RESUMO
Here, we report the process for creating a patient visible quality educational display to highlight the collaborative quality working practices of Radiation Oncology clinicians and staff in the main Radiotherapy Centers throughout three Canadian provinces. These processes are often not visible to patients yet they speak directly to the standards of care delivered at these centers. The Canadian Partnership for Quality Radiotherapy (CPQR) Quality Assurance Guidelines for Canadian Radiation Treatment Programs guided this process. The display slides created were approved by the local Radiation Oncology departmental leadership for each participating medical center as well as patient focus groups and revised with feedback from both perspectives. Of 27 patients/families who evaluated the resulting educational patient display, 70% expressed high engagement in the information presented, and 81% felt the display will be of interest to patients receiving radiotherapy treatment. Patients/families surveyed reported that the displayed content made them feel more informed and more comfortable with their treatments. Survey data from this project indicates that increasing transparency and deepening patient education about the quality working practices behind radiotherapy treatments has the potential to empower patients receiving radiotherapy and increase their confidence in the care they are receiving.
Assuntos
Recursos Audiovisuais , Instrução por Computador/métodos , Atenção à Saúde/normas , Hospitais/normas , Modelos Educacionais , Participação do Paciente , Radioterapia (Especialidade)/educação , Canadá , HumanosRESUMO
Efforts to improve clinical preventive services (CPS) receipt among women with disabilities are poorly understood and not widely disseminated. The reported results represent a 2-year, Centers for Disease Control and Prevention and Association of Maternal and Child Health Programs partnership to develop a central resource for existing tools that are of potential use to maternal and child health practitioners who work with women with disabilities. Steps included contacting experts in the fields of disability and women's health, searching the Internet to locate examples of existing tools that may facilitate CPS receipt, convening key stakeholders from state and community-based programs to determine their potential use of the tools, and developing an online Toolbox. Nine examples of existing tools were located. The tools focused on facilitating use of the CPS guidelines, monitoring CPS receipt among women with disabilities, improving the accessibility of communities and local transportation, and training clinicians and women with disabilities. Stakeholders affirmed the relevance of these tools to their work and encouraged developing a Toolbox. The Toolbox, launched in May 2013, provides information and links to existing tools and accepts feedback and proposals for additional tools. This Toolbox offers central access to existing tools. Maternal and child health stakeholders and other service providers can better locate, adopt and implement existing tools to facilitate CPS receipt among adolescent girls with disabilities who are transitioning into adult care as well as women with disabilities of childbearing ages and beyond.
Assuntos
Pessoas com Deficiência , Serviços de Saúde Materna/organização & administração , Medicina Preventiva/métodos , Melhoria de Qualidade , Adolescente , Adulto , Feminino , Humanos , Serviços de Saúde Materna/normas , Medicina Preventiva/organização & administração , Medicina Preventiva/normas , Estados Unidos , Saúde da Mulher , Adulto JovemRESUMO
OBJECTIVE: To describe the percentage of US public health schools and programs offering graduate-level courses with disability content as a potential baseline measurement for Healthy People 2020 objective DH-3 and compare the percentage of public health schools that offered disability coursework in 1999 with those in 2011. DESIGN: In 2011, using SurveyMonkey.com, cross-sectional information was collected from the deans, associate deans, directors, or chairpersons of master of public health-granting public health schools and programs that were accredited and listed with the Council on Education for Public Health. Two rounds of follow-up were conducted at 4-month intervals by e-mails and phone calls to program contacts who had not responded. The responses from schools and programs were calculated and compared. RESULTS: There were 78 responses (34 schools and 44 programs) for a response rate of 63%. Fifty percent of public health schools and programs offered some disability content within their graduate-level courses. A greater percentage of schools than programs (71% vs 34%; P = .003) offered some graduate-level disability coursework within their curricula. The percentage of schools that offered disability coursework was similar in 1999 and 2011. CONCLUSION: This assessment provides a potential baseline measurement for Healthy People 2020 objective DH-3. Future assessments should focus on clarifying disability content within courses and identifying capacity to offering disability training within public health schools and programs.
Assuntos
Currículo/normas , Pessoas com Deficiência/educação , Saúde Pública/educação , Faculdades de Saúde Pública/normas , Estudos Transversais , Currículo/estatística & dados numéricos , Educação de Pós-Graduação/normas , Humanos , Estados UnidosRESUMO
This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan.
