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Lindsay S, Hsu S. Emergency and disaster preparedness among children and youth with disabilities and chronic conditions, their caregivers and service providers: a scoping review. Disabil Rehabil 2024; 46:1239-1255. [PMID: 38554389 DOI: 10.1080/09638288.2023.2185294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE People with disabilities, especially children and youth, are often not considered in emergency and disaster preparedness planning, which leaves them vulnerable and at a higher risk of the negative effects of natural and human caused disasters. The purpose of this study was to understand the extent of emergency and disaster preparedness and factors influencing preparedness among children and youth with disabilities and chronic conditions, their caregivers and service providers. METHODS Our scoping review involved searching six international databases that identified 1146 studies of which 27 met our inclusion criteria. RESULTS The studies in this review involved 2613 participants (i.e., children, parents, educators and clinicians) across nine countries over a 20-year period. Our results highlighted the following trends: (1) the extent of emergency preparedness; (2) factors affecting emergency preparedness; and (3) interventions to enhance preparedness. CONCLUSIONS Our findings underscore the critical need for more attention to emergency preparedness for children and youth with disabilities, their families and service providers and their inclusion in planning.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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Amberson T, Heagele T, Wyte-Lake T, Couig MP, Bell SA, Mammen MJ, Wells V, Castner J. Social support, educational, and behavioral modification interventions for improving household disaster preparedness in the general community-dwelling population: a systematic review and meta-analysis. Front Public Health 2024; 11:1257714. [PMID: 38596429 PMCID: PMC11003604 DOI: 10.3389/fpubh.2023.1257714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/22/2023] [Indexed: 04/11/2024] Open
Abstract
Background The efficacy of household emergency preparedness interventions for community-dwelling, non-institutionalized people is largely unknown. Objective To ascertain the state of the science on social support, educational, and behavioral modification interventions to improve all-hazard household disaster preparedness. Design Systematic review and meta-analysis. Methods Databases, trial registers, reports, and websites were searched, and citation trails followed utilizing replicable methods. Individual, cluster, and cross-over randomized controlled trials of non-institutionalized, community-dwelling populations and non-randomized controlled trials, controlled before-after, and program evaluation studies were included. At least two review authors independently screened each potentially relevant study for inclusion, extracted data, and assessed the risk of bias. Risk of bias was assessed using Cochrane's RoB2 tool for randomized studies and ROBINS-I tool for nonrandomized studies. Meta-analyses were applied using a random-effects model. Where meta-analysis was not indicated, results were synthesized using summary statistics of intervention effect estimates and vote counting based on effect direction. The evidence was rated using GRADE. Results 17 studies were included with substantial methodological and clinical diversity. No intervention effect was observed for preparedness supplies (OR = 6.12, 95% 0.13 to 284.37) or knowledge (SMD = 0.96, 95% CI -0.15 to 2.08) outcomes. A small positive effect (SMD = 0.53, 95% CI 0.16 to 0.91) was observed for preparedness behaviors, with very low certainty of evidence. No studies reported adverse effects from the interventions. Conclusion Research designs elucidating the efficacy of practical yet complex and multi- faceted social support, educational, and behavioral modification interventions present substantial methodological challenges where rigorous study design elements may not match the contextual public health priority needs and resources where interventions were delivered. While the overall strength of the evidence was evaluated as low to very low, we acknowledge the valuable and informative work of the included studies. The research represents the seminal work in this field and provides an important foundation for the state of the science of household emergency preparedness intervention effectiveness and efficacy. The findings are relevant to disaster preparedness practice and research, and we encourage researchers to continue this line of research, using these studies and this review to inform ongoing improvements in study designs.
