An interactional model of independence.

Proposes an interactional model of independence that focuses on personal and environmental variables. Personal variables in rehabilitation include physical abilities, knowledge and skills, and values and goals. Environmental variables include the physical environment, social networks and service programs, and the system of laws, policies, and public attitudes that guide institutional responses to people with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A structural analysis of secondary conditions experienced by people with physical disabilities.

Examined how secondary conditions experienced by people with a physical disability might group together and how these clusters might be related to various primary impairments. It was predicted that primary impairments would predict specific clusters of secondary conditions and that certain secondary conditions (e.g., depression) would be endorsed independently of primary impairments. A survey measuring 40 secondary conditions was completed by 594 adults (mean age 55.4 yrs) who experienced a mobility impairment. Results indicate that certain secondary conditions (e.g., depression) are evident across a wide variety of impairments. Results are discussed with respect to their implications for the treatment and prevention of secondary conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Living Well With a Disability Health Promotion Intervention: Improved Health Status for Consumers and Lower Costs for Health Care Policymakers.

Objective: Investigate effectiveness of a health promotion intervention for adults with mobility impairments. Study Design: Interrupted time series, staggered baseline quasi-experimental with random assignment to treatment start date. Setting: 9 Centers for Independent Living in 8 states. Participants: Adults with mobility impairments living independently (N = 188). Intervention: Living Well With a Disability: Facilitated group health promotion (16 hr over 8 weeks). Main Outcomes Measures: Secondary conditions, symptom days, health care utilization. Results: Reductions in limitation from secondary conditions, symptom days, and health care utilization over the intervention period. Effects on secondary conditions maintained for 12 months. Overall cost savings of $807 per person (total for sample = $151,716) projected from reductions in health care utilization of study sample. Conclusions: Health promotion interventions can increase quality of life while helping to control health care costs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing environmental factors that affect disability: Establishing a baseline of visitability in a rural state.

Purpose: The homes in which people live are one element of the shared built environment. The concept of visitability describes features of private homes that provide a minimal level of accessibility, allowing a person with mobility impairments to visit the homes of family and friends. This study's aim was to establish a baseline rate of basic home visitability in Montana. Method: A visitability question was included as part of the 2004 Montana Behavioral Risk Factor Surveillance System (BRFSS) Questionnaire, a random-digit-dialed telephone survey of 5,005 Montana adults. Results: Nearly 1 in 5 respondents (19.3%) said "a person who uses special equipment such as a wheelchair...could get into [their] house without being carried up steps or over other obstacles." Respondents with a disability who reported living in a visitable house were less likely than those who did not live in a visitable house to report any days of poor mental health in the past month. Conclusion: The BRFSS affords the opportunity to measure elements of the community environment important to the health and life quality of people with disabilities. Here, BRFSS data provided a baseline rate for visitable homes in the state. Strategies to increase this number are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of self-help guides on three consumer advocacy skills: Using personal experiences to influence public policy.

Examined the effects of self-help guides on the performance of 3 consumer advocacy skills (preparing and presenting brief personal testimony, writing letters to a newspaper editor, and writing letters to public officials) by members of a disabilities advocacy group. These guides were used as behavioral prosthetics, and no training was provided by the researchers. In Exp I, a 40-yr-old female with multiple sclerosis prepared independent living (IL) advocacy letters. Skill performance was measured by observers using behavioral checklists. Experts rated the quality and potential impact of performances. Results indicate that use of self-help guides improved performance and led to higher ratings by experts. Exp II extended these results with 10 IL group members (aged 19–57 yrs). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using ecological momentary assessment to measure participation: A preliminary study.

Purpose/Objective: Participation is emerging as the gold standard of outcome measurement in disability and rehabilitation, but there are few methods for measuring it. This article describes the development of a dynamic measure of participation that uses the International Classification of Functioning, Disability and Health as the framework for measure development and ecological momentary assessment (EMA) as the data collection methodology. Research Method/Design: Researchers programmed personal data assistants to prompt 5 residents of a rural community to report their location, activity, social contact, environmental barriers and facilitators, secondary conditions, and ratings of community connectedness and fulfillment. Results: Overall, 5 participants reported data on 1,352 engagements over 7 weeks. Participants reported greater community connectedness and fulfillment when they spent time with others, were not home, and were not experiencing barriers or secondary conditions. Conclusions/Implications: EMA measures and methodology are 1 step in answering questions about participation within the ecological framework of disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)