Assuntos
Planejamento em Saúde/organização & administração , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Humanos , Desenvolvimento de Programas , Saúde Pública , Estados UnidosRESUMO
BACKGROUND: Cigarette smoking is the leading cause of preventable disease and death in the United States. The tobacco product landscape has diversified to include electronic cigarettes (e-cigarettes). Adults with disabilities are more likely than adults without disabilities to smoke cigarettes, but within the current body of literature, there is limited information on the use of e-cigarettes among adults with disabilities. OBJECTIVE: To assess overall and state-specific prevalence of current e-cigarette use among adults by disability status, disability type, sex, and age. METHODS: Disability was defined as having serious difficulty with vision, hearing, mobility, cognition, or any difficulty with self-care or independent living. The Behavioral Risk Factor Surveillance System cross-sectional survey data (2016-2018; n = 1,150,775) were used to estimate state and District of Columbia prevalence of current e-cigarette use among adults (aged ≥18 years) with and without disabilities, overall and by disability type, sex, and age group. RESULTS: Median prevalence of current e-cigarette use was higher among adults with than without disabilities (6.5% vs. 4.3%, P < 0.05). Among adults with disabilities, use varied from 2.5% in DC to 10.0% in Colorado; median use was highest among those with cognitive disabilities (10.0%) and those aged 18-24 years (18.7%). CONCLUSIONS: Prevalence of current e-cigarette use was higher among adults with than without disabilities and varied across states by disability status, type, and age group. The findings underscore the need to monitor e-cigarette use among adults with disabilities and specifically include them in tobacco control policies and programs addressing e-cigarette use.
Assuntos
Pessoas com Deficiência , Sistemas Eletrônicos de Liberação de Nicotina , Vaping , Adolescente , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , Estudos Transversais , Humanos , Vigilância da População , Prevalência , Estados Unidos/epidemiologia , Vaping/epidemiologia , Adulto JovemRESUMO
State, local, tribal, and territorial emergency managers and public health officials must address the specific needs of people with disabilities in their pandemic influenza plans. Evidence from Hurricane Katrina indicated that this population was disproportionately affected by the storm and aftermath. People with disabilities, particularly those who require personal assistance and those who reside in congregate care facilities, may be at increased risk during an influenza pandemic because of disrupted care or the introduction of the virus by their caregivers. Emergency and public health planners must ensure that personal assistance agencies and congregate care operators make provisions for backup staffing and that those who provide critical care are given adequate antiviral drugs and vaccines as they become available.
Assuntos
Pessoas com Deficiência , Surtos de Doenças/prevenção & controle , Influenza Humana/prevenção & controle , Adolescente , Adulto , Idoso , Barreiras de Comunicação , Acessibilidade aos Serviços de Saúde , Humanos , Pessoa de Meia-Idade , Instituições Residenciais , Estados Unidos/epidemiologia , Populações Vulneráveis , Adulto JovemRESUMO
Lower- and higher-prejudiced individuals may strategically derogate negatively stereotyped individuals. Regardless of degree of prejudice, participants with a directional goal to discredit a threatening message and its source were more likely to do so when the source belonged to a negatively stereotyped group. They also were less persuaded by that stigmatized source. When this directional goal was negated by making the message nonthreatening, lower-prejudiced individuals evaluated the stigmatized and nonstigmatized sources, and their messages, similarly and were equally persuaded by both sources. When an accuracy goal was simultaneously introduced, lower-prejudice participants again rated the stigmatized and nonstigmatized sources comparably yet continued to derogate the stigmatized speaker's message and were less persuaded by him. Removing the directional goal or adding the accuracy goal did not affect higher-prejudiced participants' evaluations. The importance of examining situational goals and individual differences when studying biased responding is discussed.
Assuntos
Motivação , Comunicação Persuasiva , Preconceito , Estereotipagem , Objetivos , Humanos , Manitoba , Inquéritos e Questionários , Universidades , Gravação de Videoteipe , População BrancaRESUMO
PURPOSE: To examine the interface between mobility limitations and minority status and its effect on multiple health and health-related domains among adults, using the framework of the International Classification of Functioning, Disability and Health (ICF). METHODS: We combined 8 years of data from the 1997-2004 US National Health Interview Survey to investigate health disparities among minorities with mobility limitations as defined by the ICF. A total of 79,739 adults surveyed met these criteria. RESULTS: Adults with both mobility limitations and minority status experienced the greatest disparities (p<0.001) in worsening health (adjusted odds ratio [AOR]=8.5), depressive symptoms (AOR=17.2), diabetes (AOR=5.5), hypertension (AOR=3.4), stroke (AOR=7.2), visual impairment (AOR=4.6), difficulty with activities of daily living (AOR=42.7) and instrumental activities of daily living (AOR=27.7), use of special equipment (AOR = 28.1), obesity (AOR=3.3), physical inactivity (AOR=2.7), and low workforce participation (AOR=0.35). CONCLUSIONS: For most outcome measures, findings supported our hypothesis that persons with both mobility limitations and minority status experience greater health disparities than do adults with minority status or mobility limitations alone.
Assuntos
Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Limitação da Mobilidade , Atividades Cotidianas , Adolescente , Adulto , Idoso , Estudos Transversais , Avaliação da Deficiência , Feminino , Inquéritos Epidemiológicos , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
Preparedness planning is essential to minimizing the impact of disasters on communities and individuals. Attention to the needs of people with disabilities is vital as they have additional needs before, during and after a disaster that are specific to the disabling condition. In this Commentary, we emphasize national guidelines on disability inclusion in emergency preparedness. We examine some potential areas of planning and response that need attention as suggested by preparedness data for people with self-reported disabilities (also referred to as access and functional needs) and highlight selected resources (e.g., tools, trainings, and online webinars) to enhance whole community preparedness and disability inclusion efforts. This Commentary intends to bridge the gap between those various facets of preparedness, at all levels of government and among individuals, with the aim of ensuring that the whole community is prepared to adapt, withstand and rapidly recover from disruptions due to disasters.
