Disability and social participation: The case of formal and informal volunteering

The bidirectional association between the disability in activities of daily living and depression: a longitudinal study in Chinese middle-aged and older adults

AIM

Depression and disability in activities of daily living (ADL) are common in middle-aged and older adults. This study investigated the bidirectional relationship between depression and disability in ADL in Chinese middle-aged and older adults.

METHODS

Data from a baseline study of 17,596 participants from the China Health and Retirement Longitudinal Study (CHARLS) and two follow-up visits at 4 and 7 years were included. We designed Study A and Study B to explore the interaction between depression and disability in ADL in middle-aged and older people.

RESULTS

Individuals with disability in ADL at baseline had adjusted odds ratios (ORs) of 1.331 (1.118, 1.584) and 1.969 (1.585, 2.448) for developing depression compared with those without disability in ADL at the 4- and 7-year follow-ups, respectively. Individuals with depression at baseline had adjusted ORs of 1.353 (1.127, 1.625) and 1.347 (1.130, 1.604), respectively, for developing disability in ADL 4 and 7 years later.

CONCLUSIONS

There was a bidirectional relationship between depression and disability in ADL. Depression increased the risk of disability in ADL, but this risk did not increase with time, whereas the effect of disability in ADL on depression increased with time.

Economic precarity and changing levels of anxiety and stress among Canadians with disabilities and chronic health conditions throughout the COVID-19 pandemic

Early in the COVID-19 pandemic, multiple event stressors converged to exacerbate a growing mental health crisis in Canada with differing effects across status groups. However, less is known about changing mental health situations throughout the pandemic, especially among individuals more likely to experience chronic stress because of their disability and health status. Using data from two waves of a targeted online survey of people with disabilities and chronic health conditions in Canada (N = 563 individuals, June 2020 and July 2021), we find that approximately 25% of respondents experienced additional increases in stress and anxiety levels in 2021. These increases were partly explained by worsening perceived financial insecurity and, in the case of stress, additional negative financial effects tied to the pandemic. This paper understands mental health disparities as a function of social status and social group membership. By linking stress process models and a minority stress framework with a social model of disability, we allude to how structural and contextual barriers make functional limitations disabling and in turn, life stressors.

Exploring the barriers and facilitators to volunteering as an intervention for those with long-term neurological conditions: How make therapeutic volunteering possible?

BACKGROUND

Volunteering may have therapeutic benefits, but little is known about its requirements and potential for people with neurological conditions (pwNC).

DESIGN

Two separate focus groups were conducted in Darmstadt, Germany: one group consisting of six pwNC and another group consisting of four health care professionals and three volunteering service providers. The focus groups were audio-recorded, transcribed and data were managed using NVivo12. The thematic analysis was applied.

RESULTS

Four main themes were identified: (1) Impact of volunteering, (2) Individualisation, (3) Developmental space and (4) Funded supported volunteering.

CONCLUSION

According to the findings, volunteering can be used as a strategy to enhance physical, mental and social well-being in disease management for people with long-term neurological conditions.

PATIENTS OR PUBLIC CONTRIBUTION

Facilitators for accessibility of therapeutic volunteering; involvement of pwNC.

Protective Role of Social Networks for the Well-Being of Persons with Disabilities: Results from a State-Wide Cross-Sectional Survey in Kerala, India

The current study presents the findings from a cross-sectional survey on social factors associated with the well-being of persons with disabilities (PWDs) in Kerala, India. We conducted a community-based survey across three geographical zones, North, Central, and South of Kerala state, between April and September 2021. We randomly selected two districts from each zone using a stratified sample method, followed by one local self-government from each of these six districts. Community health professionals identified individuals with disabilities, and researchers collected information on their social networks, service accessibility, well-being, and mental health. Overall, 244 (54.2%) participants had a physical disability, while 107 (23.78%) had an intellectual disability. The mean well-being score was 12.9 (S.D = 4.9, range = 5-20). Overall, 216 (48%) had poor social networks, 247 (55%) had issues regarding service accessibility, and 147 (33%) had depressive symptoms. Among the PWDs with issues with service access, 55% had limited social networks. A regression analysis revealed that social networks (b = 2.30, p = 0.000) and service accessibility (b = -2.09, p = 0.000) were associated with well-being. Social networks are more important than financial assistance because they facilitate better access to psycho-socioeconomic resources, a prerequisite for well-being.

