Health promotion challenges for young adults living with intellectual disability and type 1 diabetes.

BACKGROUND: Self-management of type 1 diabetes mellitus (T1DM) can be challenging for people with intellectual disability. Often, parents provide health support due to lack of appropriate services outside the home. The study aim was to identify barriers and facilitators to T1DM self-management for young adults with intellectual disability and the implications for health promotion. METHODS: Five male participants with intellectual disability, aged 17-26 years, and seven parents were interviewed between October 2017 and February 2019. Interview data were descriptively analysed. FINDINGS: Two categories for barriers and facilitators were identified: 1) Diabetes self-management is complex (carbohydrate counting, blood glucose level monitoring, insulin therapy); 2) support for diabetes care (reliance on parents and carers, the National Disability Insurance Scheme, mainstream diabetes service support). CONCLUSIONS: Parents are critical for the support of people with intellectual disability and T1DM in the absence of disability staff with appropriate health skills.

An exploration of person-centred concepts in human services: A thematic analysis of the literature.

Being 'person-centred' in the delivery of health and human services has become synonymous with quality care, and it is a core feature of policy reform in Australia and other Western countries. This research aimed to identify the uses, definitions and characteristics of the term 'person-centred' in the ageing, mental health and disability literature. A thematic analysis identified seven common core themes of person-centredness: honouring the person, being in relationship, facilitating participation and engagement, social inclusion/citizenship, experiencing compassionate love, being strengths/capacity focussed, and organisational characteristics. These suggest a set of higher-order experiences for people that are translated differently in different human services. There is no common definition of what it means to be person-centred, despite being a core feature of contemporary health and human service policy, and this suggests that its inclusion facilitates further misunderstanding and misinterpretation. A common understanding and policy conceptualisation of person-centredness is likely to support quality outcomes in service delivery especially where organisations work across human service groups. Further research into the application and service expressions of being 'person-centred' in context is necessary.

A systematic review evaluating the psychometric properties of measures of social inclusion.

INTRODUCTION: Improving social inclusion opportunities for population health has been identified as a priority area for international policy. There is a need to comprehensively examine and evaluate the quality of psychometric properties of measures of social inclusion that are used to guide social policy and outcomes. OBJECTIVE: To conduct a systematic review of the literature on all current measures of social inclusion for any population group, to evaluate the quality of the psychometric properties of identified measures, and to evaluate if they capture the construct of social inclusion. METHODS: A systematic search was performed using five electronic databases: CINAHL, PsycINFO, Embase, ERIC and Pubmed and grey literature were sourced to identify measures of social inclusion. The psychometric properties of the social inclusion measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. RESULTS: Of the 109 measures identified, twenty-five measures, involving twenty-five studies and one manual met the inclusion criteria. The overall quality of the reviewed measures was variable, with the Social and Community Opportunities Profile-Short, Social Connectedness Scale and the Social Inclusion Scale demonstrating the strongest evidence for sound psychometric quality. The most common domain included in the measures was connectedness (21), followed by participation (19); the domain of citizenship was covered by the least number of measures (10). No single instrument measured all aspects within the three domains of social inclusion. Of the measures with sound psychometric evidence, the Social and Community Opportunities Profile-Short captured the construct of social inclusion best. CONCLUSIONS: The overall quality of the psychometric properties demonstrate that the current suite of available instruments for the measurement of social inclusion are promising but need further refinement. There is a need for a universal working definition of social inclusion as an overarching construct for ongoing research in the area of the psychometric properties of social inclusion instruments.

Men with disabilities - A cross sectional survey of health promotion, social inclusion and participation at community Men's Sheds.

BACKGROUND: The intersections between chronicity, disability and social inequality are well understood. Novel ways to counter the social determinants of health and disability are needed. Men's Sheds are a community space where men can participate in a range of shared activities and potentially experience a health and social benefits. OBJECTIVE: This cross-sectional survey was conducted to inform future research by determining who attended Men's Sheds and the range of health, social, community, and educational activities undertaken there. This paper explores the membership of people with disabilities (PWD) at Men's Sheds and the factors that predict their membership. METHODS: An online survey link was sent to all known Men's Sheds internationally in 2012. Data were analyzed using descriptive and inferential (univariate and multivariate) statistics. RESULTS: 32.2% of international sheds and 29% of Australian sheds specifically targeted the inclusion of PWD. 80% of these sheds have significantly more members with disabilities than sheds who do no target PWD. Factors associated with greater membership of PWD included the provision of transport, social outings and promoting occupational skills. CONCLUSIONS: PWD are being encouraged to join and are joining Men's Sheds. This is significant as the value of participation and inclusion toward better health and wellbeing is well known. Men's Sheds offer a community space where the social determinants of chronicity and disability can potentially be countered.

