Mobility-related Disabilities Research Articles

A Qualitative Evaluation of the Usability and Accessibility of Home COVID-19 Tests Among People with Disabilities

Home COVID-19 test kits are increasingly available in the United States, and efforts are underway to develop ones that are more accessible to people with disabilities. The primary objective of this research was to assess the usability and accessibility of existing home COVID-19 tests among people with disabilities. The aim is to better understand their needs and provide evidence for improved product design. A survey that included short-response questions about user experience with various home COVID-19 test kits was completed by 219 people with vision and mobility-related disabilities. A thematic analysis identified three overarching themes: Ease of Use, Privacy and Autonomy in Home COVID-19 Testing, and Recommendations for Improvement. The results of this study contribute to an increased understanding of how to design appropriate, accessible home COVID-19 test kits for people with disabilities.

Examining the roles of disability-related body esteem and perceived burdensomeness in suicidal ideation among adults with vision- and mobility-related disabilities.

People with disabilities (PWD) generally exhibit an increased risk of suicidal ideation (SI) and behaviors. Underlying cognitive states, namely perceived burdensomeness, have been identified as a contributor to the increased risk of suicidal thoughts and behaviors in PWD. However, the role of body esteem in the development of SI in this population remains unexamined, despite its salience in other populations. In this study, we examined whether the interaction of perceived burdensomeness and body esteem contributed to the perceived likelihood of future SI among PWD, and whether this relationship was further moderated by disability type. Participants included 119 adults with self-reported vision- and mobility-related disabilities who participated in a larger study focused on disability and suicide involving interviews and self-report measures. We examined the interaction between perceived burdensomeness and disability-related body esteem on self-reported likelihood of future SI and whether this interaction was further moderated by disability type (i.e., vision- or mobility-related disability). Greater perceived burdensomeness was associated with a greater perceived likelihood of future SI only for participants with vision impairments and at low levels of body esteem. The combination of experiences of perceived burdensomeness and low body esteem may be particularly relevant to SI among people with vision-related versus mobility-related disabilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

I Know My Rights! A Longitudinal Study of Discrimination due to Physical Inaccessibility from the Perspective of Wheelchair Users.

It is a fundamental right to be able to access society and the services in it. From the perspective of disability rights, people with mobility-related disabilities who use wheelchairs must have equal opportunities to participate in and contribute to society - whether it is school, work, or (activity) leisure. This ongoing study is a longitudinal document study with qualitative content analysis. The document study is based on incoming complaints of discrimination due to inaccessibility received by the DO in Sweden, 2015-2023. The study explores how the users of wheelchairs and scooters experience discrimination due to their inaccessibility, using the ICF framework, among reported complaints to the DO from 2015-2023. The preliminary results show an increase in the number of complaints about discrimination across the entire period of 2015-2023. Responding to peoples' lived perspectives has often been cited as crucial to understanding how inclusion and exclusion play out in real life. A more accessible world depends on the extent of our knowledge and the politics of knowing-making, according to recently published research. Analyzing complaints about lack of accessibility over time generates essential knowledge for how discrimination against people who use wheelchairs can be prevented. This project also contributes to essential knowledge for social sustainability, economic sustainability, and a sustainable, accessible environment for people who use wheelchairs.

Disparities in Breast Cancer Patients with Disabilities: Care Gaps, Accessibility, and Best Practices.

Significant disparities exist in detecting and treating breast cancer in women with disabilities, leading to cancer detection at advanced stages. This paper provides an overview of disparities for women with disabilities related to breast cancer screening and care, primarily focusing on significant mobility disabilities. Current care gaps include screening barriers related to accessibility and inequitable treatment options, with race/ethnicity, socioeconomic status, geographic location, and disability severity factors, mediating the disparities for this population. The reasons for these disparities are myriad and stem from both system-level deficiencies and individual-level provider bias. Although structural changes are warranted, individual healthcare providers must also be incorporated in the requisite change. Intersectionality is critical to disparities and inequities and should be central to any discussion of strategies for improving care for people with disabilities, many of whom have intersectional identities. Efforts to reduce screening rate disparities for breast cancer in women with significant mobility disabilities should start with improving accessibility through removing structural barriers, establishing comprehensive accessibility standards, and addressing healthcare provider bias. Future interventional studies are needed to implement and assess the value of programs to improve breast cancer screening rates in women with disabilities. Increasing the representation of women with disabilities in clinical trials may provide another avenue for reducing treatment disparities, as these trials often provide breakthrough treatment to women with cancer diagnosed at later stages. Ultimately, attention to the specific needs of patients with disabilities should be improved across the US to promote inclusive and effective cancer screening and treatment.