Restrictions on persons with disabilities for participating in family and community activities

OBJECTIVE

To identify the influence of functional impairments and limitations activities for persons with disabilities to particípate in family and community activities.

METHODS

This is a cross-sectional study with 4 044 persons with disabilities, selected using probabilistic sampling and a door-to-door active search model in 5 towns in the District of Barranquilla. The data were processed with univariate analysis and bivariate analysis to determine the relationship between the study variables.

RESULTS

55.9% of the population were males, 41.6% were between 15 and 44 years of age, and 92.9% belonged to the lower socioeconomic stratum. 82.9% reported mobility limitations and 99% reported barriers to access non-formal learning activities, 98.6% to access public activities, and 97.5% to access productive activities. Individuals with that a lower limitation in exercising the power of reason, particularly thinking, can increase participation in activities with family and friends (OR, 0.8; 95% CI, 0.6-0.9), with the community (OR, 0.7; 95% CI, 0.6-0.9), religious or spiritual activities (OR, 0.8; 95% CI, 0.7-0.9).

CONCLUSIONS

There is a directly proportional relationship between structural impairment with the development of dependency and limited family, social, and work participation in the persons with disabilities.

Association between Social Participation and Remaining Teeth and Urban-Rural Difference among Older Adults in China

Oral health is an important part of older adults' general health. The study examined the association between social participation (formal and informal) and remaining teeth and the urban-rural difference based on a national survey of older adults in China. The data of older adults were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed. A total of 11,948 respondents were ultimately involved, including 6836 urban respondents and 5112 rural respondents. Informal social participation and formal social participation were used to assess social participation. The number of remaining natural teeth was measured. Social participation was significantly associated with remaining teeth among older adults, after adjusting for confounders, a one-level increase in the informal social participation was associated with a decrease in natural teeth by 0.152 (95% CI = -0.274; -0.030) and a one-level increase in the formal social participation was associated with a decrease in natural teeth by 0.370 (95% CI = -0.585; -0.156). In addition, the association between social participation (formal and informal) and remaining teeth was observed among urban older adults, but not rural older adults. A high level of social participation may effectively decrease the risk of oral-health problems for the Chinese older adults. The findings suggest recommendations for an older adults-targeted policy and the practice of oral-health promotion. However, the urban-rural difference should be taken into full consideration in social-participation-driven oral-health promotion interventions.

Volunteering among youth with disabilities: a population-based study

PURPOSE

The benefits of volunteering among youth are well documented. However, research is limited on volunteering among youth with disabilities. This study examined prevalence and associations of volunteering among youth with disabilities.

METHODS

We analyzed data from the 2016-2018 National Survey of Children's Health (n= 42 204). Prevalence estimates were calculated for sociodemographic and household factors, volunteering, and functional limitations. Bivariate and multivariable associations between participation in volunteering activities and variables of interest were assessed.

RESULTS

Youth with disabilities had lower prevalence of volunteering compared to youth without disabilities (48.4% vs. 55.6%). Youth with hearing and vision impairments had the lowest prevalence of volunteering (2.1% and 2.5%, respectively). Correlates of volunteering included health status (adjusted odds ratios (aOR)=1.81; 95% confidence interval (CI) 1.13-2.91), sex, and age.

