Community-based Rehabilitation Research Articles

The impact of community-based pulmonary rehabilitation on the health and lives of migrant workers with pneumoconiosis in China: a qualitative study exploring patient experience

Background Globally, China has the highest prevalence and incidence of pneumoconiosis, which mainly occurs among migrant workers employed in dusty work environments. Pulmonary rehabilitation (PR) is recommended as the most effective therapeutic strategy in managing chronic obstructive pulmonary disease, and recent quantitative studies have validated PR’s effect on the health outcomes of patients with pneumoconiosis. However, qualitative evidence regarding PR’s impact on pneumoconiosis patients’ health and lives is lacking in the literature. Therefore, this study aimed to address this knowledge gap by exploring the experience of pneumoconiosis patients in community-based PR (CBPR). Methods A qualitative study based on the phenomenological perspective was conducted. The convenience sampling method was used to recruit pneumoconiosis patients attending a CBPR program supported by a patient advocacy non-governmental organisation. Web-based semi-structured interviews were conducted using a self-made interview guide. Thematic analysis was performed to analyse the interview data. This study was conducted after gaining ethical approval and informed consent from all participants. Results Fifteen migrant workers with pneumoconiosis patients aged 49 to 71 years old (median: 54 years old) participated in this study. Four themes were identified from the interview data: triggering of a difficult life, reconstruction of life, sense of empowerment, and gaps in PR. Pneumoconiosis severely impaired participants’ well-being, and it triggered heavy financial strain and care burden in their families. The CBPR program allowed them to restore their physical and psychosocial health, and they achieved reconstructing their lives by leading a PR-centred life. Participating in the CBPR program, pneumoconiosis patients recognised multiple supports and were empowered with enhanced disease-coping abilities and strengthened hope to survive. Overall, participants reflected on their positive experience in the CBPR program, despite their unmet needs and existing barriers in PR. Conclusions The CBPR program integrating multiple supports empowered the vulnerable migrant workers with pneumoconiosis and facilitated their health transition and life reconstruction experience. To optimise their PR experience and improve their QoL, health service addressing their unmet needs and barriers in PR is needed. PR for pneumoconiosis patients with different sociodemographic characteristics and family-oriented management of pneumoconiosis should be explored in future research.

Biopsychosocial predictors of drug dependence among Filipino drug users in community-based drug rehabilitation

This study examines the biopsychosocial predictors of drug use and dependence among Filipino drug users enrolled in community-based drug rehabilitation. Data from 925 clients revealed that the severity of drug use, cigarette and alcohol use, recovery skills, and mental health problems predict drug dependence. Family support, life skills, and psychological well-being are indirect predictors of severity of use. Results also revealed differences in predictors by sex, level of use, and type of clients. These findings highlight the importance of a client-centered approach to treatment and suggest what might be critical elements in a community-based drug rehabilitation program in the Philippines.

Effectiveness of Community-Based Rehabilitation Interventions on Symptoms and Functioning for People with Schizophrenia: A Systematic Review and Meta-Analysis.

Schizophrenia is a serious mental illness that imposes huge burden of illness on the society. We aimed to conduct a meta-analytic and systematic review of literature on the effectiveness of community-based rehabilitation interventions on symptoms and functioning for people with schizophrenia. The PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL databases were searched through April 16 and 17, 2021, including clinical trial registries and previous Cochrane reviews. We included 24 randomized controlled trials in this review. The content of interventions varied from single-faceted rehabilitation intervention or cognitive retraining, to multi-component rehabilitation interventions or case management. Among 20 studies that reported effects of community-based rehabilitation interventions on symptoms, the pooled SMDs across all interventions was 0.94 (95% CI = 0.11, 1.76; P < 0.001; I2 = 99.1%; n = 3694), representing a strong effect. 21 included studies showed that community-based rehabilitation interventions also had beneficial impacts on functioning (SMD = 1.65; 95% CI = 0.88, 2.43; P < 0.001; I2 = 98.9%; n = 3734). Overall quality of evidence was moderate with a high level of heterogeneity. Community-based rehabilitation interventions have positive effectiveness in improving patients' symptoms and functioning. Community-based rehabilitation interventions should therefore be provided as an adjuvant service in addition to facility-based care for people with schizophrenia.

Cardiovascular risk factor profile in patients admitted to a community-based cardiac rehabilitation program after one year: what risk factors are not being controlled?

