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1.
Front Pediatr ; 11: 1189686, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37576140

RESUMO

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.

2.
Am J Occup Ther ; 77(3)2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37294679

RESUMO

IMPORTANCE: Bangladesh hosts a large number of Rohingya refugees from Myanmar. Living in refugee camps, the Rohingya refugees face challenges in everyday occupations because of violence, limited opportunities, and corporal punishment by the community. OBJECTIVE: To explore how Rohingya refugees experience participation in everyday occupations while living in temporary refugee camps in Bangladesh. DESIGN: Phenomenological study to describe, understand, and interpret the meanings of life experiences in particularly adverse conditions. SETTING: Rohingya refugee camps in Bangladesh. PARTICIPANTS: Fifteen purposively selected participants from the camps. OUTCOMES AND MEASURES: In-depth semistructured interview, as well as participant and environmental observations. Researchers used line-by-line data analysis to capture quotations and patterns using interpretive phenomenological analysis, which included establishment of initial codes, interpretation, determining selected codes, and categorization. RESULTS: The research identified four major themes-(1) mental stress, sleep disturbances, and daily occupations; (2) adjustment to inconsistent daily activities; (3) complex relationships and limited social roles that decreased occupational engagement; and (4) involvement in precarious occupations that exacerbated severe health risks-and four subthemes-(1) fragmented family relationships, (2) formation of new relationships to perform social roles, (3) inconvenient and inaccessible living conditions, and (4) continuation of unlawful work to survive. CONCLUSIONS AND RELEVANCE: Rohingya refugees should receive comprehensive health and rehabilitative care because of their perilous mental health conditions, precarious occupations, and lack of trustworthy relationships with family and neighbors. What This Article Adds: Rohingya refugees experience imbalanced, deprived, and maladapted occupations in refugee camps. Suggestions to improve their lived experience with further peer support programs may help them participate in occupation-based rehabilitation services to facilitate their social integration.


Assuntos
Refugiados , Humanos , Refugiados/psicologia , Campos de Refugiados , Violência , Bangladesh , Ocupações
3.
J Health Care Poor Underserved ; 33(4): 1925-1948, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36341671

RESUMO

OBJECTIVE: To explore parent perspectives on barriers, facilitators, and priorities related to coordinating care for children and youth with special health care needs (CYSHCN). METHODS: Thirty-nine parents of Medicaid-eligible CYSHCN participated in focus groups and completed a brief survey about their child's health insurance coverage, access to specialized services, and need for support with service coordination. Survey data were analyzed using descriptive statistics. Focus group data were analyzed by multiple independent coders using an approach that combines inductive reasoning with predetermined coding strategies. RESULTS: Sixty-seven percent of parents reported that they needed care coordination support. Qualitative data were organized into three main themes: the work of caregiving; the impact of caregiving on multiple aspects of parents' lives; and caregivers' needs related to emotional acceptance, service referrals and navigation, and developmental transitions. CONCLUSIONS: Findings support importance of services such as medical homes, care coordinators, peer navigators, respite care, and transition planning.


Assuntos
Crianças com Deficiência , Serviços de Saúde para Pessoas com Deficiência , Adolescente , Criança , Humanos , Cuidadores/psicologia , Necessidades e Demandas de Serviços de Saúde , Pais/psicologia , Cuidados Intermitentes
4.
Rev J Autism Dev Disord ; : 1-24, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-36032995

RESUMO

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.

5.
Disabil Rehabil ; 44(2): 301-314, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32478575

RESUMO

PURPOSE: Individuals who lack proficiency in the dominant language of their region experience difficulty accessing healthcare and exhibit poorer health outcomes. Utilization of professional interpreters can improve health services and outcomes for this population. Most existing studies focus on medical settings, with very little research about language barriers in rehabilitation services such as occupational and physical therapy. The purpose of this study was to explore experiences of English-speaking rehabilitation clinicians working with limited English proficient (LEP) patients, as well as LEP patients receiving rehabilitation services. METHODS: A qualitative study was conducted involving four focus groups with seven Spanish-speaking patients and 13 primarily English-speaking occupational and physical therapy clinicians. Transcripts and field notes were analyzed using directed content analysis. RESULTS: Time and resource constraints, session demands, environmental factors, previous experiences, and patient characteristics influenced clinicians' decisions about whether to use professional interpretation, rely on untrained interpreters, or go without interpretation. Clinicians discussed both challenges and joys of working across language barriers. Patients reported minimal experiences with, and expectations of professional interpretation in rehabilitation, instead describing clinicians' attempts to "get by" with limited non-English language skills. CONCLUSIONS: Findings highlight unique considerations for language access in rehabilitation compared with other settings. These findings inform structural, process, and outcomes recommendations and changes in practice guidelines to improve language access in rehabilitation services.Implications for RehabilitationRehabilitation encounters present unique challenges for language interpretation services that require creative technological, procedural, and structural solutions.Technological solutions include flexible and mobile telecommunication devices, such as headsets, which allow real-time interpreting without interfering with treatment processes.Procedural solutions include establishing a systematic mechanism for recording patients' language needs, creating a standard and seamless protocol for clinicians to obtain language supports, and hiring trained interpreters who are familiar with rehabilitation jargon.Structural solutions include budgeting for interpreter services, sponsoring trainings for staff and clinicians, and adjusting clinicians' workload and expectations to allow greater time and flexibility to meet patients' language needs.