High-Intensity Functional Training: Perceived Functional and Psychosocial Health-Related Outcomes from Current Participants with Mobility-Related Disabilities.

People with mobility-related disabilities (MRDs) experience many personal and environmental barriers to engagement in community-based exercise programs. We explored the experiences of adults with MRD who currently participate in high-intensity functional training (HIFT), an inclusive and accessible community-based exercise program. Thirty-eight participants completed online surveys with open-ended questions, with ten individuals also participating in semi-structured interviews via telephone with project PI. Surveys and interviews were designed to examine changes to perceived health, and the elements of HIFT that promote sustained participation. Thematic analysis revealed themes related to health changes following HIFT participation including improved physical, functional, and psychosocial health outcomes. Other themes emerged within the HIFT environment that promoted adherence for participants such as accessible spaces and equipment, and inclusive HIFT sessions and competitions. Additional themes included participants' advice for the disability and healthcare communities. The resulting themes are informed by the World Health Organization's International Classification of Functioning, Disability, and Health. The findings provide initial data on the potential effects of HIFT on multiple dimensions of health outcomes and contribute to the growing literature on community-based programs that are adaptable and inclusive for people with MRD.

Quality of Life of People with Mobility-Related Disabilities in Sweden: A Comparative Cross-Sectional Study.

Little is known about the Quality of Life (QoL) and how QoL is related to the social and economic situation of people with mobility-related disabilities in Sweden. QoL and well-being do not only relate to the absence of impairments but also to the level of social inclusion and the economic situation. The objective of this study was to explore if there were differences in QoL between a group with and a group without mobility-related disabilities in Sweden. Cross-sectional data were collected through self-reported questionnaires. WHOQOL-BREF was used to assess QoL. Recruitment was conducted through social media platforms. Comparisons were made between and within groups using the Welch t-test. Generalized linear models were used to predict score change for the WHOQOL-BREF items and domains accounting for sex, age, education, social inclusion, economic situation, and presence of additional or other disability. Included in the analysis was data from 381 participants, 143 with mobility-related disabilities and 238 without. Participants in the mobility-related disability group scored significantly lower than those without on General Health, General QoL, Health Satisfaction, and the four WHOQOL-BREF domains. The group with mobility-related disabilities also reported a lower Social Inclusion Score (SIS) and a higher proportion of people without a cash margin. An increased SIS indicated higher QoL in the generalized linear model, whereas the absence of cash margin and mobility-related disability negatively influenced the QoL scores. This study indicated that a person with mobility-related disabilities has lower QoL than those without mobility-related disabilities. A lower QoL was also related to a lack of cash margin, a lower social inclusion score, and whether there were additional or other disabilities present.

Access and Inclusion: The Experiences of Postsecondary Students with Mobility-Related Physical Disabilities


 
 
 Relatively little is known about how physical and social environments influence access to and inclusion in educational and leisure activities for students with a mobility-related physical disability attending a post-secondary institution. Understanding how environments shape access is important because educational and leisure activities affect one’s emotional, social, mental, and physical health. The aim of this qualitative exploratory study was to gain an understanding of the lived experiences of access and inclusion for students with a mobility-related physical disability, and specifically, the barriers and facilitators within the physical and social environments which shape access and inclusion. One-on-one semi-structured interviews were conducted with nine students attending a post-secondary institution in Nova Scotia, Canada who self-identified as living with a mobility-related physical disability. From an analysis of the interviews, five themes emerged: 1) navigating disclosure; 2) invisibility (and passing) and visibility; 3) accommodations and supports; 4) the prevailing conceptualization of mobility-related disabilities; and 5) places and spaces for the “normal” body. Although there have been actions taken by the post-secondary institution to transform environments and improve access and inclusion, additional efforts are urgently needed, and it is suggested that Universal Design is one possible strategy.
 
 

Differences in suicide risk correlates and history of suicide ideation and attempts as a function of disability type.

