Reproductive justice for Black, Indigenous, Women of Color: Uprooting race and colonialism.

Historically, atrocities against Black, Indigenous, and Women of Color's (BIWoC) reproductive rights have been committed and continue to take place in contemporary society. The atrocities against BIWoC have been fueled by White supremacy ideology of the "desirable race" and colonial views toward controlling poverty and population growth, particularly that of "undesirable" races and ethnicities. Grounded in Critical Race Theory, this paper aims to provide a critical analysis of historical and contemporary violations of BIWoC reproductive rights; discuss interventions based on empowerment and advocacy principles designed to promote women's reproductive justice; and discuss implications for future research, action, and policy from the lenses of Critical Race Theory and Community Psychology. This paper contributes to the special issue by critically analyzing historical and contemporary racism and colonialism against BIWoC, discussing implications for future research and practice, and making policy recommendations.

Participation Outcomes Among Black Children with Disabilities: A Scoping Review.

AIM: Participation disparities among Black children with disabilities are widely documented in a variety of disciplines. Grounded in the Social Model of Disability and Disability Critical Race Theory, the purpose of this scoping review was to examine the extent to which occupational therapy has contributed to the study of participation outcomes among Black children with disabilities. METHODS: Empirical studies published from 2010 to 2021 that reported participation outcome data published in nine frequently cited journals were included in this scoping review. Twenty studies were found to meet the criteria. RESULTS: Participation outcomes were reported for six occupations: play, social participation, activities of daily living (ADLs), education, sleep, and health management). The majority of studies reviewed recruited small samples of Black children with disabilities and provided limited to no description of the specific participation differences by racial/ethnic demographics. CONCLUSION: Occupational therapy has made few contributions to the growing literature on participation disparities for Black children with disabilities. Implications for practice are discussed.

Promoting Justice, Diversity, Equity, and Inclusion Through Caring Communities: Why It Matters to Occupational Therapy.

The global challenges humanity faces today, such as social and economic inequalities, occupational deprivation, racism, exclusion, displacement and migration crises, violence, wars, and political oppression, all contribute to health and participation inequities (Powell & Toppin, 2021). The depth and breadth of these inequities became strikingly evident and were exacerbated with the coronavirus 2019 pandemic (Khanijahani et al., 2021). More than ever before, we need to apply an occupational perspective to create caring communities that strengthen each person's sense of belonging (Beagan, 2015; Lavalley & Johnson, 2020; Mahoney & Kiraly-Alvarez, 2019). In this column, we argue that occupational therapy academic programs have a unique role in advancing justice, equity, diversity, and inclusion through the creation of caring communities.

Disability rights and empowerment: Reflections on AJCP research and a call to action.

People living with physical, sensory, intellectual, and/or developmental disabilities experience complex social, environmental, political, and cultural challenges along with stigma and marginalization in education, employment, and community life. These multiple and complex barriers often hinder their full and effective participation in society. In this reflection, we curated articles on physical, sensory, intellectual, and/or developmental disabilities published in the American Journal of Community Psychology from 1973 to 2022. We reviewed titles and abstracts to identify themes that grouped manuscripts in relevant community psychology core concepts and values. From our analysis, five themes emerged: (a) promoting empowerment and advocacy; (b) promoting organizations and settings that support people with disabilities; (c) including people with disabilities in knowledge production; (d) promoting social justice in disability research, and (e) promoting support networks of families of people with disabilities. We conclude this reflection with a discussion of recommendations for future research, practice, and a call to action.

Associations between parenting strategies and BMI percentile among Latino children and youth with intellectual and developmental disabilities.

Introduction: Maintaining healthy weight is a challenge for all children, and particularly for children with IDD compared to nondisabled children and for Latino children compared to non-Latino White children. Parenting practices related to food intake and physical activity have been found to be important in maintaining children's weight. In this study, we describe the prevalence of overweight and obesity status among Latino children with IDD and their maternal caregivers and determine the relationship between food and physical activity parenting practices and childhood obesity among Latino children with IDD. Methods: We interviewed 94 Latino parent/child dyads and collected information about parenting practices, home environment, and parent and child height and weight using standardized measures. Parent body mass index (BMI) and child BMI percentile were calculated from height and weight. Results: The combined overweight/obesity status for children in our sample was high (60.3%) compared to national rates among nondisabled Latino children (56%) and non-Latino White children with autism (37%). Contrary to research on nondisabled children, we found that greater parental use of controlling dietary strategies was associated with lower BMI percentile in Latino children with IDD. These findings may be indicative of the fact that children with IDD tend to have unique dietary behaviors that warrant more disability and culturally sensitive strategies. Discussion: Our findings suggest that overweight and obesity is especially prevalent for Latino children with IDD and that more research is needed on family factors that promote health in Latino families of children with IDD.