Assuntos
Relações Médico-Paciente , Tradução , Barreiras de Comunicação , Grupos Focais , Humanos , Idioma
6.
J Immigr Minor Health ; 24(1): 145-153, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33755840

RESUMO

Medicaid beneficiaries in most states must go through a redetermination process every 6-12 months to demonstrate continued eligibility. This study sought to examine Medicaid redetermination experiences among beneficiaries with Limited English Proficiency (LEP). A sequential mixed methods study was conducted involving quantitative phone surveys and semi-structured, in-person interviews with Arabic, Chinese, Korean, and Vietnamese speaking beneficiaries in Illinois. Survey respondents experienced notable barriers during the redetermination process. Quantitative data showed LEP respondents to have 5.3 times the odds of losing their Medicaid benefits as compared to English proficient respondents. Qualitative interviews illustrated the impact of Medicaid loss on individuals and families, as well as strategies for successfully navigating redetermination. Findings suggest that language barriers hinder Medicaid redetermination and play a role in cancellation of benefits. Recommendations for better language supports during the Medicaid redetermination process are discussed.


Assuntos
Proficiência Limitada em Inglês , Barreiras de Comunicação , Humanos , Illinois , Idioma , Medicaid , Estados Unidos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34360263

RESUMO

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.


Assuntos
COVID-19 , Saúde Mental , Cuidadores , Criança , Deficiências do Desenvolvimento/epidemiologia , Humanos , Pandemias , SARS-CoV-2
8.
Arch Phys Med Rehabil ; 102(11): 2125-2133, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34052214

RESUMO

OBJECTIVE: To obtain expert consensus on indicators of quality rehabilitation services for individuals with limited English proficiency (LEP). DESIGN: Three-round Delphi study. SETTING: Delphi survey conducted online with 30 experts. Most experts worked in adult physical rehabilitation settings and were from Illinois (n=16), and the remaining participants were from 8 other US states or Canadian provinces. PARTICIPANTS: Experts (N=30) had a minimum of 2 publications on health care services for patients with LEP and/or a minimum of 5 years clinical experience in physical rehabilitation. Of 43 experts (11 researchers, 32 clinicians) who received the round 1 survey by e-mail, 30 returned complete responses (70% response rate). Of those, 25 completed round 2 and 24 completed round 3. Of round 1 participants, most (n =21) identified their primary professional activity as clinical, whereas the others worked in research (n =5) or education (n =4). Twenty-four were women. The median age was 43 years (range, 27-67y). Disciplines included occupational therapy (n =14), physical therapy (n =13), psychology (n=1), nursing (n=1), and medicine (n=1). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Indicators were rated on a 7-point Likert scale for importance and feasibility. Interquartile range (IQR) and 95% confidence intervals were calculated for importance and feasibility ratings. Indicators with an IQR <2 and a median importance score ≥6 were accepted as reaching consensus for importance. RESULTS: Round 1 responses were categorized into 15 structural, 13 process, and 18 outcome indicators. All 15 structural indicators reached consensus for importance; 8 were rated as feasible. All 13 process indicators reached consensus, of which 8 were deemed feasible. Sixteen outcome indicators reached consensus, of which 7 were deemed feasible. CONCLUSIONS: This Delphi study identified structural, process, and outcome indicators that can inform delivery and assessment of quality rehabilitation services for individuals with LEP. Future research should operationalize and measure these quality indicators in clinical practice.