Disability status is associated with correlates of suicide risk (perceived burdensomeness, thwarted belongingness, negative future disposition, felt stigma, suicidal ideation, and suicide attempts). This study aimed to examine whether suicide-related correlates differ significantly as a function of disability type. Individuals with mobility and vision disabilities (N = 102) completed semistructured interviews and online-based questionnaires. Analysis of variance/analysis of covaiance and Fisher's exact tests were conducted to examine whether mean levels of suicide-related correlates differed significantly between individuals with blindness/low vision (n = 63) versus mobility-related (n = 39) disabilities. No significant between-group differences were observed for most outcomes; however, individuals with vision disabilities reported higher mean levels of felt stigma and positive future disposition than those with mobility-related disabilities. The limited representation of disabilities among participants precludes generalization to individuals with other forms of disability and the cross-sectional design prevents inference about causality. Interventions targeting cognitive processes that underlie suicide risk may be applicable to people with mobility and vision disabilities.

Efficacy of Communication Techniques and Health Outcomes of Bushfire Smoke Exposure: A Scoping Review

Public health officials communicate the relevant risks of bushfire smoke exposure and associated health protection measures to affected populations. Increasing global bushfire incidence in the context of climate change motivated this scoping review. English-language publications related to adverse health outcomes following bushfire smoke exposure and publications relating to communication during natural disasters were included. Bushfire smoke events potentially increase healthcare contact, especially presentations triggered by respiratory illness. At-risk populations include those with underlying cardiorespiratory disease, elderly, paediatric, pregnant persons, and First Nations people. We found that social media, television, and radio are among the most common information sources utilised in bushfire smoke events. Message style, content, and method of delivery can directly influence message uptake and behaviour modification. Age, rurality, and geographical location influence information source preferences. Culturally and linguistically diverse groups and those with hearing, vision, and mobility-related disabilities may benefit from targeted health recommendations. This review emphasises the health effects of bushfire smoke exposure and related communication recommendations during and after bushfire smoke events. Additional investigation may further clarify the health effects of bushfire smoke exposure and efficacy of related health messaging, particularly in at-risk populations. Quantitative comparison of communication methods may yield more specific recommendations for future bushfire smoke events.

Quality of life, self-esteem, self-efficacy and social participation of persons living with mobility-related disability using mobility aids devices within select Nigerian communities

Background/purpose Disability has gained further global attention as a result of the integration of persons with disabilities into the societies. However, the association among quality of life (QoL), self-esteem (SE), self-efficacy (SEf) and social participation (SP) is inconclusive. This study was aimed to investigate the correlation among QoL, SE, SEf and SP in people living with mobility-related disability using mobility aid devices (MADs) in some selected communities of Enugu State. Methods This cross-sectional survey involved 200 consenting participants (mean age = 37.47 ± 13.00 years) purposively recruited from four different sampled communities who have community-based rehabilitation (CBR) services. Quality of life (QoL), SE, SEf and SP of participants were explored using 36-item Short Form Survey, Rosenberg Self-Esteem Scale, General Self-Efficacy Scale and Participation Scale respectively. Data obtained was summarised using frequency counts, mean, standard deviation and analysed using spearman’s Rank Order Correlation, Mann Whitney U and Kruskal-Wallis tests. Results The mean QoL, SEf, SE, and SP of the participants are 55.06 ± 10.67, 25.00 ± 5.57, 16.36 ± 4.33 and 35.60 ± 13.50 respectively, which imply moderate QoL and SEf, high SE and severe restricted participation. QoL, SEf, SE, and SP significantly correlated with one another (p < 0.05). There was no significant influence of gender and occupational status of the participants on their QoL, SE, SEf and SP (p > 0.05). Conclusion Persons living with mobility-related disabilities have moderate QoL and SEf, high self-esteem and severe restriction in SP. QoL, SEf, SE, and SP correlated with one another. The possibility of improving other constructs by targeting one can be explored in disability rehabilitation. IMPLICATIONS FOR REHABILITATION The increasing prevalence of disability presented the need to study four constructs of well-being (Quality of Life, Self-esteem, Self-efficacy and Social participation). The perception of one’s status and position in life can be negatively impacted upon by a mobility-related disability. Social participation may improve satisfaction and quality of life, which in turn could lead to better self-esteem and self-efficacy.