Interventions for Health Promotion and Obesity Prevention for Children and Adolescents with Developmental Disabilities: a Systematic Review.

This systematic review evaluated interventions and relevant outcomes for health promotion and obesity prevention among children and adolescents with developmental disabilities (DD). Twenty-one studies including randomized control trials (n= 9) and quasi-experimental studies (n=12) published between 2010 and 2021 met inclusion criteria related to participant characteristics, intervention type, and child obesity-related outcomes. Five types of intervention programs were identified: aerobic and strength training, sport-based physical activity, aquatic exercise, active video gaming, and diet and lifestyle. Whereas analysis of intervention outcomes, efficacy, and study rigor showed mixed results and weak evidence of effective interventions, this review identified gaps in the literature, promising strategies for addressing obesity in children with DD, and implications for practice and future research. Supplementary Information: The online version contains supplementary material available at 10.1007/s40489-022-00335-5.

Promoting justice through community-based research: International case studies.

Community-based participatory research (CBPR) approaches to promoting justice focus on working from the ground up and giving a voice to marginalized communities regarding their concerns, potential solutions, and how to address social justice issues that matter to them. The pursuit of justice is often related to efforts to attain personal as well as collective well-being. In this paper, we illustrate three exemplars of community psychologists' efforts to promote justice. Within each case study, we discuss the social and community context and examine how the researchers built partnerships and solidarity, developed ways of doing, and approached challenges and solutions. First, we present an example to promote economic justice through an entrepreneurship initiative developed in collaboration with young Black youth with disabilities in the United States. The second case illustrates an effort to promote reproductive justice in collaboration with Roma women and girls in Spain. The third exemplar depicts the use of life stories as a method to raise the voices of displaced, marginalized indigenous women in Peru. Based on these three case studies, we present a synthesis model of social justice. We also discuss implications for future studies emphasizing the importance of engaging community participants in research meaningful ways, developing sustainable partnerships, and decolonizing research.

Community-engaged asset mapping with Latinx immigrant families of youth with disabilities.

Asset mapping is a participatory methodology that engages community members in identifying services and settings that promote health and well-being. This study aimed to identify community assets from the perspective of Latinx immigrant families with youth with disabilities. Latinx immigrant families (n = 21) participated in the mapping, followed by a reflection session and an open forum (n = 30). The findings revealed that families identified faith-based organizations and social service agencies as some of the main assets in their communities, while they identified mental health services as the most needed. The results also showed that participants preferred to utilize services and resources that are within walking distance of their homes, provide safe spaces, treat them well, offer bilingual services, do not require documentation, and are affordable. This study has important implications for community scholars and practitioners interested in implementing asset-based methodologies that focus on participants as experts of their own realities and agents of change and that promote advocacy and empowerment actions.

Goal Setting with Latinx Families of Children with Intellectual and Developmental Disabilities: Case Studies.

Behavioral community psychology focuses on studying issues that matter to communities, unpacking contextual factors that impact people's behaviors, and identifying strategies to address such issues. Goal setting is one such strategy often used by behavioral psychologists. Grounded in the values of behavioral community psychology and a behavior analysis paradigm, this study illustrated two case studies of Latinx parents of children with disabilities where goal-setting strategies were implemented to promote behavior change. The first case study focused on the promotion of healthy lifestyle behaviors and routines among Latinx families of children with disabilities in the United States. The second case study examined goal setting related to youth development by parents of adolescents with disabilities in Colombia. In both cases, participants received training on goal setting and had opportunities to discuss progress toward achieving their goals, share action steps taken, and discuss the contextual challenges or barriers that they experienced. The results indicate that behavioral goal-setting procedures can be effective in helping parents attain their goals and brainstorm strategies for addressing behavioral and contextual challenges. Implications for future research advancing behavioral community psychology are discussed.