Assuntos
Proficiência Limitada em Inglês , Indicadores de Qualidade em Assistência à Saúde/normas , Reabilitação/normas , Adulto , Idoso , Comunicação , Competência Cultural , Técnica Delfos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Melhoria de Qualidade
9.
Am J Occup Ther ; 74(5): 7405205030p1-7405205030p13, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804621

RESUMO

IMPORTANCE: Occupational therapy can play a role in primary care management of chronic diseases among older adults. OBJECTIVE: To assess the feasibility of delivering a primary care occupation-focused intervention (Integrated PRimary care and Occupational therapy for Aging and Chronic disease Treatment to preserve Independence and Functioning, or i-PROACTIF) for older adults with chronic disease. DESIGN: Feasibility study comparing i-PROACTIF with complex care management using a two-group randomized controlled trial design with data gathered at baseline and during and after the 8-wk intervention. SETTING: Family medicine clinic serving an urban, low-income, working-class community. OUTCOMES AND MEASURES: Feasibility indicators were recruitment, retention, utility of clinical assessments, and acceptability of interventions assessed through feedback surveys completed by patients and primary care providers (PCPs). Patient outcomes, including perspectives on chronic illness care, occupational performance, and overall well-being, were collected using standardized, validated measures and analyzed descriptively. PARTICIPANTS: Eighteen adult volunteers, ages ≥50 yr, with heart disease, arthritis, and uncontrolled diabetes completed the study. Ten PCPs completed feedback surveys. INTERVENTION: i-PROACTIF focuses on preserving functional independence, is based on the Person-Environment-Occupation framework, and consists of two assessment sessions and six weekly treatment sessions. RESULTS: Recruitment goals were achieved, with an 86% retention rate. Clinical measures unearthed deficits in areas that were unreported or underreported by patients. Participants reported being extremely satisfied with the intervention. Physicians and nurses also supported the intervention. Both groups showed improved scores on most outcomes. CONCLUSION AND RELEVANCE: Delivering and evaluating i-PROACTIF was feasible and acceptable. Future efficacy trials are needed before it can be used in clinical settings. WHAT THIS ARTICLE ADDS: The results of this study can inform future occupational therapy interventions and clinical trials in primary care for older adults with chronic conditions.


Assuntos
Terapia Ocupacional , Idoso , Doença Crônica , Estudos de Viabilidade , Humanos , Atenção Primária à Saúde , Inquéritos e Questionários
10.
Disabil Rehabil ; 42(18): 2580-2592, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-30686125

RESUMO

Purpose: Deafblindness, also known as dual sensory loss, creates a distinct condition more disabling than either deafness or blindness alone. The participation experiences of persons with deafblindness have not been understood well. This phenomenological study aims to understand the meanings of participation for persons with deafblindness and identify the domains of life that are important to them.Methods: We used the International Classification of Functioning, Disability and Health as a guiding framework. Sixteen adults with deafblindness were interviewed between March and May 2017 in India using a qualitative interview guide.Results: Findings suggest participation as a dynamic, individualized construct that is not just an end outcome. Rather, it is a means to achieve other goals important to the participants such as gaining respect, autonomy, independence, support and relationships, to fulfill aspirations and responsibilities, and to feel included and recognized in society. Life domains that they deemed important for participation were communication and access to information, mobility, relationships, education and productivity, and recreation and leisure.Conclusions: In order to enhance societal participation of people with deafblindness, a significant change in the focus of rehabilitation services is required which involves professionals viewing participation as both a means and an end outcome while designing interventions.


Assuntos
Transtornos da Surdocegueira , Pessoas com Deficiência , Adulto , Cegueira , Humanos , Índia , Atividades de Lazer
11.
Health Equity ; 3(1): 604-611, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31763576

RESUMO

Objective: This article describes the demographic distribution of, and association between, neighborhood disorganization and mental health diagnosis by race in a large cohort of urban children with chronic medical conditions. Methods: Data for this study were from Coordinated Healthcare for Complex Kids (CHECK), a health care demonstration project funded by the Center for Medicare and Medicaid Innovation. We conducted regression analyses to examine the relationship between neighborhood disorganization and mental health diagnosis among 6,458 children enrolled in CHECK. Results: The most common mental health diagnoses were mood disorders (8.6%), Attention-Deficit/Hyperactivity Disorder (7.4%), conduct disorders (6.1%), and anxiety disorders (4.8%). Black children had the highest neighborhood disorganization scores compared with other racial/ethnic categories. However, Black children had the lowest proportion of mental health diagnoses. Lower neighborhood disorganization was associated with having a mental health diagnosis; however, when adding race/ethnicity to the model, neighborhood disorganization no longer was significant. Conclusions: Level of neighborhood disorganization was highly correlated with racial/ethnic composition of the neighborhoods, and Black children disproportionately resided in highly disorganized neighborhoods compared with other groups. Neighborhood disorganization may not have sufficient variability within the racial/ethnic categories, which may explain the absence of an interaction between race/ethnicity and mental health diagnosis.