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Affiliation(s)
- Taryn Amberson
- Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Tara Heagele
- Hunter-Bellevue School of Nursing, Hunter College, The City University of New York, New York City, NY, United States
| | - Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center, Los Angeles, CA, United States
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, United States
| | - Mary Pat Couig
- College of Nursing, University of New Mexico, Albuquerque, NM, United States
| | - Sue Anne Bell
- University of Michigan, Ann Arbor, MI, United States
| | | | - Valerie Wells
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Jessica Castner
- Castner Incorporated, Grand Island, NY, United States
- University at Albany School of Public Health, Albany, NY, United States
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Lindsay S, Hsu S, Ragunathan S, Lindsay J. The impact of climate change related extreme weather events on people with pre-existing disabilities and chronic conditions: a scoping review. Disabil Rehabil 2023; 45:4338-4358. [PMID: 36426560 DOI: 10.1080/09638288.2022.2150328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE People with disabilities experience a disproportionate impact of extreme weather events and there is a critical need to better understand the impact that climate change has for them. Most previous reviews focus on the risk of acquiring a new disability or injury after a climate-related event and not the impact on people with pre-existing disabilities or chronic conditions, which is the purpose of this study. METHODS We conducted a scoping review while searching seven international databases that identified 45 studies meeting our inclusion criteria. RESULTS The studies included in our review involved 2 337 199 participants with pre-existing disabilities and chronic conditions across 13 countries over a 20-year period. The findings demonstrated the following trends: (1) the impact on physical and mental health; (2) the impact on education and work; (3) barriers to accessing health and community services (i.e., lack of access to services, lack of knowledge about people with disabilities, communication challenges, lack of adequate housing); and (4) coping strategies (i.e., social supports and connecting to resources) and resilience. CONCLUSIONS Our findings highlight the critical need for rehabilitation clinicians and other service providers to explore opportunities to support their clients in preparing for climate-related emergencies.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - John Lindsay
- Department of Geography, Environment & Geomatics, University of Guelph, Guelph, Canada
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Salazar AP, Bottari C, Lecours S, McDonald M, Gignac MAM, Swaine B, Schmidt J, Lemsky C, Brosda A, Engel L. Impact of the COVID-19 pandemic on community-based brain injury associations across Canada: a cross-sectional survey study. Front Public Health 2023; 11:1166106. [PMID: 38026412 PMCID: PMC10663341 DOI: 10.3389/fpubh.2023.1166106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background The COVID-19 pandemic created new difficulties for people living with brain injury, their families, and caregivers while amplifying the challenges of community-based associations that support them. We aimed to understand the effects of the pandemic on clients who live with brain injury, as well as on the provision of community brain injury services/programs in Canada. Methods Online cross-sectional survey conducted in January 2022. Representatives of brain injury associations across Canada completed the 31 open- and closed-ended questions about meeting clients' needs, addressing public health guidelines, and sustaining the association. Data were analyzed using descriptive statistics (close-ended questions) and qualitative content analysis (open-ended questions). Results Of the 45 key representatives from associations in Pacific/Western (40%), Central (56%), and Atlantic Canada (4%), the majority were paid executive directors (67%). Participants reported that the most frequent psychosocial challenges experienced by their clients during the pandemic were social isolation (98%), loneliness (96%), and anxiety (93%). To alleviate these challenges, associations implemented wellness checks and psychosocial support. Most respondents (91%) affirmed that clients faced multiple technological barriers, such as a lack of technological knowledge and financial resources for devices and/or internet. In the open-ended questions, twenty-nine (64%) associations reported providing clients with devices, technology training, and assistance. Regarding public health measures, thirty (67%) respondents reported that clients had challenges understanding and/or following public health guidelines. Forty-two associations (93%) provided tailored information to help clients understand and comply with public health measures. Although associations (67%) received pandemic-related funding from the Canadian government they still struggled with the association's sustainability. Thirty-four (76%) lost funding or financial resources that prevented them from delivering programs or required the use of reserve funds to continue to do so. Only 56% reported receiving sufficient funding to address additional COVID-19-related expenses. Conclusion Although the pandemic added further challenges to the sustainability of brain injury associations across Canada, they quickly adapted services/programs to respond to the increasing and varied needs of clients, while complying with protective measures. To ensure community associations' survival it is essential to aptly recognize the vital role played by these associations within the brain injury care continuum.