Lifetime history of total body skin examinations in patients with disabilities: Examining for differences in skin cancer screening

Lifetime history of total body skin examinations in patients with disabilities: Examining for differences in skin cancer screening

Weight management for adults with mobility related disabilities: Rationale and design for an 18-month randomized trial

Adults with mobility related disabilities (MRDs) represent an underserved group with a high prevalence of overweight/obesity and limited options for weight management. We previously demonstrated clinically meaningful 12-month weight loss in adults with MRDs (−6.2%, 36% ≥5% of baseline weight) using an enhanced Stop Light Diet (eSLD) delivered using at home face-to-face behavioral sessions and optional physical activity. However, the costs/logistics associated with intervention delivery by individual home visits limits the potential for scaling and implementation of this approach. Thus, we will conduct a two-arm randomized trial in 128 overweight/obese adults with MRDs to compare weight loss (6 mos.) and maintenance (12 mos.) between interventions utilizing the eSLD, behavioral counseling, and increased physical activity delivered to individual participants in their homes or delivered to groups of participants in their homes remotely via video conferencing. The primary aim will compare weight loss between interventions arms across 6 months. Secondarily, we will compare weight loss (0–18 mos.), the proportion of participants who achieve clinically meaningful weight loss (≥5%) from 0 to 6 and 0 to18 months, and changes in quality of life from 0 to 6 and 0 to 18 months between interventions arms. We will also conduct cost, cost-effectiveness and contingent valuation comparisons and explore the influence of behavioral session attendance, compliance with the recommendations for diet and physical activity, self-monitoring of diet and physical activity, barriers to physical activity, sleep quality, and medications on weight change across 6 and 18 months. NCT registrationNCT04046471

Should Wellness Be a Core Competency for Physicians?

There has been a recent rise in calls for action around wellness and physician health. In medical education, wellness has been proposed as a physician competency. In this article, the authors review the history of the "wellness as a competency" concept within U.S. and Canadian residency programs and medical schools. Drawing from literature on the discourses of wellness and competence in medical education, they argue that operationalizing wellness as a physician competency holds profound implications for curricula, admissions, evaluation, and licensure. While many definitions of "wellness" and "competency" are used within medical training environments, the authors argue that the definitions institutions ultimately use will have significant impacts for trainees who are considered "unwell." In particular, medical learners with disabilities-including those with mental health, chronic health, learning, sensory, and mobility disabilities-may not conform to dominant conceptions of "wellness," and there is a risk they will become further stigmatized or even be considered unsuitable to practice in the profession. The authors conclude that framing wellness as a competency has the potential to legitimize support-seeking and prioritize physician health, yet it may also have the potential unintended effect of excluding certain learners from the profession. They propose a universal design approach to understand wellness at a systems level and to remove barriers to wellness for all medical learners.

Accessibility of veterinary hospitals for clients with mobility-related disabilities.

Accessibility of veterinary hospitals for clients with mobility-related disabilities.

Lived experiences of people with mobility-related disability using assistive devices

Purpose Assistive devices (ADs) are an essential component for people with disability to achieve functional independence and improved quality of life. The current study explored lived experiences of adults with mobility related disability using ADs, with reference to access to ADs, facilitators and barriers in access, use and adaptation of devices and whether any changes experienced after use of ADs. Materials and methods Data were collected through interviews using narrative inquiry approach with 25 individuals having mobility related disabilities and who had experience of using one or more ADs for minimum 12 months. Transcripts were analyzed using thematic analysis procedure. Results The analysis resulted in four main themes. The first theme of “access to ADs” revealed apathy of and disappointment towards public health service providers. The second theme “life with ADs” described personal and social adaptation of ADs. Third important theme was “barriers to use of ADs” which brought out physical barriers in public places, lack of home modification, and inaccessible built environment. Major concern was economic dependence, out of pocket expenditure and lack of services for maintenance and upgradation of ADs. The last theme “achieving a better life” described a sense of achievement with ease of mobility, relief of agony and gaining independence. Conclusion In spite of the challenging experiences of disability, usage of ADs has increased social participation, independence and self-esteem. These major components helped participants to achieve “normalcy” in life. Implications for rehabilitation Early identification of need of AD is necessary to support disabled individual Availability, accessibility and affordability of appropriate devices at public health centres will improve rehabilitation Raising awareness and removing stigma about ADs will improve utilization of rehabilitative services Timely use and use of appropriate devices are necessary to improve quality of life Upgradation and maintenance of devices is a major concern which need to be linked with rehabilitation service provision

Mechatronics Enabling Kit for 3D Printed Hand Prosthesis

AbstractNew advances in both neurosciences and computational approaches have changed the landscapes for smart devices design serving mobility-related disabilities. In this paper we present the integration of affordable robotics and wearable sensors through our mechatronic product platform, Sparthan, to enable accessibility of the technology in both the power prosthesis and neurorehabilitation space. Sparthan leverages 3rd party EMG sensors, Myo armband, to process muscles sensor data and translate user intention into hand movements. Key innovation includes the modularity, scalability and high degree of customization the solution affords to the target users. User-centered design approaches and mechatronic system design are detailed to demonstrate the versatility of integrative systems and design. What started off as an engineering research endeavor is also positioned to be deployed to deliver real-world impact, especially for prosthesis users in developing countries.