12.
Arch Phys Med Rehabil ; 100(11): 2179-2192.e1, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31336102

RESUMO

OBJECTIVE: To investigate the content and effectiveness of interventions that address poststroke community participation. DATA SOURCES: EMBASE, PsycINFO, PubMed, and Cumulative Index to Nursing and Allied Health (CINAHL) were searched using 3 indexing terms and respective thesaurus: stroke, social participation, and clinical trials. Filters for English, publication dates (January 2001-May 2017), and publication types were used. The search also included checking references from relevant systematic reviews. STUDY SELECTION: Studies conducted with adults with stroke, evaluating interventions addressing community participation, having a comparison group, and reporting at least 1 of 3 outcomes (participation, depression, and health-related quality of life) were selected. Retrieved articles were screened by 2 reviewers. After substantial agreement was achieved using interrater reliability, reviewers screened articles independently. Eighteen of 1130 articles were included. DATA EXTRACTION: Characteristics of participants, key elements of intervention, comparator, and results were independently extracted by 2 reviewers. Intervention content was categorized based on 9 categories from the International Classification of Functioning, Disability, and Health Activities and Participation domains. Risk of selection, performance, attrition, and reporting bias were evaluated. DATA SYNTHESIS: Two intervention categories were identified: leisure participation and community integration. Three leisure and 4 community integration interventions showed significant group differences favoring the intervention group in the target outcomes. The majority of interventions addressed the leisure, interpersonal relations, and community life categories of International Classification of Functioning, Disability, and Health with few focusing on political life, education, assisting others, and religion. CONCLUSIONS: A limited number of studies showed an effect on participation, depression, and health-related quality of life outcomes. There were gaps in intervention content indicating that current community participation interventions fall short in addressing full inclusion and citizenship of people with stroke. Future interventions should focus on civic- and societal-level participation and community activities beyond leisure.


Assuntos
Modalidades de Fisioterapia , Qualidade de Vida , Participação Social , Reabilitação do Acidente Vascular Cerebral/métodos , Ensaios Clínicos como Assunto , Depressão/epidemiologia , Avaliação da Deficiência , Humanos , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Atividades de Lazer , Reprodutibilidade dos Testes
13.
Arch Phys Med Rehabil ; 100(12): 2324-2333, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30986411

RESUMO

OBJECTIVE: To identify and describe the contextual factors that influence the participation of people with deafblindness in India. DESIGN: Qualitative study, using directed content analysis approach and the International Classification of Functioning, Disability and Health (ICF) as a framework to analyze the data. SETTING: Community and social participation settings. PARTICIPANTS: Community-dwelling individuals with deafblindness (N=16). Age ranges from 18-45 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Personal and environmental factors that influence the participation of individuals with deafblindness using the ICF framework. RESULTS: Results indicate that the age of onset and nature of impairment (deafblindness) and willingness to explain the condition (functional consequences of deafblindness) emerged as important personal factors. Access to resources such as assistive technology, social support, and deafblind-specific services were found to be enablers of participation. Lack of services, systems, and policies specific to deafblindness along with negative societal attitude toward disability were highly perceived environmental barriers that influence participation of people with deafblindness in India. CONCLUSIONS: Professionals must acknowledge aspects of the environment in conducting assessments and delivering interventions and understand the dynamic interactions between environment of the individual and his/her concurrent vision and hearing impairments. Approaches to enable participation require rehabilitation professionals to work with those with deafblindness to advocate for removal of environmental barriers and ensure provision of appropriate resources from the government to facilitate their participation. Social policy and government must ensure emphasis on awareness about deafblindness, access to deafblind-specific services, positive societal attitude, and opportunities for full participation for people with deafblindness in society.