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Affiliation(s)
- Ana Paula Salazar
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Sophie Lecours
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | | | - Monique A. M. Gignac
- Institute for Work & Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Bonnie Swaine
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Julia Schmidt
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Carolyn Lemsky
- Community Head Injury Resource Services, Section of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Lisa Engel
- Institute for Work & Health, Toronto, ON, Canada
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
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Crapis C, Chang KYJ, Villeneuve M. A cross-sectional survey of Australian service providers' emergency preparedness capabilities. Disabil Rehabil 2023:1-11. [PMID: 37855373 DOI: 10.1080/09638288.2023.2270916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Emergency and disaster management planning is an emerging role with limited practical guidance on how it should be implemented by community, disability, health and rehabilitation service providers. This study examined the emergency preparedness of service providers and how they viewed their role and contributions to disaster risk reduction, including their capacity and willingness to facilitate preparedness planning with their clients. MATERIALS AND METHODS A questionnaire was developed and administered nationally. Descriptive statistics, multivariate regression analyses, and thematic analysis of open-ended questions provide insight on the knowledge, tools and training needs of service providers to contribute to preparedness of themselves and the people they support. RESULTS Facilitating emergency preparedness with people with disability was strongly associated with a high level of mental preparedness, household preparedness scores, and completion of Person-Centred Emergency Preparedness (P-CEP) training. Perceived lack of funding, insufficient tools, and exclusion of emergency planning from job descriptions were negatively associated with facilitating emergency preparedness with clients. CONCLUSIONS Study findings lay the groundwork for development of the role and capabilities of individual service providers including the need to equip disability, health and rehabilitation service providers with training and tools to prepare themselves and the people they support for emergencies.
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Affiliation(s)
- Carla Crapis
- D18 Susan Wakil Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Kuo-Yi Jade Chang
- Centre for Disability Research and Policy, The University of Sydney, Sydney, Australia
| | - Michelle Villeneuve
- D18 Susan Wakil Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Centre for Disability Research and Policy, The University of Sydney, Sydney, Australia
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Currie G, Materula D, Gall N, Lachuk G, Richard C, Yohemas M, Dewan T, Gibbard WB, Zwicker J. Care coordination of children with neurodevelopmental disabilities and medical complexity during the COVID-19 pandemic: Caregiver experiences. Child Care Health Dev 2023. [PMID: 37407028 DOI: 10.1111/cch.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/19/2023] [Accepted: 03/04/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic and subsequent public health restrictions created significant challenges for children with neurodevelopmental disabilities with medical complexity and their caregivers including restrictions in care coordination for children and their families. Care coordination enhances families' skills in accessing and coordinating medical, education and disability care across sectors and systems. OBJECTIVE This study examined the implications of pandemic restrictions on care coordination from caregiver perspectives. These experiences can inform emergency preparedness planning and recovery strategies. METHOD A qualitative descriptive design was utilized to explore and describe the experience of caregivers of children with neurodevelopmental disabilities and medical complexity. Nineteen caregivers were interviewed about their experience with care coordination during the pandemic. FINDINGS Caregiver experiences of care coordination during the pandemic highlighted the importance of care coordination during a public health emergency. Two themes emerged: (1) disruptions to care coordination from initial COVID-19 restrictions leading to lack of access to supports and services, increasing level of need, and impacts of disruption for caregivers and children; and (2) adaptation and responsiveness to COVID-19 restrictions by advocating for families and managing uncertainties. RECOMMENDATIONS Recommendations include recognition of care coordination as a protective factor, designation as an essential service and sustained or increased funding for care coordination during emergencies. Families should be engaged in identifying care needs during care coordination, including during public health emergencies.