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiac rehabilitation (CR) is a multidisciplinary intervention designed to reduce cardiovascular (CV) risk, encourage healthy behaviors, reduce physical impairment, and promote an active lifestyle. After completing a phase II CR program, it is important to maintain long-term CV risk factor control. However, many patients do not achieve or maintain lifestyle and risk factor targets on a long-term basis. Therefore, it is of interest to understand which risk factors are not reaching the targets to better understand and personalize long-term community-based CR programs. Purpose To characterize the modifiable CV risk factors profile in coronary artery disease (CAD) patients admitted to a community-based phase III CR program, including lipid profile, overweight/obesity, physical activity (PA) and sedentary behaviour (SB), at the beginning and after completing the first year of the CR program. Methods This retrospective cohort study included CAD patients that attended for 1-year a community-based phase III CR program. At the beginning (M0) and after one year (M1) of the CR program, all patients performed a risk profile assessment including: Lipid profile [total cholesterol (total-c), high density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL)], body mass index (BMI), PA and SB. BMI was assessed with the patient's weight in kilograms divided by the square of height in meters and lipid profile values were obtained from blood testing. PA and SB were objectively measured by using an accelerometer. All participants attended supervised exercise sessions, 3x week, 60 mins, including aerobic and resistance exercises, 3 educational sessions and a nutritional counseling consultation per year. Results In the sample of 159 patients at baseline (81.8% male, mean age 61±10 years, BMI: 28.3±4.3 kg/m²), overweight and obesity proved to be the most prevalent risk factor (80.7%), followed by uncontrolled LDL levels (74.8%). After a 1-year intervention (n=48, 90% male, mean age 62±10 years), LDL levels were kept above the targets (M0: 73.3±28.9 mg/dL and M1: 68.6±19.6 mg/dL, p=0.186), BMI did not change (M0: 27.5±3.9 kg/m² and M1: 27.8±4.0 kg/m², p=0.168) and SB remained high (M0: 11.50±2.90 hours/day and M1: 11.58 ± 2.71 hours/day, p=0.908). Although, moderate to vigorous PA (MVPA) decreased (M0: 343±195 mins/week and M1: 293±164 mins/week, p&amp;lt;0.001), participants were still on target, between 150 to 300 mins MVPA week. Conclusion Our findings show that after a 1-year of a phase III CR program intervention CVD patients maintained MVPA recommended levels, but did not reach body composition, lipid profile, and SB targets. Future strategies should be implemented in long-term CR programs to better control LDL, body composition and SB.

Community-based rehabilitation interventions on quality of care for people with schizophrenia in China (CRISC): study protocol for a cluster-randomized controlled trial

BackgroundInternational consensus shows that community-based rehabilitation (CBR) service is an effective way to improve functioning and negative symptoms and address the treatment gap for schizophrenia. Rigorous trials are needed in China to demonstrate effective and scalable CBR interventions to significantly improve outcomes for people with schizophrenia and to provide evidence of the economic benefits. The objectives of this trial are to examine the effectiveness of CBR as an adjunct to test the usual facility-cased care (FBC) in comparison to FBC alone in improving a range of outcomes in people with schizophrenia and their caregivers.Methods This trial is a cluster randomized controlled trial design in China. The trial will be conducted at three districts of Weifang city, Shandong province. Eligible participants will be identified from the psychiatric management system where community-dwelling patients with schizophrenia have been registered. Participants will be recruited after providing informed consent. 18 sub-districts will be randomly allocated in a 1:1 ratio to facility-based care (FBC) plus CBR (intervention arm) or FBC alone (control arm). The structured CBR intervention will be delivered by trained psychiatric nurses or community health workers. We aim to recruit 264 participants. The primary outcomes include symptoms of schizophrenia, personal and social function, quality of life, family burden of caring, etc. The study will be conducted according to good ethical practice, data analysis and reporting guidelines.Discussion If the hypothesized clinical benefit and cost-effectiveness of CBR intervention are confirmed, this trial will provide significant implications for policy makers and practitioners to scale up rehabilitation services, as well as for people with schizophrenia and their family to promote recovery and social inclusion, and to alleviate the burden of care.Trial registrationChinese Clinical Trial Registry (ChiCTR2200066945). Registered December 22, 2022.