Assuntos
Transtornos da Surdocegueira/reabilitação , Pessoas com Deficiência/reabilitação , Meio Ambiente , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Participação Social , Atividades Cotidianas , Adolescente , Adulto , Comunicação , Transtornos da Surdocegueira/classificação , Países em Desenvolvimento , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Tecnologia Assistiva , Apoio Social , Adulto Jovem
14.
Child Care Health Dev ; 45(4): 551-558, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30897231

RESUMO

BACKGROUND: Social determinants of health play a vital role in population health. Awareness of household social factors and their impact on health can help health professionals to provide effective strategies in health promotion, especially for children and adolescents showing signs of psychosocial dysfunction. The objective of this study was to explore the association between parents' perceptions of the psychosocial behaviour of their children and the functionality of their household. METHODS: This cohort study analysed data from the Coordinated Health Care for Complex Kids programme. The sample included 293 parents of children aged 4-17 years with chronic conditions, and from urban, low-income families. Psychosocial behaviour of the child was measured using the Pediatric Symptom Checklist (PSC-17), which included subscales for internal, external, and attention symptoms. Household functionality was measured using the Confusion, Hubbub, and Order Scale. Responses to both assessments were scored in a standard manner. RESULTS: There was a significant association between parents' perceptions of the psychosocial behaviour of their children and the functionality of the home environment. The mean Confusion, Hubbub, and Order Scale scores in the home environment improved from baseline to the first reassessment (the period between the two assessments ranged from 4 to 8 months). Additionally, positive PSC-17 screening results of the children decreased by 11% in the first reassessment. The odds of having a positive PSC-17 screening result also decreased in the first reassessment after receiving interventions. CONCLUSION: The association between psychosocial dysfunction and household functionality indicates the importance of family-centred care and taking the home environment into consideration when administering health services to low-income children with chronic conditions. This study brings attention to the more hidden factors that influence child mental health, which must be addressed to improve care delivery and child health outcomes.


Assuntos
Transtornos do Comportamento Infantil/etiologia , Comportamento Infantil/psicologia , Doença Crônica/psicologia , Saúde da Família , Adolescente , Atitude Frente a Saúde , Criança , Transtornos do Comportamento Infantil/prevenção & controle , Transtornos do Comportamento Infantil/psicologia , Serviços de Saúde da Criança/organização & administração , Pré-Escolar , Estudos de Coortes , Feminino , Promoção da Saúde/métodos , Humanos , Illinois , Masculino , Pais/psicologia , Psicometria , Características de Residência , Fatores de Risco , Meio Social
15.
PLoS One ; 13(9): e0203772, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30212504

RESUMO

BACKGROUND: Deafblindness, also known as dual sensory loss, is a varying combination of visual and hearing impairment in the same individual. Interest in this topic has increased recently due to evidence suggesting an increase in prevalence of this condition among older adults. Persons with deafblindness frequently experience participation barriers and social isolation. Developing an understanding of their experiences can inform the design of programs and policies to enhance participation of people with deafblindness in society. OBJECTIVE: To identify and summarize available research literature on participation experiences of people with deafblindness or dual sensory loss. METHODS: A comprehensive literature search of eight databases (CINAHL/EBSCO, Embase, ERIC, Global Health, MEDLINE, ProQuest, PsycINFO, PubMed) was performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) during January 2017 and last updated in June 2017. In addition, non-peer reviewed (grey) literature was also retrieved in the form of online published reports of research projects by 16 deafblind-specific organizations across the globe. To be included, sources had to be published after 1990, had persons with deafblindness as the focal population, and focused on their participation experiences. RESULTS: A total 1172 sources were identified of which 54 studies were included. The findings reveal that persons with deafblindness, regardless of origin of their impairment, experience difficulty in communication, mobility, daily living functioning, and social interactions. While these experiences may vary between individuals with congenital versus acquired conditions, they generally feel socially isolated, insecure and uncertain about their future. CONCLUSION: Participation experiences of persons with deafblindness are shaped by dynamic interactions between personal factors (such as onset and type of impairments) and environmental influences (such as attitude, technology, and supports). A better understanding of participation experiences may help professionals in placing emphasis on affected participation domains to design services to enhance participation of people with deafblindness.


Assuntos
Transtornos da Surdocegueira/psicologia , Atividades Cotidianas , Comunicação , Bases de Dados Factuais , Transtornos da Surdocegueira/patologia , Humanos , Relações Interpessoais
16.
Occup Ther Health Care ; 32(2): 105-123, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29461136

RESUMO

Nearly one in ten US residents have difficulty speaking and understanding English and are deemed to have limited English proficiency (LEP). Despite federal mandates for provision of interpreters and other language access services, individuals with LEP experience notable health disparities. Occupational therapists must be prepared to equitably serve this population, however there is a dearth of research evidence and practical recommendations about our profession's readiness to serve this growing population. This paper maps the current healthcare policy environment and existing language access research relevant to occupational therapy. Implications for the future of occupational therapy research, education and practice are discussed.