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Affiliation(s)
- Genevieve Currie
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
- School of Nursing and Midwifery, Mount Royal University, Calgary, Alberta, Canada
| | - Dercia Materula
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Nadine Gall
- Alberta Health Services, Calgary, Alberta, Canada
| | - Gina Lachuk
- Alberta Health Services, Calgary, Alberta, Canada
| | | | | | - Tammie Dewan
- Alberta Health Services, Calgary, Alberta, Canada
| | | | - Jennifer Zwicker
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Alberta, Canada
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Flanagan SK, Sterman JJ, Merighi JR, Batty R. Bridging the gap, how interprofessional collaboration can support emergency preparedness for children with disabilities and their families: an exploratory qualitative study. BMC Public Health 2023; 23:777. [PMID: 37118724 PMCID: PMC10140711 DOI: 10.1186/s12889-023-15580-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/31/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Children with disabilities and their families are at higher risk during emergencies and disasters, which is often attributed to the lack of disability inclusion in emergency response as well as disparities in preparedness. This disparity speaks to a need for emergency preparedness that centers children with disabilities and their families. The purpose of this study was to elicit the perspectives of health professionals (nurses, occupational therapists, social workers), disability advocates, and public safety personnel (e.g., fire fighters, police officers, emergency management administrators) on what would enable these types of professionals to support family-centered emergency preparedness for families who care for children with disabilities. One goal of this research is to provide recommendations for practice and policy to improve safety outcomes for children with disabilities and their families in emergency situations. METHODS This study consisted of 46 qualitative interviews with nurses, occupational therapists, social workers, public safety personnel, and advocacy organization representatives about their role in emergency preparedness for families of children with disabilities. Qualitative content analysis was used to identify themes from participants' responses. RESULTS Participants expressed interest in family-centered emergency preparedness, and stated that greater awareness, more education and training, increased networking between professions, and institutional support would enable their involvement. CONCLUSIONS These findings have implications for the importance of interprofessional collaboration in supporting family-centered emergency preparedness for families of children with disabilities. Stronger interprofessional networks would help overcome many of the barriers identified by participants, and advocacy groups appear to be well-positioned to bridge the gap between these professionals and their areas of expertise.
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Affiliation(s)
- Shelby K Flanagan
- School of Social Work, University of Minnesota, Twin Cities, Saint Paul, USA.
| | - Julia J Sterman
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Joseph R Merighi
- School of Social Work, University of Minnesota, Twin Cities, Saint Paul, USA
| | - Rachael Batty
- Center for Allied Health Programs, University of Minnesota, Twin Cities, Minneapolis, USA
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Seth A, Finlay B, Currie G, Roth C, Lach L, Hudon A, Lencucha R, Hunt M, Nicholas D, Shikako-Thomas K, Zwicker J. Impacts of the COVID-19 Pandemic: Pan-Canadian Perspectives From Parents and Caregivers of Youth With Neurodevelopmental Disabilities. J Pediatr Health Care 2023; 37:122-132. [PMID: 36639341 PMCID: PMC9832342 DOI: 10.1016/j.pedhc.2022.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The COVID-19 pandemic brought unprecedented challenges for youth with neurodevelopmental disabilities (NDD) and their families. Although health measures were implemented to contain the COVID-19 virus, they disrupted public service, profoundly impacting youth and their families' access to services. This study sought to better understand the perspectives and experiences of parents and caregivers of youth with NDD across Canada in accessing services and their mental health needs during the pandemic. METHOD The study used a qualitative research design in which we interviewed 40 parents and caregivers across Canada. RESULTS The results enabled us to understand the impact of service disruptions in significant areas of life, including health, education, employment, and risk mitigation. DISCUSSION Policymakers must consider a disability-inclusive lens during public health emergency planning and response to reduce the disproportionate impacts faced by youth with NDD and their families.