Impact of COVID-19 on the Mental Health and Well-Being of Latinx Caregivers of Children with Intellectual and Developmental Disabilities.

The COVID-19 pandemic has impacted the entire world in unprecedented ways. However, populations that have had a history of marginalization have experienced a more profound impact. One such group is Latinx families of children with intellectual and developmental disabilities (IDD) in the Unites States. In this study, we used a mixed methods approach to explore the impact of the pandemic on the mental health and well-being of Latinx caregivers of children with IDD. Specifically, we (1) identified which social determinants of health are correlated with maternal caregivers perceived general health, mental health, and well-being; (2) explored the impact of the pandemic on families' overall eating and physical activity routines; and (3) identified emergent themes from caregivers' experiences during the pandemic. Thirty-seven Latinx caregivers participated in three interviews in which several validated instruments were administered. The results indicated that perceived social support, annual family income, food security, and receipt of financial benefits were correlated with fewer depressive symptoms. Annual family income was also significantly correlated with perceived general health. Most caregivers reported that the pandemic had placed a strain on their economic situation; increased their isolation; and disrupted their child's therapeutic supports, online education, eating routines, and engagement in physical activity. Meanwhile, some caregivers reported positive changes as a result of the pandemic. Implications for future research and practice are discussed.

Latinx Parents' Perceptions of Neighborhood Walking Safety for Their Youth With Intellectual Disabilities: A Mixed-Methods Investigation.

Increased walking distance and frequency has been linked to positive health outcomes. Neighborhood walkability disproportionately impacts youth with intellectual and developmental disabilities (IDD). We investigated concerns of Latinx parents of youth with IDD about walkability and their impact on families' walking behavior. We surveyed Latinx parents of youth with IDD (n = 21) and compared results with the general population. Results were triangulated with a focus group (n = 5). Survey data were analyzed using a Mann-Whitney U test, and focus group data via thematic analysis. We found a significant difference (P < .05) between parents of youth with IDD and the general population on perceived aesthetics, opportunity to participate, and satisfaction. Latinx parents and their youth with IDD experience disparities in the safety and pleasantness of their communities for walking, which may contribute to decreased community participation, poorer health outcomes, and lower levels of neighborhood satisfaction among this already vulnerable population.

Applying Community-Based Participatory Approaches to Addressing Health Disparities and Promoting Health Equity.

This special issue highlights work that contributes to our understanding of health disparities and community-based participatory research (CBPR) approaches to promoting health equity across diverse populations and issues that matter to communities. We take on a global perspective, and thus, various efforts across international contexts are illustrated. Articles elucidate a variety of CBPR approaches designed to empower and build capacity among individuals and communities in order to seek changes at the level of community practices, programs, and systems. These articles span across diverse populations-children, youth, and families; adults and older adults; immigrants; refugees; Black people; Latinx people; Native Americans/Indigenous people, the Roma community; Muslim women, and women with disabilities-experiencing inequities of interest to community psychologists and other researchers and practitioners.

Barriers to and facilitators of community participation among Latinx migrants with disabilities in the United States and Latinx migrant workers in Canada: An ecological analysis.

Individuals migrate to improve their wellbeing and quality of life, and often experience adverse situations, both during the process of migration and once within the host country. The purpose of this paper is to unpack the barriers to and facilitators of community participation, among Latinx immigrants with disabilities in the United States and Latinx migrant workers in Canada, following the Social Ecological Model. The authors draw from an appraisal of existing literature and their own participatory research with Latinx immigrants. Based on this integrative literature review, Latinx experience individual issues such as language barriers and lack of knowledge of the services available to them. At the community level they experience discrimination, limited opportunities for community participation, and lack of opportunities for meaningful employment. At the systemic and policy level in the United States, the antimigrant political environment keeps Latinx immigrants with disabilities from participating in their communities due to fear of deportation. In Canada, Latinx workers experience the paradox of migration and discrimination. The discussion of barriers and facilitators is followed by recommendations for community research and action.

Clinical Relevance and Psychometric Properties of the Swedish Version of the Cultural Competence Assessment Instrument.

