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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 January 2015) | Viewed by 74141

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Prof. Dr. Alarcos Cieza

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Guest Editor

Faculty of Social and Human Sciences, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK
Interests: public health; disability; functioning; measurement; psychometrics; brain disorders

Priv.-Doz. Dr. Carla Sabariego

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Guest Editor

Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health und Health Services Research, Ludwig-Maximilians-Universität (LMU) München, Marchioninistr. 17, 81377 Munich, Germany
Interests: international classification of functioning, disability and health (icf); public health and public mental health; disability; health and disability surveys; health economics
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Jerome E. Bickenbach

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Guest Editor

Disability Policy Unit, Swiss Paraplegic Research, Guido A. Zäch-Strasse 4, 6207 Nottwil, Switzerland

Special Issue Information

Dear Colleagues,

People with disabilities comprise approximately 15% of the population. These are people with impairments, such as visual impairment and low back pain, and health conditions such as multiple sclerosis, spinal cord injury, depression and schizophrenia. This percentage is expected to increase, in part because of the world-wide ageing population and the increase of chronic health conditions.

People with disabilities often experience lower levels of health due to primary and secondary health conditions and comorbidities and also for being socially marginalised and suffering the health risks associated with social disadvantage. Nonetheless, public health has not always taken the needs of people with disabilities into account, and the time has come to change this.

Public health interventions need to reach people with disabilities for at least two reasons. First, people with disabilities are at higher risk of further health deterioration; and secondly because they have the human right to the full range of health services, including prevention and health promotion programmes, on an equal basis with others. This right is stated in Article 25 of in the United Nations Convention on the Rights of Persons with Disabilities.

Beyond planning, implementing and evaluating interventions, another core activity of public health is to track the health, population characteristics and health determinants of populations. Here again, public health has neglected the needs of persons with disabilities. In part, this is due to the fact that disability is a complex and multidimensional experience that poses many challenges for description and measurement. Data about all dimensions of disability—information about impairments, activity limitations, participation restrictions, and the environmental factors that facilitate or hinder full participation—are essential to understand how disability plays out in peoples’ lives and to identify the determinants of increased disability. It is necessary to examine the entirety of the disability experience, however, in order to understand the impact of disability on peoples’ lives and determine the appropriate public health response.

This Special Issue wishes to make the point that disability is a public health issue of increasing importance. It is open to submissions describing approaches to public health data collection that target disability, as well as those concerning public health interventions that address the challenges that disability poses for public health. Papers that address both topics from an economic or policy perspective are very welcome.

Prof. Dr. Alarcos Cieza
Dr. Carla Sabariego
Prof. Dr. Jerome E. Bickenbach
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (12 papers)

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Editorial

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216 KiB

Open AccessEditorial

Disability and Public Health

by Jerome E. Bickenbach, Alarcos Cieza and Carla Sabariego

Int. J. Environ. Res. Public Health 2016, 13(1), 123; https://doi.org/10.3390/ijerph13010123 - 12 Jan 2016

Cited by 8 | Viewed by 4929

Abstract

People with disabilities comprise approximately 15% of the world’s population. [...] Full article

(This article belongs to the Special Issue Disability and Public Health)

Research

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777 KiB

Open AccessArticle

Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates

by Carla Sabariego, Cornelia Oberhauser, Aleksandra Posarac, Jerome Bickenbach, Nenad Kostanjsek, Somnath Chatterji, Alana Officer, Michaela Coenen, Lay Chhan and Alarcos Cieza

Int. J. Environ. Res. Public Health 2015, 12(9), 10329-10351; https://doi.org/10.3390/ijerph120910329 - 25 Aug 2015

Cited by 58 | Viewed by 7765

Abstract

The usual approach in disability surveys is to screen persons with disability upfront and then ask questions about everyday problems. The objectives of this paper are to demonstrate the impact of screeners on disability rates, to challenge the usual exclusion of persons with mild and moderate disability from disability surveys and to demonstrate the advantage of using an a posteriori cut-off. Using data of a pilot study of the WHO Model Disability Survey (MDS) in Cambodia and the polytomous Rasch model, metric scales of disability were built. The conventional screener approach based on the short disability module of the Washington City Group and the a posteriori cut-off method described in the World Disability Report were compared regarding disability rates. The screener led to imprecise rates and classified persons with mild to moderate disability as non-disabled, although these respondents already experienced important problems in daily life. The a posteriori cut-off applied to the general population sample led to a more precise disability rate and allowed for a differentiation of the performance and needs of persons with mild, moderate and severe disability. This approach can be therefore considered as an inclusive approach suitable to monitor the Convention on the Rights of Persons with Disabilities. Full article