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Affiliation(s)
- Ash Seth
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada.
| | - Brittany Finlay
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Genevieve Currie
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Christiane Roth
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Lucyna Lach
- Associate Professor, School of Social Work, McGill University, Montreal, Quebec, Canada
| | - Anne Hudon
- Assissant Professor, Assistant professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Raphael Lencucha
- Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Matthew Hunt
- Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - David Nicholas
- Professor, Associate Dean of Research and Partnerships, Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Keiko Shikako-Thomas
- Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Jennifer Zwicker
- Associate Professor, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
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Harrati A, Bardin S, Mann DR. Spatial distributions in disaster risk vulnerability for people with disabilities in the U.S. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 87:103571. [PMID: 36776598 PMCID: PMC9894828 DOI: 10.1016/j.ijdrr.2023.103571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The spread of Coronavirus Disease 2019 (COVID-19) in the United States has centered the role of natural hazards such as pandemics into the public health sphere. The impacts of these hazards disproportionately affect people with disabilities, who are frequently in situations of social, political, or economic disadvantage. Because of these disadvantages, people with disabilities may have less access to necessary resources and services, putting them at risk due to unmet health needs. These disparities in access also highlight important regional, state, and county-level differences with regards to vulnerability and preparedness for natural hazards. OBJECTIVE The objective of this paper is to examine the relationship between disability and disaster risk in the United States. We examine the geographic variation in the relationship between risk from natural disasters and the percentage of people with disabilities living in a community. Because emergency management functions in the U.S. are directed and enacted at the county level, we also explore how these relationships change across U.S. counties. In addition to the overall prevalence of people with disabilities, we disaggregate the population of people with disabilities by gender, race, ethnicity, age, and disability impairment type. METHODS To measure risk of natural hazards, we use Expected Annual Loss index, a component of the 2020 National Risk Index, developed by Federal Emergency Management Agency, which identifies communities most at risk to18 natural hazards. We measure the percent of people with disabilities per county using the American Community Survey. We estimate the nationwide relationship between the proportion of people with disabilities and risk of natural hazards using ordinary least squares regression. To explore geographic differences in these relationships across the United States, we use a geographically weighted regression model to estimate local relationships for each county in the contiguous United States. We use mapping techniques to display regional differences across different disability demographic groups. RESULTS Counties with higher percentages of people with disabilities have a lower risk of natural disasters. Across the United States, a one percent increase in prevalence of people with disabilities in a county is associated with two percent decrease in the natural hazard risk score. Small but statistically significant regional differences exist as well. County-specific estimates range from a five percent decrease to a one percent increase. Stronger associations between risk and the prevalence of people with disabilities are observed in the Midwest and parts of the Southwest and West, whereas the relationship across racial groups is more scattered across the United States. CONCLUSION In this study, nationwide results suggest that people with disabilities are more likely to live in communities with lower risk of natural hazards, but this relationship differs across U.S. counties and by demographic subgroups. These findings represent a contribution in further understanding the health and well-being of people with disabilities in the United States and the geographic variation therein.
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Affiliation(s)
- Amal Harrati
- Mathematica, 600 Alexander Park, Suite 100, Princeton, NJ, 08450, USA
| | - Sarah Bardin
- Mathematica, 600 Alexander Park, Suite 100, Princeton, NJ, 08450, USA
| | - David R Mann
- Mathematica, 600 Alexander Park, Suite 100, Princeton, NJ, 08450, USA
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Salazar AP, Lecours S, Engel L, Gignac MAM, Rotenberg S, Zarshenas S, McDonald M, Bottari C. Understanding the Early Impacts of the COVID-19 Pandemic on Brain Injury Associations Across Canada: A Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231209161. [PMID: 37970821 PMCID: PMC10655638 DOI: 10.1177/00469580231209161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/02/2023] [Accepted: 09/01/2023] [Indexed: 11/19/2023]
Abstract
The COVID-19 pandemic has increased challenges for people living with brain injury and community associations to support this vulnerable population. This study aimed to gain an in-depth understanding of the challenges faced by brain injury survivors during the first year of the pandemic and how community brain injury associations adapted their services to respond to these needs. Findings from seven focus-group with 31 representatives of Canadian brain injury associations revealed 4 main themes: (1) Addressing evolving client needs; (2) Keeping clients safe; (3) Challenges and opportunities navigating the digital world; and (4) Sustaining brain injury associations in the face of uncertainties and disruptions. To comply with public health measures, associations reported pivoting their service delivery online, despite recognizing the difficulties this could create for many brain injury survivors in accessing and using technology. Our findings also highlight concrete directions for not-profit organizations providing instrumental help with activities, acting as a liaison and interpreter of public health guidelines, and in connecting with clients using technology while handling potential cognitive and technological challenges. Addressing these issues has the potential to protect people living with brain injury and community associations from external threats, like pandemics, in the future.
