequent outings into the community than did their peers who reported exercising infrequently; regular exercisers were also more likely to live in intermediate care facilities (ICF) as opposed to living independently or with family members. We discuss possible reasons for this as well as ideas for future research needed to expand on this area.
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Ouellette-Kuntz H, Cobigo V, Balogh R, Wilton A, Lunsky Y. The Uptake of Secondary Prevention by Adults with Intellectual and Developmental Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2014; 28:43-54. [DOI: 10.1111/jar.12133] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- H. Ouellette-Kuntz
- Department of Public Health Sciences; Queen's University; Kingston ON Canada
- Ongwanada; Kingston ON Canada
| | - V. Cobigo
- School of Psychology; University of Ottawa; Ottawa ON Canada
| | - R. Balogh
- University of Ontario Institute of Technology; Toronto ON Canada
| | - A. Wilton
- Institute for Clinical Evaluative Sciences; Toronto ON Canada
| | - Y. Lunsky
- Centre for Addiction and Mental Health; Toronto ON Canada
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McDermott S, Turk M. How can research lead to change in practice? Disabil Health J 2014; 8:1-2. [PMID: 25500199 DOI: 10.1016/j.dhjo.2014.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Scott HM, Havercamp SM. Race and health disparities in adults with intellectual and developmental disabilities living in the United States. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 52:409-418. [PMID: 25409129 DOI: 10.1352/1934-9556-52.6.409] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Research has documented disparities in health care and access for people with intellectual and developmental disabilities (IDD) and people in racial and ethnic minority groups. Though both populations are underserved, the additive impact of being both a member of a racial/ethnic minority and having IDD is largely unknown. This study uses data from a nationally representative survey to explore health service utilization among adults with IDD belonging to minority racial/ethnic groups compared to adults with IDD who are White. The results of this study indicated that racial/ethnic minority groups are disadvantaged in several essential areas of health care utilization and that Hispanic Americans are particularly underserved. Additional research is needed to identify and address the factors driving this difference.
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22
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Race/Ethnicity and the Use of Preventive Health Care Among Adults With Intellectual and Developmental Disabilities. Med Care 2014; 52:S25-31. [DOI: 10.1097/mlr.0000000000000130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Shogren KA, Luckasson R, Schalock RL. The Definition of “Context” and Its Application in the Field of Intellectual Disability. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12077] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Viola D, Arno PS, Byrnes JG, Doran EA. The Postpediatrician Transition. JOURNAL OF DISABILITY POLICY STUDIES 2013. [DOI: 10.1177/1044207313503684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A variety of factors impacts the transition from childhood to adulthood for persons with special health care needs or disabilities. Among these are the barriers in care coordination associated with our bifurcated health care delivery system in which pediatric medicine does not smoothly link up with the medical care received by adults. After reviewing the literature, we discuss the strong case to be made for reconceptualizing the medical home model, introducing a life span perspective to resolve the postpediatrician transition. Rather than a “hand off” from pediatrician to adult provider, this approach provides a pathway to fully integrating this patient population into our evolving health care system.
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Affiliation(s)
| | - Peter S. Arno
- Political Economy Research Institute, Amherst, MA, USA
- City University of New York, Lehman College, Bronx, NY, USA
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25
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Parish SL, Swaine JG, Son E, Luken K. Determinants of cervical cancer screening among women with intellectual disabilities: evidence from medical records. Public Health Rep 2013; 128:519-26. [PMID: 24179263 PMCID: PMC3804095 DOI: 10.1177/003335491312800611] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We examined receipt of cervical cancer screening and determinants of screening for women with intellectual disabilities in one Southeastern state. METHODS Using medical records data from 2006 through 2010 for community-dwelling women with intellectual disabilities who were 18-65 years of age (n=163), we employed descriptive and bivariate statistics and a multivariate regression model to examine receipt of cervical cancer screening and the determinants of cervical cancer screening across women's sociodemographic and health-care provider characteristics. RESULTS Of women 18-65 years of age with intellectual disabilities, 55% received a Papanicolaou (Pap) test during 2008-2010, markedly below the Healthy People 2020 targets or rates of Pap test receipt of women without intellectual disabilities. Women with intellectual disabilities who lived in residential facilities, those who lived in rural communities, and those who had an obstetrician/gynecologist had higher rates of receipt of care than other women with intellectual disabilities. CONCLUSIONS Assertive measures are required to improve the receipt of cervical cancer screening among women with intellectual disabilities. Such measures could include education of women with intellectual disabilities, as well as their paid and family caregivers, and incentives for health-care providers who achieve screening targets.
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Affiliation(s)
- Susan L. Parish
- Brandeis University, Heller School for Social Policy and Management, Lurie Institute for Disability Policy, Waltham, MA
| | - Jamie G. Swaine
- University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, NC
| | - Esther Son
- Brandeis University, Heller School for Social Policy and Management, Lurie Institute for Disability Policy, Waltham, MA
| | - Karen Luken
- University of North Carolina at Chapel Hill, FPG Child Development Institute, North Carolina Office on Disability and Health, Chapel Hill, NC
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Tichá R, Hewitt A, Nord D, Larson S. System and individual outcomes and their predictors in services and support for people with IDD. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2013; 51:298-315. [PMID: 24303819 DOI: 10.1352/1934-9556-51.5.298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The growth and advancement of community-based services for people with intellectual and developmental disabilities (IDD) have resulted in vast changes in the long-term services and support landscape as well as in expected outcomes of service systems for service recipients. Investments in IDD research have been made to provide a deeper understanding of these outcomes and to explain them. This article summarizes outcomes and their predictors through systems and individual lenses by examining the research and findings of the Administration on Intellectual and Developmental Disabilities' Data Projects of National Significance that address residential services, employment services, costs of services, and individual outcomes. The article also discusses challenges and debates associated with outcome-related research and poses future research questions.
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