Women with disabilities experience elevated risk for adverse pregnancy outcomes. Most studies have inferred disabilities from diagnosis codes, likely undercounting disabilities. We analyzed data, including self-reported disability status, from the National Survey of Family Growth for the period 2011-19. We compared respondents with and without disabilities on these characteristics: smoking during pregnancy, delayed prenatal care, preterm birth, and low birthweight. A total of 19.5 percent of respondents who had given birth reported a disability, which is a much higher prevalence than estimates reported in US studies using diagnosis codes. Respondents with disabilities were twice as likely as those without disabilities to have smoked during pregnancy (19.0 percent versus 8.9 percent). They also had 24 percent and 29 percent higher risk for preterm birth and low birthweight, respectively. Our findings suggest that studies using diagnosis codes may represent only a small proportion of pregnancies among people with disabilities. Measurement and analysis of self-reported disability would facilitate better understanding of the full extent of disability-related disparities, per the Affordable Care Act.
ABSTRACT Prostate cancer survivors (PCS) receiving androgen deprivation therapy (ADT) often experience adverse effects that negatively affect physical function and quality of life. Exercise may ameliorate those treatment adverse effects, and effective, scalable interventions to increase exercise behaviors are needed. The objective of our review is to evaluate both the efficacy and the implementation methods of exercise interventions for PCS receiving ADT. We searched MEDLINE®, PsycINFO, and the Cochrane Central Register of Controlled Trials through May 2016. Randomized controlled trials of exercise intervention PCS receiving ADT were included. The protocol was registered with PROSPERO (#CRD42015017348). Two authors independently reviewed articles for inclusion and risk of bias. Nine articles describing eight randomized controlled trials were included. The included interventions varied in training type (resistance or aerobic), length of intervention, dose of training (number of exercise sessions per week), and whether training was supervised or unsupervised. Despite heterogeneous interventions, varied measures, and generally short duration of training (average of 12 wk), improvements in fitness, symptoms, physical function, and quality of life were reported. The exercise training sessions were well attended, because few participants discontinued their participation in the exercise interventions, and attendance at supervised exercise sessions ranged from 74% to 94%. Self-reported compliance with the unsupervised exercise component was lower than that with the supervised sessions for trials that reported these data. In conclusion, supervised programs may be less scalable or accessible to populations with limited access. Future efforts should focus on delivery of programs that can adequately scale and contain the features of successful supervised interventions so that broad uptake by PCS on ADT can be achieved.
Background: There is an important need to better understand how self-evaluations of health are reached among people with and without disabilities. The purpose of the present study was to use epidemiological data to confirm differences in self-rated health and healthrelated quality of life among people with and without disabilities, and to demonstrate that disability status influences how one thinks about self-rated health. Methods: Secondary analysis of cross-sectional data from the Behavioural Risk Factor Surveillance System (BRFSS). Health-related quality of life (HRQOL) core questions were asked, including self rated health, and the Healthy Days Index. Participants consisted of 303,822 adults (18 or older) from all states, the District of Columbia, and all U.S. territories who responded to the BRFSS in 2004. Results: Adults who self-reported an activity limitation or use of adaptive equipment reported poorer self-rated health, more recent days when physical health or mental health was not good, and fewer healthy days. Within the same SRH category, people with disabilities reported significantly more recent days when physical health was not good, more days when mental health was not good, and fewer healthy days than people without disabilities. Conclusions: The findings suggest that people with disabilities may construct health or the self-rating process differently than persons without disabilities. Further understanding of the underlying process of health and HRQOL self-assessment may help elucidate the meaning of self-rated health among adults with and without disabilities. This conceptual disentangling of health from disability is necessary to track
Public health qualitative research has largely failed to achieve full inclusion of people with disabilities and Black people and Latinx/as. Although there is a small, but growing, community of academic researchers from each of these communities, there has been limited involvement of non-academic community members in research. While Community-Based Participatory Research (CBPR) has informed the inclusion of marginalized groups in research for decades, instances of full inclusion of disabled Black people and Latinx/as in public health research have been minimal. One way to ensure the inclusion of Black/Latinx community members with disabilities is to involve them as peer researchers. As part of a qualitative study examining pregnancy experiences of individuals with physical disabilities from Black/Latinx communities, academic researchers trained four peer researchers to conduct interviews and analyze the data. This paper describes our approach, which may serve as a model for training peer researchers in qualitative research methodology for future studies. All peer researchers were women who identified as Black or Latina parents with physical disabilities. This approach was chosen due to the study’s focus on the intersections of disability, race, ethnicity, and pregnancy, and applied a disability justice lens. Although CBPR offers important principles for research existing literature suggests CBPR is not always inclusive and power sharing. Therefore, we developed a research training model which places a unique and timely focus on the intersections of CBPR, racial and disability justice, the importance of building the capacity of Black and Latina disabled peer researchers, and its importance to building community relationships and trust.
This study investigated associations between chronic medical conditions, activities of daily living (ADL), and health-related quality of life (HRQOL). Our findings suggest that the number of ADL limitations reported by older adults is associated with their HRQOL. Findings from our analyses also suggest that the association between having multiple comorbid conditions and HRQOL is stronger for those with no ADL limitations than those with at least some limitations. These data will aid practitioners in determining the relative importance of chronic medical conditions and ADL limitations on HRQOL and demonstrate how ADL limitations and comorbid conditions may differentially impact HRQOL.