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Affiliation(s)
- Ana Paula Salazar
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Sophie Lecours
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Lisa Engel
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
- Institute for Work & Health, Toronto, ON, Canada
| | - Monique A. M. Gignac
- Institute for Work & Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shlomit Rotenberg
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sareh Zarshenas
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
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Asher A, Estes J, Allender S, Ferguson M, Schoen M, Villarosa G. Safety of Students with Disabilities in Emergency Situations. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2022. [DOI: 10.1080/19411243.2022.2156421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | - Mary Schoen
- Gottlieb Memorial Hospital, Melrose Park, IL
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Currie G, Finlay B, Seth A, Roth C, Elsabbagh M, Hudon A, Hunt M, Jodoin S, Lach L, Lencucha R, Nicholas DB, Shakako K, Zwicker J. Mental health challenges during COVID-19: perspectives from parents with children with neurodevelopmental disabilities. Int J Qual Stud Health Well-being 2022; 17:2136090. [PMID: 36309898 PMCID: PMC9629071 DOI: 10.1080/17482631.2022.2136090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background The global pandemic and subsequent denials, delays, and disruptions in essential daily activities created significant challenges for children with neurodevelopmental disorders (NDDs) and their parents. Public health restrictions during the COVID-19 pandemic limited access to supports and services required by children with NDDs to maintain their health and well-being. Objective This study sought to understand the impacts of these public health measures and restrictions on mental health from the perspective of parents with children with NDDs to inform pathways for public health policies responsive to the needs of this population. Method Interpretive descriptive design was used to guide data collection and data analysis. Forty caregivers were interviewed about their experience with pandemic restrictions. Findings Generic policy measures contributed to many gaps in families’ social support systems and contributed to mental health challenges for children and their parents. Four themes emerged: 1) lack of social networks and activities, 2) lack of access to health and social supports, 3) tension in the family unit, and 4) impact on mental health for children and their parents. Recommendations Emergency preparedness planning requires a disability inclusive approach allocating resources for family supports in the home and community. Families identified supports to minimize further pandemic disruptions and enhance recovery.
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Affiliation(s)
- Genevieve Currie
- School of Public Policy, University of Calgary, Calgary, AB, Canada.,School of Nursing and Midwifery, Mount Royal University, Calgary, AB, Canada
| | - Brittany Finlay
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Ashish Seth
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Christiane Roth
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Myada Elsabbagh
- Faculty of Medicine, McGill University, Montreal, Que., Canada
| | - Anne Hudon
- Faculty of Medicine, Universite de Montreal, Montreal, Que., Canada
| | - Matthew Hunt
- Faculty of Medicine and Health Sciences School of Physical and Occupational Therapy, McGill University, Montreal, Que., Canada
| | | | - Lucyna Lach
- School of Social Work, McGill University, Montreal, Que., Canada
| | - Raphael Lencucha
- Faculty of Medicine and Health Sciences School of Physical and Occupational Therapy, McGill University, Montreal, Que., Canada
| | - David B Nicholas
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Keiko Shakako
- Faculty of Medicine and Health Sciences School of Physical and Occupational Therapy, McGill University, Montreal, Que., Canada
| | - Jennifer Zwicker
- School of Public Policy; Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