Based on the increasing diversity of Swedish society, health professionals, like occupational therapists, find it challenging to provide culturally competent services to international clients. Consequently, cultural competence among professionals needs to be measured and improved using psychometrically tested instruments. This study examines the clinical relevance, construct validity, and reliability of the Swedish version of the Cultural Competence Assessment Instrument among Swedish occupational therapists. Material and Methods. A randomised sample of 312 Swedish occupational therapists answered a survey based on the Swedish version of the Cultural Competence Assessment Instrument with supplementary questions on the clinical relevance of the instrument. Descriptive statistics were used to examine the clinical relevance of the Swedish version of the Cultural Competence Assessment Instrument. Factor analyses, both exploratory and confirmatory, were run to examine the factor structure. Cronbach's alpha was performed to assess the internal consistency of the instrument. Results. The participants reported that the 24 items had high clinical relevance. The validation yielded a three-factor model: openness and awareness, workplace support, and interaction skills. All three of these factors showed high loadings. Conclusions. The study results indicated positive clinical relevance and psychometric properties for the Swedish version of the Cultural Competence Assessment Instrument and strong support to be utilised in Sweden. The implications of this study are important given the rapid growth in migration over the last few decades. A self-rating instrument measuring cultural competence could support occupational therapists' professional knowledge and development when they interact with international clients. As the tool was originally developed in English in the United States, the feedback from the Swedish version could potentially be useful for the instrument in modified form and for use by occupational therapists in English-speaking countries.

Walkability Safety and Walkability Participation: A Health Concern.

Walking is correlated with both improved physical and emotional health. However, walking behavior is often heavily influenced by environmental conditions. The goal of this study was to examine actual and perceived walkability safety and the relationship between perceived walkability safety and self-rated levels of walkability participation, defined as the number of places one walks within the community on a regular basis. Researchers used a mixed-methods approach, combining direct observations of traffic safety and in-person surveys within a specific Chicago neighborhood from 2015 to 2016 and from 2016 to 2017, respectively. We conducted behavioral assessments on 25 intersections and 48 sidewalks and surveyed 96 pedestrians on perceived walkability safety and walkability participation. Findings showed 68% and 81% of vehicles in 2015 and 2016, respectively did not obey street signs, placing pedestrians at significant risk. Pedestrians expressed concerns about the safety of walking in their neighborhood yet walked to a median of eight places weekly. The results indicated a marginally significant positive relationship between self-reported community participation and walking habits, as well as relationships between various factors of perceived walkability and age, gender, or language of survey completion. It is clear from the results of this study that walkability in this community is not a safe activity. However, walking habits may also be influenced by community satisfaction and SES factors. Communities need to engage in safe driving campaigns and educate walkers on how to protect themselves from distracted drivers. Local governments should implement policy initiatives such as police enforcement and drivers' education campaigns.

Meaningful Engagement in Research: Community Residents as Co-creators of Knowledge.

Community psychologists have contributed significantly to the body of literature on community-based participatory research (CBPR) and its application in understanding and addressing health and community participation disparities. At the core of CBPR are mutually beneficial partnerships with communities, whereby community members' voices are heard and they become co-researchers, helping guide the research process. In this article, I argue that for community psychologists to change the landscape of community participation, health, and well-being disparities experienced by many vulnerable populations who often face multiple forms of oppression, CBPR needs to be transformative and emancipatory. Stakeholders must be meaningfully involved as co-creators of knowledge and promoters of social justice embracing a human rights agenda. Drawing from work conducted with Latinx immigrant families with youth who have disabilities, I propose the following strategies moving forward: promoting meaningful participation of community members as co-creators of knowledge; promoting meaningful conversations that matter to communities; promoting civic engagement, activism, and advocacy; promoting an assets- and strengths-based approach to research; and promoting culturally relevant interventions. Community psychologists have the opportunity to make significant contributions to addressing disparities when community residents' knowledge is valued and recognized.

A Community-Based Participatory Action Research for Roma Health Justice in a Deprived District in Spain.

Addressing health disparities and promoting health equity for Roma has been a challenge. The Roma are the largest disadvantaged ethnic minority population in Europe and have been the victims of deep social and economic injustices, institutional discrimination, and structural antigypsyism over many centuries. This has resulted in a much worse health status than their non-Roma counterparts. Current strategies based on ameliorative and top-down approaches to service delivery have resulted in paradoxical effects that solidify health disparities, since they do not effectively address the problems of vulnerable Roma groups. Following a health justice approach, we present a community-based participatory action research case study generated by a community and university partnership intended to address power imbalances and build collaboration among local stakeholders. This case study involved a group of health providers, Roma residents, researchers, Roma community organizations, and other stakeholders in the Poligono Sur, a neighborhood of Seville, Spain. The case study comprises four phases: (1) identifying Roma health assets, (2) empowering Roma community through sociopolitical awareness, (3) promoting alliances between Roma and community resources/institutions, and (4) building a common agenda for promoting Roma health justice. We highlighted best practices for developing processes to influence Roma health equity in local health policy agendas.