(This article belongs to the Special Issue Disability and Public Health)

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1126 KiB

Open AccessArticle

An ICF-Based Model for Implementing and Standardizing Multidisciplinary Obesity Rehabilitation Programs within the Healthcare System

by Amelia Brunani, Alberto Raggi, Anna Sirtori, Maria Elisa Berselli, Valentina Villa, Francesca Ceriani, Stefania Corti, Matilde Leonardi, Paolo Capodaglio and ICF-OBESITY Group

Int. J. Environ. Res. Public Health 2015, 12(6), 6084-6091; https://doi.org/10.3390/ijerph120606084 - 29 May 2015

Cited by 9 | Viewed by 6980

Abstract

Introduction/Objective: In this study, we aimed to design an ICF-based individual rehabilitation project for obese patients with comorbidities (IRPOb) integrated into the Rehab-CYCLE to standardize rehabilitative programs. This might facilitate the different health professionals involved in the continuum of care of obese patients to standardize rehabilitation interventions. Methods: After training on the ICF and based on the relevant studies, ICF categories were identified in a formal consensus process by our multidisciplinary team. Thereafter, we defined an individual rehabilitation project based on a structured multi-disciplinary approach to obesity. Results: the proposed IRPOb model identified the specific intervention areas (nutritional, physiotherapy, psychology, nursing), the short-term goals, the intervention modalities, the professionals involved and the assessment of the outcomes. Information was shared with the patient who signed informed consent. Conclusions: The model proposed provides the following advantages: (1) standardizes rehabilitative procedures; (2) facilitates the flow of congruent and updated information from the hospital to outpatient facilities, relatives, and care givers; (3) addresses organizational issues; (4) might serve as a benchmark for professionals who have limited specific expertise in rehabilitation of comorbid obese patients. Full article

(This article belongs to the Special Issue Disability and Public Health)

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680 KiB

Open AccessArticle

In Search of an Integrative Measure of Functioning

by Rosamond H. Madden, Nick Glozier, Nicola Fortune, Maree Dyson, John Gilroy, Anita Bundy, Gwynnyth Llewellyn, Luis Salvador-Carulla, Sue Lukersmith, Elias Mpofu and Richard Madden

Int. J. Environ. Res. Public Health 2015, 12(6), 5815-5832; https://doi.org/10.3390/ijerph120605815 - 26 May 2015

Cited by 24 | Viewed by 8028

Abstract

International trends towards people-centred, integrative care and support require any measurement of functioning and disability to meet multiple aims. The information requirements of two major Australian programs for disability and rehabilitation are outlined, and the findings of two searches for suitable measures of functioning and disability are analysed. Over 30 current measures of functioning were evaluated in each search. Neither search found a generic measure of functioning suitable for these multibillion dollar programs, relevant to a wide range of people with a variety of health conditions and functioning experiences, and capable of indicating support needs, associated costs, progress and outcomes. This unsuccessful outcome has implications internationally for policy-relevant information for disability, rehabilitation and related programs. The paper outlines the features of an Integrative Measure of Functioning (IMF) based on the concepts of functioning and environmental factors in the International Classification of Functioning, Disability and Health (ICF). An IMF would be applicable across a variety of health conditions, settings and purposes, ranging from individual assessment to public health. An IMF could deliver person-centred, policy-relevant information for a range of programs, promoting harmonised language and measurement and supporting international trends in human services and public health. Full article

(This article belongs to the Special Issue Disability and Public Health)

679 KiB

Open AccessArticle

Do People with Disabilities Have Difficulty Finding a Family Physician?

by Mary Ann McColl, Alice Aiken and Michael Schaub

Int. J. Environ. Res. Public Health 2015, 12(5), 4638-4651; https://doi.org/10.3390/ijerph120504638 - 28 Apr 2015

Cited by 13 | Viewed by 5754

Abstract

Primary care has been ideally characterized as the medical home for all citizens, and yet recent data shows that approximately 6% do not have a family physician, and only 17.5% of family practices are open to new patients. Given acknowledged shortages of family physicians, this research asks the question: Do people with disabilities have particular difficulty finding a family physician? Health Care Connect (HCC) is a government-funded agency in Ontario Canada, designed to “help Ontarians who are without a family health care provider to find one”. Using data from HCC, supplemented by interviews with HCC staff, the study explores the average wait time for patients with disabilities to be linked with a primary care physician, and the challenges faced by agency staff in doing so. The study found that disabled registrants with the program are only slightly disadvantaged in terms of wait times to find a family physician, and success rates are ultimately comparable; however, agency staff report that there are a number of significant challenges associated with placing disabled patients. Full article

