Sex disparities in the prevalence of physical function disabilities: a population-based study in a low-income community.

BACKGROUND: Functional disability continues to be a significant public health problem that increases older adults' vulnerability to experience a diminished quality of life, loss of independence, higher healthcare costs and health services utilization, and increased risks of mortality. Thus, we aimed to study the prevalence of functional disabilities by sex according to the types of daily living activities, controlling for specific sociodemographic variables among older Hispanics from low-income communities. METHODS: We used a cross-sectional epidemiological research design, considering a complex sampling design of households to interview adults ≥65 years living in low-income communities in Puerto Rico. Functional disability was measured by the PROMIS® Physical Function Short Form-20 T-score. The selected community was reported to have 5980 adult residents ≥65 years, according to the USA Census. The prevalence of functional disability was estimated using the logistic regression model, weighting by the effect of the sampling. Our estimated prevalence was compared between sexes using the prevalence ratio (PR), which was estimated with logistic regression models, controlling for age, income, number of chronic conditions, high and low impact of chronic conditions in functional disabilities, marital status, and sampling design. RESULTS: We recruited 211 older Hispanics from a randomly selected sample. Their mean age was 74.4 ± 7.1 years, with female predominance (57.3%). The overall estimated prevalence of physical function disability using T-score among females was 2.70 (95% CI: 1.4, 5.1) times the estimated prevalence of physical function disability among males. Women were more likely to report functional disabilities in instrumental activities of daily living, self-care activities, and functional mobility compared to males. However, sex differences were largely explained by the presence of musculoskeletal conditions of high impact in functional disability. CONCLUSIONS: The females in our study bear the greater burden of physical function disability in their adult age. Health policies, as well as future studies, should be targeted at reducing the burden of physical function disabilities in different types of daily activities through gender-sensitive disability self-management programs.

Collaborative engagement of Hispanic communities in the planning, conducting, and dissemination of assistive technology research.

INTRODUCTION: Community engagement (CE) is critical for research on the adoption and use of assistive technology (AT) in many populations living in resource-limited environments. Few studies have described the process that was used for engaging communities in AT research, particularly within low-income communities of older Hispanic with disabilities where limited access, culture, and mistrust must be navigated. We aimed to identify effective practices to enhance CE of low-income Hispanic communities in AT research. METHODS: The community stakeholders included community-based organizations, the community healthcare clinic, the local AT project, and residents of the Caño Martín Peña Community in San Juan, Puerto Rico. The CE procedures and activities during the Planning the Study Phase comprised working group meetings with stakeholders to cocreate the funding proposal for the study and address the reviewers' critiques. During the Conducting the Study Phase, we convened a Community Advisory Board to assist in the implementation of the study. During the Disseminating the Study Results Phase, we developed and implemented plans to disseminate the research results. RESULTS: We identified seven distinct practices to enhance CE in AT research with Hispanic communities: (1) early and continuous input; (2) building trusting and warm relationships through personal connections; (3) establishing and maintaining presence in the community; (4) power sharing; (5) shared language; (6) ongoing mentorship and support to community members; and (7) adapting to the changing needs of the community. CONCLUSION: Greater attention to CE practices may improve the effectiveness and sustainability of AT research with low-income communities.