Assuntos
Competência Cultural , Política de Saúde , Acesso aos Serviços de Saúde , Idioma , Terapia Ocupacional , Diversidade Cultural , Hispânico ou Latino , Humanos , Tradução , Estados Unidos
17.
J Prev Interv Community ; 46(1): 43-60, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29281600

RESUMO

Premigration trauma and postmigration stressors put refugees at high risk for mental health concerns, including substance use. However, there is limited systematic research on substance use in refugee communities exists. We conducted exploratory qualitative research to examine Bhutanese and Iraqi refugee perspectives related to the use of recreational substances after resettlement in the United States. Data were collected through separate focus groups with 28 Bhutanese and 22 Iraqi adult men. Focus groups were facilitated by an experienced clinician with an in-person interpreter, audiorecorded, and transcribed. Transcripts were checked for accurate translation and then analyzed using a conventional content analysis approach. Findings revealed similarities and differences between the two refugee groups with regard to recognizing excessive use, triggers for use, and preferred modes of outreach and intervention. Findings also revealed postmigration changes in substance use behaviors stemming from issues related to access, cost, and perceived legal ramifications.


Assuntos
Refugiados/psicologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Butão/etnologia , Comparação Transcultural , Grupos Focais , Humanos , Iraque/etnologia , Masculino , Meio-Oeste dos Estados Unidos , Estados Unidos
18.
J Prev Interv Community ; 46(1): 1-6, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29281601

RESUMO

This themed issue focuses on understanding and addressing several public health issues affecting communities today nationally and internationally. Health disparities, and global health in general, cover a large breadth of health concerns impossible to address in one issue. Here we provide a scope of some health disparities while focusing on health promotion and well-being of diverse populations, specifically within urban undeserved populations, rural communities in Peru, Roma minorities in Spain, and refugee communities. We focus on understanding contextual issue that affect health disparities as well as on examining the effectiveness of community-based interventions and community coalitions designed to address disparities.


Assuntos
Serviços de Saúde Comunitária , Promoção da Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Saúde Global , Política de Saúde , Acesso aos Serviços de Saúde , Humanos , Peru , Refugiados , Espanha
19.
J Health Care Poor Underserved ; 27(2): 427-39, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27180686

RESUMO

OBJECTIVES: (1) To profile children's health insurance coverage rates for specific rehabilitation therapies; (2) to determine whether coverage for rehabilitation therapies is associated with social participation outcomes after adjusting for child and household characteristics; (3) to assess whether rehabilitation insurance differentially affects social participation of children with and without disabilities. METHODS: We conducted a cross-sectional analysis of secondary survey data on 756 children (ages 3-17) from 370 households living in low-income neighborhoods in a Midwestern U.S. city. Multivariate mixed effects logistic regression models were estimated. RESULTS: Significantly higher proportions of children with disabilities had coverage for physical therapy, occupational therapy, and speech and language pathology, yet gaps in coverage were noted. Multivariate analysis indicated that rehabilitation insurance coverage was significantly associated with social participation (OR = 1.67, 95% CI: 1.013-2.75). This trend was sustained in subgroup analysis. CONCLUSIONS: Findings support the need for comprehensive coverage of all essential services under children's health insurance programs.


Assuntos
Acesso aos Serviços de Saúde , Cobertura do Seguro , Participação Social , Criança , Estudos Transversais , Crianças com Deficiência , Humanos , Seguro Saúde , Pobreza
20.
Occup Ther Health Care ; 29(4): 352-69, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26270148

RESUMO

Trends in policy, practice, and research point to the need for a community-engaged Scholarship of Practice (SOP) model that can be used to inform the development of occupational therapy practitioners, educators, and researchers. This article describes a community-engaged SOP model, the evidence justifying the need for such a model, and strategies to effectively create community-engaged practitioners, educators and career scientists within occupational therapy. We highlight several examples of community-based participatory research to further inform this model, and in turn, translate this knowledge back to communities for action and systems change that can affect the lives of people with disabilities and the communities in which they seek to live and participate long term.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Comportamento Cooperativo , Pesquisa sobre Serviços de Saúde , Serviços de Saúde para Pessoas com Deficiência , Terapia Ocupacional , Características de Residência , Pesquisa Translacional Biomédica , Atenção à Saúde , Pessoas com Deficiência , Pessoal de Saúde , Humanos , Terapia Ocupacional/educação , Pesquisadores , Recursos Humanos
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