CONCLUSIONS

Our study found low prevalence of volunteering among youth with disabilities. Since youth with disabilities face unique barriers to social inclusion, it is important to identify and reduce the barriers to participation among this group. Volunteer opportunities in the community should be designed to be both environmentally and programmatically accessible to youth with disabilities. These efforts should include accommodations and other support so that participants can fully experience all of the benefits of volunteering.Implications for rehabilitationOur multiyear nationally representative study found low prevalence of volunteering among youth with disabilities, particularly those with hearing and vision impairments.Since youth with disabilities face unique barriers to social inclusion, it is important to identify and reduce the barriers to participation among this group.Our findings support the need for environmentally and programmatically accessible volunteering opportunities for youth with disabilities.These efforts should include accommodations and other support so that participants can fully experience all of the benefits of volunteering.

Associations between volunteering and cognitive impairment: The moderating role of race/ethnicity

Although volunteering has been shown to benefit cognitive health, there is a paucity of evidence on informal volunteering and subjective measures of cognitive impairment. Also, little is known about whether such relationships vary by race/ethnicity. This study aimed to examine the associations of both formal and informal volunteering with older adults' objective and subjective cognition and explore the moderating role of race/ethnicity in such associations. Using data from the Health and Retirement Study in the United States (2010-2016), 9941 older adults (51+) who were cognitively unimpaired in 2010 and alive through 2016 were included. Ordered logistic regression models were performed to assess the relationships among volunteering, cognitive impairment and race/ethnicity. Findings showed that more years of formal and informal volunteering significantly reduced the odds of objective cognitive impairment; neither volunteering type was significant for subjective cognitive impairment. The relationship between informal volunteering and objective cognition varied by race/ethnicity. Compared to non-Hispanic Whites, non-Hispanic Black older adults who engaged in more years of informal volunteering had a significantly higher odds of cognitive impairment over time. The current study is one of the first to look at the associations between informal volunteering and cognition. The inclusion of subjective cognitive impairment, paired with objective measures of cognition, also adds value to the knowledge body. Our findings indicate any type of volunteering is a viable approach to prevent cognitive impairment for older populations. However, more research is needed to better understand why racial/ethnic minority, particularly non-Hispanic Black older adults, do not benefit from informal volunteering.

"Helping Somebody Else Has Helped Me Too": Resilience in Rural Women With Disabilities With Experiences of Interpersonal Violence

The concept of resilience, the ability to "bounce back," from adversity, can inform interpersonal violence interventions and victim assistance services. Unfortunately, though women with disabilities (WWD) experience high rates of all forms of violence and multiple layers of adversity, existing resilience research overlooks this populations' experiences, perspectives, and resilience strategies. The impairment, socially misperceived as a personal tragedy, precludes individuals with disabilities from being considered resilient; rather, they are designated almost universally as "at risk" or "vulnerable." This study aims to remedy this gap in understanding and scholarship. This qualitative study engaged 33 rural women with diverse disabilities who experienced violence to learn about how they cultivated resilience to support recovery and growth after experiencing abuse. Women described key personal qualities and supportive networks and services, such as internal drive, connectedness, dedication, healthy and helpful outlets, and an evolution of thoughts and behaviors. Counter to prevailing perceptions of WWD as dependent and helpless, women described how living with a disability honed strengths fundamental to their resilience. Women also described an "altruism born of suffering" wherein their experiences of violence contributed to a desire to give back and help others in difficult circumstances.Women's insights help to build a more comprehensive understanding of effective strategies and supports to bolster WWD's resilience. These findings inform interventions and promote approaches to build on women's strengths and resourcefulness.

Sexual Violence Against Women With Disabilities: Experiences With Force and Lifetime Risk

INTRODUCTION

Emerging research suggests that people with disabilities experience an increased risk of sexual violence. However, few studies have examined the relationship between disability types and various forms of sexual violence, involving either physical or nonphysical force.