Evaluation of a community-based integrated care model (CIE) for frail older people in rural Foshan, China: study protocol for a stepped-wedge cluster randomized controlled trial {1}

BackgroundWhile community-based eldercare has proven to be effective in qualitative studies, there is limited evidence on the effectiveness of this geriatric care model in rural communities where caring for older people is traditionally the responsibility of family members, but a formal long-term care was recently introduced in China. CIE is a rural community-embedded intervention using multidisciplinary team, to provide evidenced-based integrated care services for frail older people including social care services and allied primary healthcare and community-based rehabilitation services.MethodsCIE is a prospective stepped-wedge cluster randomized trial conducted at 5 community eldercare centers in rural China. The multifaceted CIE intervention, guided by chronic care model and integrated care model, consists of five components: comprehensive geriatric assessment, individualized care planning, community-based rehabilitation, interdisciplinary case management, and care coordination. The intervention is rolled out in a staggered manner in these clusters of centers at an interval of 1 month. The primary outcomes include functional status, quality of life, and social support. Process evaluation will also be conducted. Generalized linear mixed model is employed for binary outcomes.DiscussionThis study is expected to provide important new evidence on clinical effectiveness and implementation process of an integrated care model for frail older people. The CIE model is also unique as the first registered trial implementing a community-based eldercare model using multidisciplinary team to promote individualized social care services integrated with primary healthcare and community-based rehabilitation services for frail older people in rural China, where formal long-term care was recently introduced.Trial registration {2a}China Clinical Trials Register (http://www.chictr.org.cn/historyversionpub.aspx?regno=ChiCTR2200060326). May 28th, 2022.

Defining a Treatment Model for Self-Management of Fatigue in Rehabilitation of Acquired Brain Injury Using the Rehabilitation Treatment Specification System.

Systematic treatment descriptions to standardize and evaluate management of fatigue after acquired brain injury (ABI) are lacking. The purpose of this multi-phase qualitative study was to formulate a treatment model for promoting self-management of fatigue in rehabilitation of ABI based on practice-based understandings and routines. The study was conducted in a community-based rehabilitation center in Denmark. The model was defined using the Rehabilitation Treatment Specification System. Phase 1 comprised co-production workshops with five service providers (occupational therapists, physiotherapists, and a neuropsychologist) to elicit preliminary treatment theories. In Phase 2, four case studies were conducted on management of fatigue in vocational rehabilitation. Interviews (n = 8) and treatment log entries (n = 76) were analyzed thematically to specify treatment targets and active ingredients. The treatment model comprised five main components: (i) Knowledge and understanding of fatigue, (ii) Interoceptive attention of fatigue, (iii) Acceptance of fatigue, (iv) Activity management, and (v) Self-management of fatigue. For each component, lists of targets and active ingredients are outlined. In conclusion, management of fatigue includes multiple treatment components addressing skills, habits, and mental representations such as knowledge and attitudes. The model articulates treatment theories, which may guide clinical reasoning and facilitate future theory-driven evaluation research.

The Dilemma and Solution of Socialized Extension Work in China&amp;apos;s Judicial Administrative Drug Rehabilitation

The Anti-Drug Law has established a four-in-one drug rehabilitation system, including voluntary drug rehabilitation, community-based drug rehabilitation, compulsory isolation drug rehabilitation, and community rehabilitation. Community rehabilitation, as a consolidation measure after drug rehabilitation, is constrained by factors such as personnel, funding, and technology, which prevent it from fully exerting its function of consolidating drug rehabilitation effects. Social extension, as an extension of the function of compulsory isolation drug rehabilitation facilities, has compensated for the shortcomings of community rehabilitation in terms of professional talent and technical support. However, due to inadequate legal support, different supervisory departments, and overlapping business responsibilities, social extension work currently faces many difficulties. With the development of society and the improvement of understanding of drug rehabilitation laws, the focus of compulsory isolation drug rehabilitation work will not be limited to fixed locations and a period of about two years. Instead, it should leverage advantages in talent, technology, and information to reshape institutions and optimize processes around reducing relapse rates. Through on-site investigations of the current social extension work, it is found that there are currently issues such as incomplete laws and regulations, unconsolidated business processes, no established follow-up care and tracking mechanisms, low social extension service levels, insufficient publicity efforts, and deviation from guiding principles. Based on China's current political, economic, and technological foundations, there is still a lot of room for improvement in the effectiveness of social extension work. From a legal perspective, the legislative process should be accelerated and current laws and regulations should be improved. From a process perspective, business processes should be re-engineered and organizational structures optimized. From a talent perspective, incentive mechanisms should be improved, and professional development strengthened. From a service perspective, employment issues should be emphasized to create a return environment. From an information perspective, digital construction should be accelerated to meet audience needs. From an acceptance perspective, drug prevention publicity should be expanded, and guiding principles clarified. From an iterative perspective, a negotiation platform should be established, and a corrective mechanism constructed.