The Potential of College Completion: How Disability Shapes Labor Market Activity Differentially by Educational Attainment and Disability Type

I conducted a descriptive analysis of how disability shapes labor market activity differentially by educational attainment and disability type using the American Community Survey, 2015 ( N = 1,504,947) and linear probability models. Having a disability is associated with a decrease in the probability of labor force participation (proportion of those employed or seeking employment; [Formula: see text]) and employment (proportion of those in the labor market who are employed; [Formula: see text]. When differentiated by disability type, education moderates the relationship between disability and labor force participation for all disability types. However, education only moderates the relationship between disability and employment for those with cognitive-, physical-, and mobility-related disabilities (not sensory or self-care). Having a bachelor’s degree is associated with a 30.68% higher probability of labor force participation and a 26.84% higher probability of employment among those in the labor force than having some college, indicating higher education may be a pivotal intervention point. The relationships between disability and labor force participation and disability and employment vary by disability type, as does the role of education.

Crowds involving individuals with disabilities: Modeling heterogeneity using Fractional Order Potential Fields and the Social Force Model

There is a need to model individuals with physical disabilities in a crowd. This requires both understanding how such individuals impact a crowd and how the crowd impacts them. Previous efforts have adjusted velocity to represent individuals with disabilities in a crowd. The various disabilities that are represented in a crowd of individuals show much more complex and varying interactions that require an improved form of modeling. Individuals with disabilities are in part composed of those using mechanical and electric wheelchairs, those who have impaired vision, and those with diverse mobility-related disabilities. In our research we conducted a large-scale crowd experiment with heterogeneous compositions of crowds involving individuals with disabilities. The initial outcomes demonstrated that each group differed in velocity as well as in the composition of their environment. Additional results showed that interaction within a crowd varied as well. The purpose of this paper is to provide some initial differences found in the study of individuals with disabilities within a crowd and how those differences change pedestrian interaction. Using the nature of Fractional Order Potential Fields (FOPF), this paper provides a method for how pedestrian interaction can be adjusted to respond to the differences created by those with various disabilities in each group. Finally, how a hybrid model between FOPF and the Social Force Model can be used to capture experimental results in simulation.

Feasibility of a Modified Ride-on Car Intervention on Play Behaviors during an Inclusive Playgroup

ABSTRACTAims: Children with mobility related disabilities often experience limited participation and access to social interactions. An emerging pediatric powered mobility device are modified ride-on cars that provide self-directed mobility experiences to children with disabilities. This study aimed to determine: (1) the feasibility of a modified ride-on car intervention during an inclusive playgroup, (2) the effect of a modified ride-on car intervention on the play behaviors of children with and without mobility related disabilities. Method: A single-subject research design was implemented. Thirteen children participated in a weekly inclusive playgroup. The five children with mobility related disabilities were provided modified ride-on cars during the intervention. Children's play behaviors were classified with Howes' Peer Play Scale. Intervention effects were examined using nonoverlap of all pairs (NAP). Results: The intervention was feasible based on participants' good attendance, retention rates, and successful use of modified ride-on cars. Overall children did not experience significant changes in play behaviors, with a few exceptions for decreased solitary, and increased parallel play, and/or direct peer interaction, among children with mobility related disabilities. Future research could examine modified ride-on car use by children with mobility related disabilities focusing on changes in unique play interactions between children with and without disabilities.

The effects of contingency contracts and performance feedback on completing data entries to self-monitor community participation of people with physical disabilities: An ecological momentary study

ABSTRACTThis article examines the use of ecological momentary assessment (EMA) to analyze the effect of contingent contracts and performance feedback in completing data entries to self-monitor community participation of people with mobility-related disabilities. Two participants with mobility-related disabilities were assigned to self-monitor their community participation activities using a personal digital assistant (PDA), which had been preprogrammed to signal four times a day throughout the entire study. At each prompt, participants were asked to complete a brief survey on a PDA. Participants received the monetary rewards based on their PDA completion rate. All participants maintained more than 95% completion and received the full monetary reward available.