METHODS

This cross-sectional study used nationally representative data from years 2011-2017 of the National Survey of Family Growth among women aged 18-44 years. Analyses were conducted in March 2020-June 2021. Using binary and multinomial logistic regression models, lifetime risk of sexual violence and experience of physical or nonphysical force at first intercourse were modeled as a function of disability type (sensory, physical, cognitive, or ≥2 disabilities). Models also controlled for relevant demographic confounders.

RESULTS

Women with any type of disability reported experiencing sexual violence in their lifetime approximately double the proportion of that experienced by nondisabled women (∼30% vs 16.9%), with women with multiple disabilities experiencing the greatest prevalence (42.1%) and risk (AOR=2.94, p<0.001) than nondisabled women. Women with cognitive disabilities or multiple disabilities were significantly more likely to experience either physical (cognitive: AOR=1.55, p<0.001; multiple: AOR=1.50, p<0.05) or nonphysical force (cognitive: AOR=2.28, p<0.01; multiple: AOR=2.74, p<0.001) during their first intercourse than nondisabled women.

CONCLUSIONS

Results of this study suggest that future research should focus on the association between various types of disability and sexual violence. The development of inclusive evidence-based violence intervention and prevention programs for girls and women with disabilities is recommended.

Professional Status of Persistent Spinal Pain Syndrome Patients after Spinal Surgery (PSPS-T2): What Really Matters? A Prospective Study Introducing the Concept of "Adapted Professional Activity" Inferred from Clinical, Psychological and Social Influence

Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) represents a main cause of work disruption. Beyond its societal consequences, occupational inactivity is responsible for a major decrease in physical/mental health in individuals but remains poorly analyzed. We designed a study to prospectively examine Professional Status (PS) evolution and its association with key bio-psychological markers. Data from 151 consecutively included working-age PSPS-T2 patients were analyzed to determine the proportion of professional inactivity and the relationships between PS and Social Gradient of Health (SGH), Numeric Pain Rating Scale (NPRS), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), and Fear-Avoidance Belief Questionnaire work subscale (FABQ-W). Despite optimized medical management, 73.5% of PSPS-T2 patients remained inactive after 1 year of follow-up/p = 0.18. Inactive patients presented a low SGH/p = 0.002, higher NPRS/p = 0.048, lower EQ-5D-5L/p < 0.001, higher ODI/p = 0.018, higher HADS-D/p = 0.019 and higher FABQ-W/p < 0.001. No significant mediation effect of FABQ-W on SGH consequences regarding PS was observed in our structural model/p = 0.057. The link between unemployment and bio-psycho-social pain dimensions appears bidirectional and justifies intense collaboration with social workers. Optimizing therapeutical sequencing towards personalized professional plans implies restoring "Adapted Physical Function" as an initial goal, and tailoring an "Adapted Professional Activity", matching with patient expectations and capabilities, as a final objective.

The importance of meaningful participation: health benefits of volunteerism for older adults with mobility-limiting disabilities

Volunteerism has been increasingly recognised as a health promotion activity for older adults. However, volunteerism has largely been the domain of those who are in good health with few to no physical limitations, and there is limited information about the experiences of older adults with disabilities. This study explores why older adults with mobility-limiting disabilities engage in volunteer work and their perceptions of the personal benefits of volunteering. Twenty older adults, from three Midwest towns in the United States of America, participated in semi-structured, in-depth, face-to-face interviews. Participants in this study identified as having serious difficulty walking or climbing stairs due to a health condition and had volunteered in the last year. Participants were selected purposively for maximum variation in terms of type of disability/impairment, race, gender and age. The constant comparative method of analysis was used to identify themes from their discussions. When asked about why they volunteer and the personal benefits of volunteering, participants discussed seeking out activities that were meaningful to them for both altruistic and more self-directed reasons. They identified a number of physical and emotional health benefits that they saw as directly and indirectly related to being able to participate in these meaningful activities. Findings from this study suggest that, for older adults with disabilities who are interested in volunteer activities, volunteerism can be a beneficial health promotion activity and a potential mechanism for increasing opportunities for meaningful inclusion and participation in their communities.

