Formal support and service needs of family caregivers of adults with intellectual and/or developmental disabilities in India.

BACKGROUND: Despite the enactment of disability laws/policies in India, research shows that caregivers of adults with intellectual and/or developmental disabilities experience inadequate formal supports/services due to dissemination barriers and lack of awareness about them. To address discrepancy between caregivers' support needs and the professionals' understanding of their needs, the study proposed to conduct a caregiver needs assessment so that culturally-tailored programs are developed. METHOD: A strengths-based mixed methods needs assessment was conducted with a convenience sample of 100 caregivers in Hyderabad, India. One hundred caregivers completed the survey and 15 caregivers participated in semi-structured interviews. RESULTS: Caregivers needed more and improved formal supports/services, particularly from the government. Caregivers faced systemic and attitudinal barriers, and personal impediments to accessing them. Needs differed by care recipients' intellectual disability level, gender, and intellectual disability related conditions. CONCLUSIONS: Researchers, service providers and policymakers need to adopt innovative strategies to improve formal supports/services access.

Information needs of caregivers of adults with intellectual and/or developmental disabilities in India.

Many families of adults with intellectual and/or developmental disabilities in India experience difficulty in accessing services/supports, due to lack of awareness/knowledge of disability rights/laws and available services, and in accessing the services. There remains insufficient research on the information needs of these caregivers and on designing interventions that aim to increase their awareness/knowledge about human rights and supports/services. A strengths-based mixed methods needs assessment was conducted to understand the information needs of these family caregivers. Results showed that caregivers ≥50 years had significantly higher information needs than younger caregivers. Specifically, caregivers with no proficiency in English needed more information on the available services for the care recipients (n = 100). Qualitative results showed that very few caregivers had any awareness or access to information on human rights, disability-related laws/policies or available supports/services (n = 15). Study findings underscore the government's role in improving awareness-raising initiatives and imparting the information in multiple Indian languages.

Supports and barriers that entrepreneurs with disabilities encounter when starting their businesses.

PURPOSE/OBJECTIVE: Entrepreneurship is increasingly emerging as a viable employment option for many people with disabilities. It provides opportunities to develop interests, skills, and passion for starting a business. We conducted multiple interviews with various stakeholders to identify the perceived supports and barriers that people with disabilities encounter in the process of pursuing entrepreneurship. RESEARCH METHOD/DESIGN: Individual interviews included 20 entrepreneurs with disabilities, 6 service providers, and 5 school administrators. This qualitative study used a constructivist grounded theory approach to shape the process of data collection, analysis, and theory building. RESULTS: People with disabilities interested in pursuing entrepreneurship benefit from facilitators such as social support, mentoring, and access to space, equipment, and money. Personal qualities include their desire to be "my own boss," help others, earn money, creativity, persistence, and flexibility. On the other hand, they may face several systemic barriers, such as the lack of infrastructure to set up the business, discrimination, lack of formal support from Vocational Rehabilitation counselors or their school settings, and/or lack of money. CONCLUSIONS/IMPLICATIONS: The systemic barriers can make it difficult for entrepreneurs to start and/or continue to operate their businesses. We discuss the implications of the findings for the development of entrepreneurship training for youth with disabilities and offer recommendations for future research and practice in the rehabilitation field. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining Association Between Reported High Cholesterol and Risk Factors in Adults With Intellectual and Developmental Disabilities (IDD): A Five-Year Follow-Up.

Adults with intellectual and developmental disabilities (IDD) are at a greater risk of developing high cholesterol and cardiovascular disease. We examined whether physical inactivity, obesity, and diabetes were predictive of reported high cholesterol and whether there were any mediating effects of diabetes on the relationship between obesity and high cholesterol in 1,618 adults with IDD across five years. Results suggest that obesity and diabetes were significantly associated with high cholesterol after adjusting for age, sex, and residence type with a partial mediator effect of diabetes in the relationship between obesity and high cholesterol across all time points. Further research is needed to explore the causal mechanisms behind the relationships between obesity, diabetes, and high cholesterol.

Associated Risk Factors for Depression and Anxiety in Adults With Intellectual and Developmental Disabilities: Five-Year Follow Up.

A better understanding of the factors associated with depression and anxiety in people with intellectual and developmental disabilities (IDD) is needed to provide guidelines for service providers, clinicians, and researchers as well as to improve the diagnostic process. The current study used a longitudinal dataset to explore demographic, health, and psychosocial risk factors of anxiety and depression in adults with IDD. Women were more likely to have depression while older adults, people with autism, and people with hearing impairments, were more likely to have anxiety. Chronic health conditions were associated with both anxiety and depression, while changes in stressful life events were associated with an increased risk of anxiety. Clinical and research contributions are discussed.

Low Levels of Physical Activity and Sedentary Behavior in Adults with Intellectual Disabilities.

Adults with intellectual disabilities (ID) are more likely to lead sedentary lifestyles and have low levels of physical activity (LLPA). The present study investigated the prevalence of reported LLPA and time spent watching TV in adults with ID and identified the associated factors for these behaviors. The proxy informants of 1618 adults with ID completed the surveys regarding their health behaviors. Multiple logistic regressions were employed for LLPA and multiple linear regressions for time spent watching TV. About 60% of adults with ID had LLPA and average time spent watching TV was 3.4 h a day. Some characteristics and health and function variables were identified as associated factors. While engaging in community activities and involvement in Special Olympics were inversely associated with LLPA, they were not associated with time spent watching TV. Attending day/educational programs or being employed were associated with spending less time watching TV. Findings highlight differential factors associated with LLPA versus TV-watching behavior in adults with ID. Hence, a key strategy aimed at increasing physical activity includes promoting participation in social and community activities, while targeted activities for reducing sedentary behavior might focus on providing day programs or employment opportunities for adults with ID.

Are the Agency for Healthcare Research and Quality obstetric trauma indicators valid measures of hospital safety?

OBJECTIVE: The objective of the study was to examine whether the United States Agency for Health Care Research and Quality obstetric patient safety indicators are significantly affected by patient-specific and hospital-level characteristics not related to the safety environment. STUDY DESIGN: Administrative data for all nonfederal Illinois hospitals in 2001 were used to analyze the association of a hospital's obstetric trauma rates with patient and hospital-level factors. Multivariable random effects logistic regression analyses was used to account for hospital-level clustering. RESULTS: A total of 175,374 deliveries from 142 Illinois hospitals were available for analysis. The frequency of obstetric trauma was significantly associated with multiple patient-specific and hospital-level factors. Specifically, for any vaginal delivery, premature delivery, multiple gestation, excessive fetal growth, and prolonged pregnancy was associated with obstetric trauma risk. For spontaneous delivery, a prior cesarean was associated with trauma risk as well. Maternal age was associated with trauma risk at cesarean as well as at vaginal delivery. With regard to hospital-level factors, a higher annual delivery volume and a higher cesarean rate were associated with increased risk of trauma with either type of vaginal delivery, whereas in the intensity with which hospitals coded their medical records was associated with trauma risk for all routes of delivery. CONCLUSION: The risk of obstetric trauma is significantly influenced by both patient and hospital characteristics and is not a good indicator of patient safety.