Formal intergenerational mentoring at Australian Men's Sheds: a targeted survey about mentees, mentors, programmes and quality.

Intergenerational mentoring enables a purposeful exchange of skills and knowledge to enhance individual and social outcomes for sub-groups at risk of health and social disparities. Male intergenerational mentoring may be an approach to help address these disparities in young men. Over 1000 Men's Sheds operate in Australia with 39% providing some form of mentoring mainly to youth. Yet, little is known about the variables intrinsic to creating and running quality programmes. This study aimed to identify the characteristics of formal intergenerational mentoring programmes, review their quality against the Australian Youth Mentoring Network (AYMN) quality benchmarks, and identify the factors that predict quality in these programmes. All known Australian Men's Sheds were invited to participate in an online cross-sectional survey. Forty sheds with formal mentor programmes completed the survey for a total of 387 mentees (mean = 9.7 mentees/programme), the majority being male. The majority of mentor programme facilitators were unpaid male volunteers aged 61 years and older, and programmes were unfunded. Promoting social and emotional well-being of the mentees was the primary focus in more than half of the programmes, and working on a shared construction project was the most common activity. Respondents rated the three most important factors that influenced programme effectiveness as being: (i) meaningful activities; (ii) mentors' approach; and (iii) a safe environment. Univariate analyses revealed that mentoring programmes that had a system in place for screening mentors, trained mentors and evaluated the programme were most likely to rate highly against the AYMN quality benchmarks.

Understanding primary carers' occupational adaptation and engagement.

BACKGROUND/AIM: Primary carers for people with intellectual disability living in remote rural areas experience high demand care commitments that may require them to be available twenty-four hours seven days a week and reduce their access to formal or respite support leaving them little time to engage in other occupations. The aim of this study was to explore the impact of caring for a person with an intellectual disability living in remote rural farming location on primary carers' occupational engagement. METHOD: A thematic analysis, using an interpretive phenomenological analysis approach, was conducted on seven in-depth semi-structured interviews of primary carers. RESULTS: Occupational adaptation and engagement, emerging as a primary theme, indicated that primary carers' occupations were affected by: limiting opportunity to develop occupations; developing new occupations; adapting occupations; and ceasing occupations. A number of influencing themes, affecting the primary carers' occupational engagement also emerged, including: lifestyle and occupational roles; wellness and health; engaging quality supports; societal and community context; and vision for the future. CONCLUSION: The results provided an initial understanding of the impact of caring on the primary carers' occupational adaptation and engagement, and a suggestion that clinicians consider using a family-centred approach as an effective and meaningful intervention.

Reliability of an assessment used in formal accommodation services: implications for adults with an intellectual disability.

BACKGROUND: The Revised Irrabeena Core Skills Assessment (RICSA) is used in formal accommodation services and evaluates the functional skills of adults with an intellectual disability. The assessment is used to inform training for skills development. This study focused on establishing evidence for interrater reliability of the RICSA. METHOD: The RICSA was completed by 101 staff members on 30 adults living in group homes. Interviews were conducted with 9 staff members in order to identify potential issues that may affect the reliability of the assessment. Interrater reliability was analysed using the intraclass correlation coefficient (ICC), and thematic analysis was conducted from the interview data. RESULTS: The ICC values ranged from .63 to .73 across the 5 main domains of the RICSA. CONCLUSIONS: The agreement found may be regarded as unsatisfactory given that the use of the RICSA is to inform skills training for people with an intellectual disability.

Do vehicle grants and vehicle adaptations grants promote transport mobility and community access for children with disabilities in Sweden?

BACKGROUND/AIM: A vast majority of the journeys made by children with disabilities in Sweden are in the family car, which usually is bought and adapted for the child with governmental subsidies. Despite the important philosophical views about accessible vehicles, little is known about the impact of vehicle adaptations on families' lives. The aim of the study was to investigate parent views about the impact of vehicle grants and vehicle adaptation grants on their children's transport mobility and community access. METHODS: In total, 434 parents of children with disabilities in Sweden who had received vehicle grants and/or vehicle adaptation grants between 1998-2007 responded to a questionnaire comprising questions with both pre-selected and open-ended answers. A non-responder analysis was performed. RESULTS: Children with disabilities were found to increase their transport mobility and community access in society as vehicle grants and/or vehicle adaptation grants were given to their parents. Their travel patterns and their travel priorities with their family car indicated that family friends and relatives and leisure activities were frequently visited and prioritised destinations. The grants were linked to access to social and family activities, provided environmental gains and led to increased experienced security. The results also showed that the potential to make spontaneous trips had increased substantially and that families experienced feelings of freedom and enhanced community access. The non-responder analysis confirmed these results. CONCLUSIONS: According to parents, vehicle grants and vehicle adaptation grants for children with disabilities have a positive impact on the children's transport mobility and community access.