Association Between Successful Aging Activities and Perceived Health Among Older Adults With Hearing and/or Vision Impairments

Due to the high prevalence of age-related sensory impairment (SI), this study examined the relative strength of the association between successful aging activities and perceived health among older adults with SI. A sample of adults aged 65 and older who experienced SI in vision and/or hearing was drawn from the 2015–2017 National Survey on Drug Use and Health ( N = 2,084). Two aspects of successful aging were considered: employment status and religious participation. Of the total sample, 1,370 (65.7%) reported hearing impairment; 440 (21.1%), vision impairment; and 274 (13.1%) dual sensory impairment. Among the covariates, female gender, higher educational attainment, non-Hispanic White race, fewer chronic diseases, alcohol use, non-hospitalization, non-cigarette use, and no mobility challenges were associated with greater perceived health status. Working older adults with SI are more likely to perceive their health status as good compared with their unemployed counterparts (odds ratio [OR] = 2.43, p < .01). Religious participants with SI also perceive greater health (OR = 1.58, p < .01). For older adults with SI, ensuring that they participate in productive activities, such as employment or religious activities, may be important for their perceived health status and may lead to better overall health outcomes.

A Mobile App to Optimize Social Participation for Individuals with Physical Disabilities: Content Validation and Usability Testing

Background: Social participation is beneficial for individuals’ health. However, people with disabilities that may lead to mobility limitations tend to experience lower levels of social participation. Information and communication technologies such as the OnRoule mobile application (app) can help promote social participation. Objectives: To obtain potential users’ perceptions on the usability and content of the OnRoule app for providing information on accessibility, as well as its potential to optimize social participation. Materials and Methods: Cross-sectional user-centered design study. Individuals with physical disabilities (n = 18) were recruited through community organizations and interviewed using a semi-structured guide. Interviews were recorded, transcribed, and analyzed using thematic analysis. Results: Three main themes were identified: (1) “user-friendliness”; (2) “balance between the amount and relevance of information”; and (3) “potential use of the app”. Discussion and Conclusion: Findings from this study indicated that the app was easy to use, had pertinent information, and enabled a positive experience of finding information. However, several areas of improvement were identified, such as the clarity of specific elements, organization and amount of information, optimization of features, and inclusiveness. Apps such as OnRoule could optimize social participation by facilitating the process of finding resources in the community and building a sense of connectedness between users.

Functional Limitations, Social Integration, and Daily Activities in Late Life

OBJECTIVES

Disability in late life has been associated with increases in receiving care and loss of autonomy. The Disablement Process Model suggests that physical impairments lead to functional limitations that contribute to disabilities in managing household, job or other demands. Yet, we know surprisingly little about how functional limitations are related to activities throughout the day among community-dwelling adults, or the possible moderating role of social integration on these associations.

METHODS

Community-dwelling adults (N = 313) aged 65+ completed a baseline interview assessing their functional limitations, social ties, and background characteristics. Over 5 to 6 days, they answered questions about daily activities and encounters with social partners every 3 hours on handheld Android devices.

RESULTS

Multilevel logistic models revealed that functional limitations are associated with increased likelihood of activities associated with poor health (e.g., TV watching, medical appointments), and reduced likelihood of social activities, or physical activities, chores, or leaving the home. Most moderation analyses were not significant; family and friends did not mitigate associations between functional limitations and daily activities, with the exception of medical appointments. Individuals with functional limitations were more likely to attend medical appointments when with their social partners than when alone.

DISCUSSION

This study provided modest indication that functional limitations in community-dwelling older adults are associated with patterns of activity that may lead to further limitations, disability or loss of autonomy. Findings warrant longitudinal follow-up to establish subsequent patterns of decline or stability.