Mental health rehabilitees’ agency construction and promotion in community-based transitional work programme

ABSTRACT Purpose The integration of mental health rehabilitees into the labour market is an important policy objective everywhere in the world. The international Clubhouse organization is a third-sector actor that offers community-based psychosocial rehabilitation and supports and promotes rehabilitees’ state of acting and exerting power over their lives, including their (re)employment. In this article, we adopt the perspective of discursive psychology and ask how mental health rehabilitees’ agency is constructed and ideally also promoted in the Clubhouse-based Transitional Employment (TE) programme. Methods The data consisted of 26 video-recorded TE meetings in which staff and rehabilitees of one Finnish Clubhouse discussed ways to further their contacts with potential employers. The analysis was informed by discursive psychology, which has been heavily influenced by conversation analysis. Results The analysis demonstrated how rehabilitees adopt agentic positions in respect to TE-related future activities, and how Clubhouse staff promote and encourage but also discourage and invalidate these agentic positionings. The analysis demonstrated the multifaceted nature of agency and agency promotion in the TE programme. Conclusions Although ideally, Clubhouse activities are based on equal opportunities, in everyday interaction practices, the staff exercise significant power over the question whose agency is promoted and validated in the TE programme.

Living the Process: Examining the Continuum of Coercion and Care in Tijuana's Community-Based Rehabilitation Centers.

In Mexico, community-based, non-biomedical treatment models for substance use are legally recognized in national drug policy, monitored by state-level Departments of Health, and in some cases publicly funded. Academic research on centers that utilize these forms of treatment have focused primarily on documenting their rapid spread and describing their institutional practices, particularly human rights abuses and lack of established biomedical efficacy. In Tijuana, these community-based therapeutic models are shaped by conceptions of health and illness from the local cultural context of the United States-Mexico border zone in ways that do not cleanly match western, biomedical notions of the illness "addiction." In this article, I examine treatment ethics by exploring the contextually understood need for coerced treatment (i.e., why centers are locked) along with experiences of compulsion in a women's 12 Step center. These discussions highlight the contested therapeutic value of coercion from multiple perspectives. Utilizing engaged listening around local care practices marks a path for global mental health researchers to understand and sit with difference in order to communicate across opposing viewpoints in the service of mental health equity and best care practices.

Technology-based interprofessional collaboration in primary care for home rehabilitation of the older adults: A dutch exploratory study.

Primary healthcare professionals face an increasing number of geriatrics patients, and patient care often involves different disciplines. eHealth offers opportunities to support interprofessional collaboration (IPC). This exploratory study aimed to gain insight in 1) IPC in community-based rehabilitation, 2) facilitators and barriers for technology-based IPC and 3) technological IPC solutions envisioned by the primary healthcare professionals An focus group with six primary healthcare professionals and a design thinking session with four participants were conducted. Data analysis was based upon an IPC model. Results indicate that facilitators and barriers for IPC can be clustered in three categories: human, organization and technology, and provide some requirements to develop suitable IPC technological solutions Primary healthcare professionals recognise the urgency of working collaboratively. Current barriers are understanding each other's professional vocabulary, engaging the older adults, and using technology within the patient's environment. Further research is needed to integrate IPC components in a technological solution.

Rehabilitasi Mental Berbasis Komunitas terhadap Kualitas Hidup ODGJ

This study aims to map community-based mental rehabilitation on the quality of life of ODGJ in primary care settings. This research method uses the Scoping Review research method. A literature search was done by searching Pubmed, Scopus, Ebsco, and Google Scholar. The search uses Severe Mental Illness (SMI), Community Based Rehabilitation, and Quality Of Life. The results showed that most community-based mental rehabilitation could improve the quality of life for ODGJ, including schizophrenic, schizoaffective, bipolar, and psychotic. This also affects the quality of life of families/caregivers. The types of rehabilitation provided include psychoeducation and social training, balancing everyday life (BEL), self-management programs, emotional management, instilling hope, mindfulness, progressive muscle relaxation, physical activity training, and peer support. In conclusion, the review results can help increase the capacity of mental health programs in the community. They can be effectively applied in developing community mental health rehabilitation therapy.&#x0D; &#x0D; Keywords: Quality of Life, Severe ODGJ, Community Rehabilitation