(This article belongs to the Special Issue Disability and Public Health)

708 KiB

Open AccessArticle

Rehabilitation Living Lab in the Mall Community of Practice: Learning Together to Improve Rehabilitation, Participation and Social Inclusion for People Living with Disabilities

by Barbara Mazer, Dahlia Kairy, Andréanne Guindon, Michel Girard, Bonnie Swaine, Eva Kehayia and Delphine Labbé

Int. J. Environ. Res. Public Health 2015, 12(4), 4439-4460; https://doi.org/10.3390/ijerph120404439 - 22 Apr 2015

Cited by 14 | Viewed by 6581

Abstract

Communities of practice (CoP) can facilitate collaboration between people who share a common interest, but do not usually work together. A CoP was initiated and developed including stakeholders from clinical, research, community and governmental backgrounds involved in a large multidisciplinary and multi-sectorial project: the Rehabilitation Living Lab in a Mall (RehabMaLL). This study aimed to evaluate the structure, process and outcomes of this CoP. A single case-study, using mixed-methods, evaluated the RehabMaLL CoP initiative after one year, based on Donabedian’s conceptual evaluation model. Forty-three participants took part in the RehabMaLL CoP with 60.5% (n = 26) participating at least once on the online platform where 234 comments were posted. Four in-person meetings were held. Members expressed satisfaction regarding the opportunity to share knowledge with people from diverse backgrounds and the usefulness of the CoP for the RehabMaLL project. Collaboration led to concrete outcomes, such as a sensitization activity and a research project. Common challenges included lack of time and difficulty finding common objectives. A CoP can be a useful strategy to facilitate knowledge sharing on disability issues. Future research is necessary to determine strategies of increasing knowledge creation between members. Full article

(This article belongs to the Special Issue Disability and Public Health)

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The Impact of Living in a Care Home on the Health and Wellbeing of Spinal Cord Injured People

by Brett Smith and Nick Caddick

Int. J. Environ. Res. Public Health 2015, 12(4), 4185-4202; https://doi.org/10.3390/ijerph120404185 - 15 Apr 2015

Cited by 25 | Viewed by 6532

Abstract

In the UK, 20% of people with spinal cord injury (SCI) are discharged from rehabilitation into an elderly care home. Despite this, and knowledge that the home is central to health and wellbeing, little research has examined the impact of being in care homes on the health and wellbeing of people with SCI. The purpose of this study was to address this gap. Twenty adults who lived in care homes or had done so recently for over two years were interviewed in-depth. Qualitative data were analyzed using inductive thematic analysis. Analyses revealed that living in a care home environment severely damages quality of life, physical health and psychological wellbeing in the short and long-term. Reasons why quality of life, health, and wellbeing were damaged are identified. These included a lack of freedom, control, and flexibility, inability to participate in community life, inability to sustain relationships, safety problems, restricted participation in work and leisure time physical activity, lack of meaning, self-expression, and a future, loneliness, difficulties with the re-housing process, depression, and suicidal thoughts and actions. It is concluded that for people with SCI, the care home environment violates social dignity, is oppressive, and denies human rights. Implications for housing and health care policies are also offered. Full article

(This article belongs to the Special Issue Disability and Public Health)

700 KiB

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Cross-Sectional Associations of Depressive Symptom Severity and Functioning with Health Service Use by Older People in Low-and-Middle Income Countries

by Conal D. Twomey, Martin Prince, Alarcos Cieza, David S. Baldwin and A. Matthew Prina

Int. J. Environ. Res. Public Health 2015, 12(4), 3774-3792; https://doi.org/10.3390/ijerph120403774 - 02 Apr 2015