Barriers to Bachelor's Degree Completion among College Students with a Disability

One of the fastest growing groups on college campuses is students with disabilities, but their rates of bachelor's degree completion remain low. We build on research about barriers to degree completion among historically underrepresented groups on college campuses to examine the extent to which academic preparation before college and processes during college contribute to gaps in bachelor's degree completion among four-year college students with a mental or physical disability. Using the Beginning Postsecondary Students Longitudinal Study, we find that students with a mental disability are significantly less likely to complete a bachelor's degree than students without disabilities and students with a physical disability, net of students' family and academic background. Decomposition of the estimated indirect effect of mental disability on degree completion reveals first-year academic performance as the largest contributor. We discuss the theoretical and practical implications for understanding the barriers faced by college students with a mental disability.

Occupational inequalities in volunteering participation: Using detailed data on jobs to explore the influence of habits and circumstances

In this paper we present empirical results that show that detailed occupations have distinctive patterns of association with voluntary participation. We draw upon data from four secondary survey datasets from the UK (coverage 1972-2012). Occupations are shown to link to volunteering in a wide range of scenarios and in individual, household, and longitudinal contexts. We argue that these linkages provide insight into social inequalities in volunteering, and that they can help us to understand the relative influence of "circumstance" and "habits" in enabling or inhibiting voluntary participation.

Managing Cross-Border Conflicts Through Volunteer Commitment: A Comparative Study Between Religious and Non-profit Organizations in the San Diego-Tijuana Area

San Diego and Tijuana configure two big cities that have faced each other across the international boundary between United States and Mexico for over 180 years. Within this context, the relationship emerging at the border can be characterized under different categories of individual, social, economic, and political situations connecting each side. Additionally, in recent years, the literature on cross-border conflicts has extensively focused on volunteers as informal agents helping children and other groups of population, but relatively little research has addressed the practical and managerial work and implications of the volunteers themselves. As actors of cross-border communities, volunteers play a relevant role in effective short-term migrants' settlement, but it is also observed that the profile of volunteers in religious organizations differs from those belonging to non-profit institutions. Grounded on the theories of Planned Behavior and Reasoned Action suggesting that intentions to cooperate with non-government institutions are influenced directly by attitudinal values and indirectly by their beliefs related to social conflicts, this paper analyzes the nature of volunteer commitment in religious and non-profit organizations (NPOs) providing information about managerial practices for newly arrived migrants. The main purpose of this study is to investigate the relevance of volunteer commitment as an instrument for managing cross-border conflicts in the particular context of San Diego and Tijuana Area. Based on research using interview data collected from beneficiaries by volunteers, institutional representatives, and documentary references, this manuscript highlights a psychological and individual-centric perspective of volunteer commitment, but it also explores a collective communicative action expanding the range of relevant voices in decisions about volunteering. Moreover, this study provides new insights into how organizational and relational elements impact sustainable volunteer management and points out the role played by attitudes toward non-government institutions such as religious and NPOs demonstrating the relevance of volunteer commitment, transforming part of the positive attitude toward social problems into a significant intention to cooperation. Understanding the importance of the organization's images in order to attract volunteers, these results show that commitment may become a key determinant of the volunteers' identity linked to strategies devoted to organizational activities.

Mental and physical health impairments at the transition to college: Early patterns in the education-health gradient

Part of the education-health gradient may be related to inequalities in the transition from high school to college by health impairment status. In this paper, we use the National Longitudinal Survey of Youth 1997 to investigate the link between health impairments beginning prior to high school completion and college-going, distinguishing between individuals with mental, physical, or multiple health impairments and between enrollment in 2-year and 4-year postsecondary institutions. We find that individuals with mental impairments or multiple impairments are less likely to initially enroll in 4-year postsecondary institutions than individuals without health impairments, controlling on background and high school preparation. We also find evidence that advanced math course-taking in high school, an important step on the pathway to a 4-year college for all students, does not provide students with mental impairments the same return as students without health impairments. We discuss implications for policy to address educational inequalities in health.