The current situation of community-based rehabilitation in commune health station of a district in Nghe An province

Community-based rehabilitation (CBR) has been proven effective for people with disabilities (PWDs) and their families, saving medical resources, and is particularly suitable for developing countries1,2. However, in Vietnam, due to the lack of facilities and CBR human resources, the rehabilitation needs of PWDs were not met. Thanh Chuong is a district that has implemented CBR activities at commune health stations for PWDs, in conjunction with the project on victims of the toxic chemical Dioxin. Several duties have been assigned to commune health workers as stated in the CBR program, yet commune health workers were not assigned specifically to do rehabilitation tasks. This study aims to describe the current status of CBR activities at commune health stations, in Thanh Chuong district, Nghe An Province in 2022. The study used a cross-sectional design, mixed methods were employed. The study was conducted from December 2021 to August 2022. Qualitative data are analyzed thematically. Participants were mainly female, about half of them aged 30-49 years old, most of them are nursing, and general medical staff and no staff had a rehabilitation background. The level of performance and confidence in performing the tasks were similar. Among the 8 tasks assigned to the commune health stations, 3 tasks have been performed in 38 communes at different levels including making management records, classifying PWDs, and reporting on transferring PWDs to higher levels. However, these activities are not carried out properly and sufficiently and there was no list of people with disabilities. It is necessary to review the list of CBR activities and have policies to support these activities at the grassroots level, especially to have a health worker in charge of CBR available to fully implement the program's activities, thus helping PWDs integrate into the community, and reducing caring burden or caregivers for PWDs.

Perspectives of patients on technology-supported community-based rehabilitation: a qualitative study

Introduction: The study's primary aim is to explore the perspectives and experiences of patients regarding technologysupported community-based rehabilitation in the Philippines. The secondary aim is to ascertain the utilization of technologysupported community-based rehabilitation based on the participants' responses. Methods: In this qualitative phenomenological study, purposive sampling for recruitment was utilized. Online focus group discussions were conducted with patients who have received rehabilitation in a technology-supported community-based rehabilitation setting. The recorded discussions were transcribed and coded using NVivo 12 software. The study employed an inductive approach of thematic analysis to extract significant themes. Continuous refinement and data analysis were done for data saturation. Results: Five themes emerged using Braun and Clarke’s thematic analysis: accessibility in technology-supported community-based rehabilitation, primary device and platforms used in technologysupported community-based rehabilitation, limitations of technology-supported community-based rehabilitation, perceived usefulness of technology in community-based rehabilitation, and patient satisfaction. Discussion: The facilitators and barriers found in the study affect the participants’ access and perceived usefulness of technology-based community-based rehabilitation which contributes to patient satisfaction. The study also found that patients perceived technology useful in community-based rehabilitation because it facilitates learning of exercises and enhances adherence to home exercise programs.

Designing a content validated community needs assessment questionnaire for Barangays in Binangonan, Rizal: a psychometric study

Introduction: Needs assessment is essential before developing a community-based rehabilitation program to identify the factors that may affect the quality of life (QOL) in a community. However, no assessment tools were readily accessible and directed toward this study's target population and research locale. The study aims to develop and validate Community Assessment for Rehabilitation Enhancement (CARE), a PRECEDE-PROCEED model-based questionnaire that assesses the needs of barangays in Binangonan, Rizal. Methods: The questionnaire items were grounded on related literature using keywords and Boolean operators across various research databases. A purposive sampling method was utilized to recruit a panel of experts to evaluate CARE’s content validity. Content validity was assessed by evaluating the tool’s grammar, choice of words, question construction, and scoring of items. The researchers then analyzed the data using content validity ratio (CVR) and content validity index (CVI). Results: After reviewing related literature, the researchers generated 75 items for CARE, 55 of which were deemed appropriate based on the CVI. However, only one item in the questionnaire had a CVR result of at least 0.99. Discussion: To further improve the current status of the questionnaire, additional rounds of Delphi, more panel experts, and a Filipino translation of the questionnaire may be done.

Measurement Properties of the Dutch Multifactor Fatigue Scale in Early and Late Rehabilitation of Acquired Brain Injury in Denmark.