Community-based participatory research to promote healthy lifestyles among Latino immigrant families with youth with disabilities.

BACKGROUND/AIMS: Community-based participatory research (CBPR) is an optimal approach that brings together community stakeholders, researchers and practitioners in an effort to understand and address social issues and health disparities experienced by vulnerable populations. Latino immigrant families in the United States with youth and young families with disabilities have experienced a number of barriers in gaining positive health outcomes. These families face challenges in maintaining a healthy lifestyle, placing them at high risk for obesity, diabetes, and other chronic health conditions. The purpose of this study was to develop a healthy lifestyles intervention in collaboration with Latino immigrant families with youth and young adults with disabilities using a CBPR approach, and to examine the impact of the intervention from participants' perspectives. METHODS: Grounded in the principles of CBPR, we developed a partnership with community stakeholders to create a healthy lifestyles intervention aimed at meeting the needs of Latino families in the United States. During and following implementation of the intervention, we conducted focus groups with 12 intervention participants to examine the impact of the intervention. RESULTS: Participants identified the intervention program as meeting a need in the community and reported specific positive aspects related to health behaviors, social learning, inclusion, community participation, and peer advocacy. DISCUSSION: CBPR healthy lifestyle interventions are relevant to the needs of Latino immigrant families with youth and young adults with disabilities. Health professionals should involve community residents in the design of healthy lifestyles programming to ensure strategies for change are relevant and relatable.

Analysis of Time in Rehabilitation and Incidence of Successful Rehabilitation Within Individuals with Disabilities Receiving Occupational/Vocational Training.

Objective To investigate the incidence of successful rehabilitation, defined as 90 successive days in employment, within individuals with disabilities receiving occupational/vocational training (OVT) service. Method The follow-up records between January 1, 2004 and December 31, 2012 of 5313 individuals aged 15-55 who obtained OVT in the vocational rehabilitation (VR) program of the State of Illinois were examined. Cox regression models were used to analyze the effect of study factors on VR outcomes. Results After controlling for the other factors, males (incidence ratio [IR] 1.11, 95% CI 1.03-1.20), individuals with learning disability (IR 1.14, 95% CI 1.03-1.26), had existing employment (IR 1.40, 95% CI 1.26-1.56), and persons who were referred from educational institutions (IR 1.17, 95% CI 1.01-1.36) or community agencies (IR 1.30, 95% CI 1.14-1.48) appeared to have a relatively high incidence of successful rehabilitation. In contrast, those who lived in densely populated areas (IR ranged from 0.56 to 0.89), had physical disability (IR 0.77, 95% CI 0.68-0.88), had disability of most significant degree (IR 0.85, 95% CI 0.79-0.93), and persons with Supplemental Security Income/Social Security Disability Insurance supports (IR 0.84, 95% CI 0.76-0.94), tended to have a lower incidence of rehabilitation than their counterparts. Conclusion The incidence of successful rehabilitation seems to be related to the demographic, disability, and pre-service characteristics, but not necessarily the provider factors.

Unpacking barriers to healthy lifestyles from the perspective of youth with disabilities and their parents.

Adolescents and young adults with disabilities experience several health inequalities and challenges in maintaining healthy lifestyles. As a group, individuals with disabilities experience higher rates of obesity compared to youth without disabilities. This study was designed to examine the types of challenges experienced by youth with disabilities and parents of youth with disabilities in maintaining a healthy lifestyle. Strong evidence indicates that having a healthy lifestyle and preventing obesity are not only the result of an individual's behavior related to physical activity and consumption of healthy products but also several complex factors in the person's environment. This study was designed to understand the perceptions of youth with disabilities and their parents about the challenges they experience in engaging in physical activity and consuming healthy products, and ideas and strategies for promoting healthy lifestyles. Overall, youth with disabilities lack access to opportunities for engaging in physical activity as well as access to affordable foods. Implications for systems and policy changes are discussed.