Cited by 5 | Viewed by 5961

Abstract

Background: Comprehensive understanding of the determinants of health service use (HSU) by older people with depression is essential for health service planning for an ageing global population. This study aimed to determine the extent to which depressive symptom severity and functioning are associated with HSU by older people with depression in low and middle income countries (LMICs). Methods: A cross-sectional analysis of the 10/66 Dementia Research Group population-based surveys dataset. Participants (n = 4590) were those aged 65 or older, in the clinical range for depressive symptoms (defined as scoring four or more on the EURO-D), living in 13 urban and/or rural catchment areas in nine LMICs. Associations were calculated using Poisson regression and random-effects meta-analysis. Results: After adjustment for confounding variables, (EURO-D) depressive symptom severity was significantly associated with “any community HSU” (Pooled Prevalence Ratios = 1.02; 95% CI = 1.01–1.03) but not hospital admission. Conversely, after adjustment, (WHODAS-II) functioning was significantly associated with hospital admission (Pooled PR = 1.14; 95% CI = 1.02–1.26) but not “any community HSU”. Conclusions: Depressive symptom severity does not explain a large proportion of the variance in HSU by older people with depression in LMICs. The association of functioning with this HSU is worthy of further investigation. In LMICs, variables related to accessibility may be more important correlates of HSU than variables directly related to health problems. Full article

(This article belongs to the Special Issue Disability and Public Health)

770 KiB

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Longitudinal Changes in Functioning and Disability in Patients with Disorders of Consciousness: The Importance of Environmental Factors

by Michelle Willems, Davide Sattin, Ad J.J.M. Vingerhoets and Matilde Leonardi

Int. J. Environ. Res. Public Health 2015, 12(4), 3707-3730; https://doi.org/10.3390/ijerph120403707 - 01 Apr 2015

Cited by 11 | Viewed by 5905

Abstract

Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in “Activities & Participation” were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in “Activities & Participation” decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor “support and relationships” reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in “Environmental Factors” were significant predictors of relative variability in “Activities & Participation”. It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness. Full article

(This article belongs to the Special Issue Disability and Public Health)

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708 KiB

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Mobile Applications for Participation at the Shopping Mall: Content Analysis and Usability for Persons with Physical Disabilities and Communication or Cognitive Limitations

by Claudine Auger, Emilie Leduc, Delphine Labbé, Cassioppée Guay, Brigitte Fillion, Carolina Bottari and Bonnie Swaine

Int. J. Environ. Res. Public Health 2014, 11(12), 12777-12794; https://doi.org/10.3390/ijerph111212777 - 10 Dec 2014

Cited by 17 | Viewed by 7158

Abstract

The aim of this exploratory study was to determine the important features in content and usability of existing mobile applications evaluating environmental barriers and facilitators (EBF) to participation for persons with physical disabilities presenting mild communication or cognitive limitations. A rigorous process based on a user-centered design approach led to the identification of two relevant mobile applications to evaluate the EBF. An accessibility expert, the research team as well as five users then tested the mobile applications in a shopping mall. A thematic content analysis of the research team’s and users’ comments established 10 categories of key features that adequately respond to the needs of the clientele targeted in this study. In terms of content, granularity and contextualization of the information provided were considered important. With respect to usability, relevant features were place finding, rating system, presentation of results, compatibility, user-friendliness, aesthetics, credibility of the information as well as connectivity/interactiveness. The research team and the users agreed on some aspects such as aesthetics, but had different perspectives on features such as the rating system or the connectivity/interactiveness of the application. The users proposed new features suggesting that the existing mobile applications did not correspond to all their needs. Full article

(This article belongs to the Special Issue Disability and Public Health)

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Other

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175 KiB

Open AccessReply

Response to Madans et al. Comments on Sabariego et al. Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates. Int. J. Environ. Res. Public Health, 2015, 12, 10329–10351

Int. J. Environ. Res. Public Health 2016, 13(1), 66; https://doi.org/10.3390/ijerph13010066 - 22 Dec 2015

Cited by 3 | Viewed by 3476

Abstract

We greatly appreciate and wish to thank Madans, Mont and Loeb for the issues they raise in their Comment [1] on our paper “Measuring Disability: Using the WHO Model Disability Survey to Address the Impact of Screeners on Disability Rates” [2]. [...] Full article

(This article belongs to the Special Issue Disability and Public Health)

157 KiB

Open AccessComment

Comments on Sabariego et al. Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates. Int. J. Environ. Res. Public Health, 2015, 12, 10329–10351

by Jennifer H. Madans, Daniel Mont and Mitchell Loeb

Int. J. Environ. Res. Public Health 2016, 13(1), 65; https://doi.org/10.3390/ijerph13010065 - 22 Dec 2015

Cited by 6 | Viewed by 3741

Abstract

In the article, Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates, in Volume 12 of the Journal International Journal of Environmental Research and Public Health, Carla Sabariego et al. [1] raise several issues regarding the use of the short set of questions developed by the Washington Group on Disability Statistics (WG) as compared with the approach to disability measurement proposed through the Model Disability Survey (MDS). We address these below. [...] Full article

(This article belongs to the Special Issue Disability and Public Health)

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