Fatigue is a major issue in neurorehabilitation without a gold standard for assessment. The purpose of this study was to evaluate measurement properties of the five subscales of the self-report questionnaire the Dutch Multifactor Fatigue Scale (DMFS) among Danish adults with acquired brain injury. A multicenter study was conducted (N = 149, 92.6% with stroke), including a stroke unit and three community-based rehabilitation centers. Unidimensionality and measurement invariance across rehabilitation settings were tested using confirmatory factor analysis. External validity with Depression Anxiety Stress Scales (DASS-21) and the EQ-5D-5L was investigated using correlational analysis. Results were mixed. Unidimensionality and partial invariance were supported for the Impact of Fatigue, Mental Fatigue, and Signs and Direct Consequences of Fatigue, range: RMSEA = 0.07-0.08, CFI = 0.94-0.99, ω = 0.78-0.90. Coping with Fatigue provided poor model fit, RMSEA = 0.15, CFI = 0.81, ω = 0.46, and Physical Fatigue exhibited local dependence. Correlations among the DMFS, DASS-21, and EQ-5D-5L were in expected directions but in larger magnitudes compared to previous research. In conclusion, three subscales of the DMFS are recommended for assessing fatigue in early and late rehabilitation, and these may facilitate the targeting of interventions across transitions in neurorehabilitation. Subscales were strongly interrelated, and the factor solution needs evaluation.

Overcoming barriers for people with disabilities participating in income-generating activities: A proposed development framework.

People with disabilities in sheltered workshops are disempowered and face many barriers, adversely affecting their income-generating activities and weakening their competitiveness in the labour market. There is limited evidence on how to overcome these barriers. This paper seeks to propose a framework to overcome the barriers experienced by people with disabilities participating in income-generating activities in a sheltered workshop. The qualitative exploratory single case study was done with observations and semi-structured interviews as data collection methods. Purposive sampling was used to select 24 participants between ages 22 and 52 years, and content analysis was done of transcribed interviews. Community-based rehabilitation (CBR) guidelines were used to develop the framework. A proposed framework was developed that outlined intervention strategies to address the barriers experienced by sheltered workshop participants to promote increased participation of people with disabilities in income-generation activities, thereby improving their quality of life. The participation of people with disabilities in income-generating activities is hindered by several barriers. However, the proposed framework overcomes the barriers to effective participation in income-generating activities. People with disabilities will benefit from this framework as it will address their challenges and needs for empowerment. It would also inform stakeholders involved about these challenges and strategies.

Evaluating Community-Based Rehabilitation for Employment Inclusion among Young People Living with Visual Impairment: Focus on Kenya

The purpose of this study was to review Community-Based Rehabilitation (CBR) as a strategy recognized internationally to address barriers of access to equal opportunities and improvement of quality of life (QOL) for people with disabilities. The study also sought to interrogate how CBR be localized in Kenya to meet the sociocultural, health, education and economic needs of young people with visual impairment. When CBR was first developed in the 1980s, it was centered on providing access to community-level health and therapy. The World Health Organization (WHO) saw CBR as a strategy to increase access to rehabilitation services at community level for people with disabilities. However, the CBR approach has evolved into a much broader, multisectoral approach to inclusivity at community level in supporting and increasing development (WHO, 2017). Young people with disabilities in Kenya are generally not accessed equal opportunities and work participation in the community. They are marginalized owing to cultural biases and severity of disabilities which interact with such factors as gender, age and poverty.

Disability, Rehabilitation, and Assistive Technologies for Refugees and Asylum Seekers in Italy: Policies and Challenges

Good health and well-being for all, including those with disabilities, is one of the main sustainable development goals. Data on refugees and asylum seekers with disabilities are limited. Refugees have poor access to rehabilitation and assistive technologies, although laws and policies in Italy guarantee this type of healthcare. However, there are several limitations to the successful implementation of these services. First, the national health system is regionally based, and therefore healthcare facilities and services vary in terms of quality in different regions. A link between reception centers and the healthcare system is therefore highly recommended, because only 10 out of 20 regions have specific services for refugees and asylum seekers with disabilities. Second, only 2% of the total available posts for hosting refugees are reserved for people with disabilities. The lack of a standardized vulnerability assessment represents the main barrier to the organization of specific services for migrants within the community. National stakeholders urgently need to collaborate in order to remove barriers to rehabilitation and assistive technology for refugees with disabilities. Initiatives should focus on health literacy and the empowerment of migrants, data collection on health, disability, and assistive technology, and the organization of community-based rehabilitation programs.

Mapping Social Network Influences of Recovering Filipino Drug Users in Community-Based Drug Rehabilitation

Mapping Social Network Influences of Recovering Filipino Drug Users in Community-Based Drug Rehabilitation