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Bailie J, Matthews V, Bailie R, Villeneuve M, Longman J. Exposure to risk and experiences of river flooding for people with disability and carers in rural Australia: a cross-sectional survey. BMJ Open 2022; 12:e056210. [PMID: 35918120 PMCID: PMC9252212 DOI: 10.1136/bmjopen-2021-056210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES In this paper, we explore the exposure to risk and experiences of people with disability and carers during a flooding event and the subsequent mental health impacts. DESIGN A cross-sectional survey between September and November 2017. Binary logistic regression models were used to investigate associations between the mental health of people with disability and carers and their exposure to the flood. Inductive content analysis was used to analyse qualitative data. SETTING Flood-affected communities in the rural area of Northern Rivers, New South Wales, Australia, 6 months after river flooding in 2017. PARTICIPANTS People over 16 years and a resident in the Northern Rivers at the time of the flood were invited to participate. Using a purposive, snowballing sampling technique participants were drawn from a wide range of socioeconomic backgrounds and had experienced different degrees of flood exposure. RESULTS Of 2252 respondents, there were 164 people with disability and 91 carers. Both groups had increased odds of having their home flooded (people with a disability: OR 2.41 95% CI 1.71 to 3.39; carers: OR 1.76 95% CI 1.10 to 2.84). On evacuation, respondents reported inaccessible, conflicting and confusing information regarding flood warnings. Essential services such as healthcare and social services were disrupted (people with a disability: OR 3.98 95% CI 2.82 to 5.60; carers 2.17 95% CI 1.33 to 3.54) and access to safe and mould free housing post flood event was limited. After taking sociodemographic factors into account, respondents with a disability and carers had greater odds of probable post-traumatic stress disorder compared with other respondents (people with a disability: 3.32 95% CI 2.22 to 4.96; carers: 1.87 95% CI 1.10 to 3.19). CONCLUSION Our findings show the profound impact and systemic neglect experienced by people with disability and carers during and after the 2017 flood event in the Northern Rivers. As people with disability will take longer to recover, they will require longer-term tailored supports and purposeful inclusion in flood preparedness and recovery efforts.
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Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Ross Bailie
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Villeneuve
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Jo Longman
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
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Bania TA, Gianniki M, Giannakoudi S, Charitaki G, Matzaroglou C, Billis E. The Interaction with Disabled Persons Scale: evidencing construct validity with factor analysis and measurement invariance in Greek-speaking healthcare students. Disabil Rehabil 2022; 44:3196-3203. [PMID: 33242287 DOI: 10.1080/09638288.2020.1850890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To explore the construct validity and reliability of the Greek version of the Interaction with Disabled Persons Scale (IDPS) amongst healthcare students. METHODS Greek IDPS factors were extracted and confirmed by Analysis of Moment Structures. Measurement invariance for the group of students completing a clinical module with people with disabilities was also evaluated. The scale was distributed twice, 3 weeks apart (test-retest reliability) to sample. Greek IDPS scores amongst students with frequent contact with people with disabilities were compared with those with infrequent contact (discriminant validity). RESULTS 327 healthcare students (21.25 ± 4.3 years, 118 males) participated. Exploratory factor analysis extracted 6 factors explaining 55.66% of total variance. Confirmatory factor analysis showed a good fit of the model (AGFI = 0.95 > 0.90, RMSEA = 0.07 < 0.08, CFI = 0.95 ≥ 0.90, SRMR = 0.00 < 0.08). An adequate fit for the students completing a clinical practice module was observed. The scale's test-retest reliability and internal consistency were excellent; ICC(2,1)=0.86 (CIs:0.82-0.89) and Cronbach's α = 0.87, respectively. Statistically significant differences between the two student groups were yielded; students with frequent contact with people with disabilities had lower scores (mean difference: -4.5; CI: -6.6 to -2.4), suggesting that they were significantly more comfortable with people with disabilities than the students with infrequent contact. CONCLUSION The Greek IDPS provided sufficient validity and reliability evidence for evaluating healthcare students' perceptions and attitudes towards people with disabilities.IMPLICATIONS FOR REHABILITATIONThe Greek IDPS demonstrated sufficient validity and reliability evidence to assess the Greek-speaking healthcare students' perceptions and attitudes towards people with disabilitiesCompleting a clinical module working with people with disabilities is not enough to produce adequately positive attitudes in Greek-speaking undergraduate healthcare students. Therefore, faculties need to organize further actions, such as lectures by people with disabilities, students' role play, and discussions or events in co-operation with people with disabilities.