Assuntos
Defesa Civil , Pessoas com Deficiência , Planejamento em Desastres , Desastres , Características de Residência , HumanosRESUMO
The Healthy People 2020 (HP2020) Midcourse Review (MCR) presents an opportunity for professionals in the disability and health field to contemplate preliminary progress toward achieving specific health objectives. The MCR showed notable progress in access to primary care, appropriate services for complex conditions associated with disability, expansion of health promotion programs focusing on disability, improving mental health, and reducing the unemployment rate among job seekers with disabilities. This commentary presents potential considerations, at least in part, for such progress including increased access to health care, greater awareness of appropriate services for complex conditions, and opportunities for societal participation. Additional considerations are provided to address the lack of progress in employment among this population -- a somewhat different measure than that for unemployment. Continuing to monitor these objectives will help inform programs, policies, and practices that promote the health of people with disabilities as measured by HP2020.
Assuntos
Logro , Atenção à Saúde , Pessoas com Deficiência , Objetivos , Programas Gente Saudável , Emprego , Promoção da Saúde , Disparidades nos Níveis de Saúde , Humanos , Saúde Mental , Políticas , Atenção Primária à Saúde , Estresse Psicológico , Desemprego , Estados UnidosRESUMO
Portraits of moral heroes often portray the hero gazing up and to the viewer's right in part because ideologically minded followers select and propagate these images of their leaders. Study 1 found that the gaze direction of portraits of moral heroes (e.g., Martin Luther King, Jr.) tend to show the hero looking up-and-right more often than chance would predict, and more often than portraits of celebrities (e.g., Elvis Presley) do. In Studies 2 and 3, we asked participants to play the role of an ideologically motivated follower, and select an image of their leader to promote the cause. Participants preferentially selected the up-and-right version. In Study 4, we found that conceptual metaphors linking directionality to personal virtues of warmth, pride, and future-mindedness helped explain why the up-and-right posture looks most heroic. Followers play an active role in advancing social causes by portraying their leaders as moral heroes.
Assuntos
Liderança , Percepção Social , Virtudes , Adulto , Reconhecimento Facial , Pessoas Famosas , Feminino , Humanos , MasculinoRESUMO
The objective of this study was to determine the prevalence of iron deficiency with and without anemia in a convenience sample of trained male and female adults. One hundred twenty-one adults (72 female, 49 male) involved in aerobic training (11.2+/-6.3 hr/wk for >/=6 consecutive months), ages 18 to 41 years old, participated in an iron status screening. The concentrations of hemoglobin (Hb), ferritin, and transferrin receptor were measured in serum to determine the prevalence of iron deficiency with and without anemia. Eight individuals (seven female, one male) had iron deficiency with anemia (serum ferritin <16 microg/L; Hb<120 g/L female, <136 g/L male). Iron deficiency without anemia (serum ferritin =16 microg/L) was found in 29% of female and 4% of male subjects. Determination of iron deficiency without anemia using the transferrin receptor-ferritin index (serum transferrin receptor:log serum ferritin>/=4.5) found 36% of female and 6% of male subjects to be iron deficient without anemia. Recreational athletes should be screened for iron deficiency without anemia using serum ferritin, serum transferrin receptor, and Hb.
Assuntos
Anemia Ferropriva/epidemiologia , Exercício Físico/fisiologia , Deficiências de Ferro , Ferro/sangue , Adolescente , Adulto , Anemia Ferropriva/sangue , Feminino , Ferritinas/sangue , Hemoglobinas/análise , Humanos , Masculino , Prevalência , Receptores da Transferrina/sangue , Fatores SexuaisRESUMO
BACKGROUND: Surveillance on paralysis prevalence has been conceptually and methodologically challenging. Numerous methods have been used to approximate population-level paralysis prevalence estimates leading to widely divergent prevalence estimates. OBJECTIVE/HYPOTHESES: To describe three phases in use of the International Classification of Functioning, Disability and Health (ICF) as a framework and planning tool for defining paralysis and developing public health surveillance of this condition. METHODS: Description of the surveillance methodology covers four steps: an assessment of prior data collection efforts that included a review of existing surveys, registries and other data collection efforts designed to capture both case definitions in use and prevalence of paralysis; use of a consensus conference of experts to develop a case definition of paralysis based on the ICF rather than medical diagnostic criteria; explanation of use of the ICF framework for domains of interest to develop, cognitively test, validate and administer a brief self-report questionnaire for telephone administration on a population; and development and administration of a Paralysis Prevalence and Health Disparities Survey that used content mapping to back code items from existing national surveys to operationalize key domains. RESULTS: ICF coding led to a national population-based survey of paralysis that produced accurate estimates of prevalence and identification of factors related to the health of people in the U.S. living with paralysis. CONCLUSIONS: The ICF can be a useful tool for developing valid and reliable surveillance strategies targeting subgroups of individuals with functional disabilities such as people with paralysis and others.