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Affiliation(s)
| | - Maria Gianniki
- Department of Physiotherapy, University of Patra, Aigio, Greece
| | | | | | | | - Evdokia Billis
- Department of Physiotherapy, University of Patra, Aigio, Greece
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15
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Genuis SK, Luth W, Bubela T, Johnston WS. Covid-19 threat and coping: application of protection motivation theory to the pandemic experiences of people affected by amyotrophic lateral sclerosis. BMC Neurol 2022; 22:140. [PMID: 35413805 PMCID: PMC9002218 DOI: 10.1186/s12883-022-02662-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/29/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND People with amyotrophic lateral sclerosis (ALS) are at high risk for severe outcomes from Covid-19 infection. Researchers exploring ALS and Covid-19 have focused primarily on system response and adaptation. Using Protection Motivation Theory, we investigated how people with ALS and family caregivers appraised and responded to Covid-19 threat, the 'costs' associated with pandemic response, and how health professionals and systems can better support people affected by ALS who are facing public health emergencies. METHODS Data were drawn from the 'ALS Talk Project,' an asynchronous, moderated focus group study. Participants were recruited from regions across Canada. Seven groups met online over 14 weeks between January and July 2020. Fifty-three participants contributed to Covid-19 discussions. Data were qualitatively analyzed using directed content analysis and the constant-comparative approach. RESULTS Participants learned about the Covid-19 pandemic from the media. They rapidly assessed their vulnerability and responded to Covid-19 threat by following recommendations from health authorities, information monitoring, and preparing for worst-case scenarios. Adopting protective behaviors had substantial response costs, including adaptations for medical care and home support workers, threatened access to advance care, and increased caregiver burden. Participants expressed need for ALS-specific, pandemic information from trusted health professionals and/or ALS health charities. Telemedicine introduced both conveniences and costs. Prior experience with ALS provided tools for coping with Covid-19. Threat and coping appraisal was a dynamic process involving ongoing vigilance and adaptation. Findings draw attention to the lack of emergency preparedness among participants and within health systems. CONCLUSIONS Clinicians should engage ALS patients and families in ongoing discussions about pandemic coping, strategies to mitigate response costs, care pathways in the event of Covid-19 infection, and changing information about Covid-19 variants and vaccines. Healthcare systems should incorporate flexible approaches for medical care, leveraging the benefits of telemedicine and facilitating in-person interaction as needed and where possible. Research is needed to identify strategies to mitigate response costs and to further explore the interaction between prior experience and coping. Further study is also needed to determine how communication about emergency preparedness might be effectively incorporated into clinical care for those with ALS and other medically vulnerable populations.
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Affiliation(s)
- Shelagh K Genuis
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada
| | - Westerly Luth
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada
| | - Tania Bubela
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall 11328, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Wendy S Johnston
- Division of Neurology, Department of Medicine, University of Alberta, 7-123 Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada.
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Amberson T, Heagele T, Castner J, Wyte-Lake T, Couig MP, Bell SA, Mammen MJ, Wells V. Social support, educational, and behavioral modification interventions for improving household disaster preparedness in the general community-dwelling population. Hippokratia 2021. [DOI: 10.1002/14651858.cd014934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Tara Heagele
- Hunter-Bellevue School of Nursing, Hunter College; The City University of New York; New York New York USA
| | - Jessica Castner
- Castner Incorporated; Grand Island New York USA
- Journal of Emergency Nursing; Grand Island New York USA
| | - Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center; Los Angeles California USA
- Department of Family Medicine; Oregon Health & Science University; Portland Oregon USA
| | - Mary Pat Couig
- College of Nursing; University of New Mexico; Albuquerque New Mexico USA
| | | | - Manoj J Mammen
- State University of New York at Buffalo; Buffalo New York USA
| | - Valerie Wells
- MRC/CSO Social and Public Health Sciences Unit; University of Glasgow; Glasgow UK
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