1
|
Powell RM, Albert SM, Nthenge S, Mitra M. Family Caregivers' Attitudes and Perspectives About the Sexual and Reproductive Health of Women With Intellectual and Developmental Disabilities: An Online Survey. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:135-150. [PMID: 38411243 DOI: 10.1352/1944-7558-129.2.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/11/2023] [Indexed: 02/28/2024]
Abstract
Although sexual and reproductive health is critically important for women with intellectual and developmental disabilities (IDD), there is limited research elucidating the role of family caregivers in assisting women with IDD access sexual and reproductive health services and information. Understanding the family caregivers' attitudes and perspectives is essential to improving access to sexual and reproductive health services and information for women with IDD. A cross-sectional online survey of family caregivers of women with IDD was administered between June and October 2018. Quantitative analysis was conducted for closed-ended responses, and qualitative analysis was conducted for open-ended responses. The analytic sample included 132 family caregivers. Most participants were parents and reported being closely involved in their family member's access to sexual and reproductive health services and information. Although most participants expressed that sexual and reproductive health services and information are essential for women with IDD, qualitative analysis of participants' open-ended responses revealed both supportive and restrictive attitudes and perspectives on sexual and reproductive health services and information for women with IDD. Supportive attitudes and perspectives included (1) "knowledge is power;" (2) supported decision-making; and (3) protection against sexual abuse. Restrictive attitudes and perspectives included (1) dependent on the individual; (2) lack of autonomy; and (3) placing responsibility on disability. Greater attention from policymakers and practitioners to systems-level changes, including universal and accessible sexual education for women with IDD, supported decision-making, and sexual abuse prevention measures, are urgently needed.
Collapse
Affiliation(s)
- Robyn M Powell
- Robyn M. Powell, University of Oklahoma College of Law and The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | - Sasha M Albert
- Sasha M. Albert, The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | | | - Monika Mitra
- Monika Mitra, The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| |
Collapse
|
2
|
Dibble KE, Lutz TM, Connor AE, Bruder MB. Breast and Ovarian Cancer Among Women with Intellectual and Developmental Disabilities: An Agenda for Improving Research and Care. Womens Health Issues 2024; 34:3-6. [PMID: 37423778 DOI: 10.1016/j.whi.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/28/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Kate E Dibble
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Tara M Lutz
- University of Connecticut Center for Excellence in Developmental Disabilities (UCEDD), Farmington, Connecticut
| | - Avonne E Connor
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Mary Beth Bruder
- University of Connecticut Center for Excellence in Developmental Disabilities (UCEDD), Farmington, Connecticut
| |
Collapse
|
3
|
Yang X, Huang L, Li C, Ji N, Zhu H. The effectiveness of mindfulness-based stress reduction intervention on alleviating anxiety and depression in postoperative patients with cervical cancer: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28706. [PMID: 35119015 PMCID: PMC8812707 DOI: 10.1097/md.0000000000028706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Surgical treatment for cervical cancer, as a stressor, largely leads to strong psychological reactions to stress like anxiety and depression. Whether mindfulness-based stress reduction (MBSR) can alleviate anxiety and depression in patients after cervical cancer surgery is controversial. Therefore, we aim to perform a meta-analysis involving randomized controlled trials analyzing the effect of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery, thus providing evidence-based medical evidences for nonpharmacological interventions. METHODS Randomized controlled trials analyzing the effect of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery will be searched in online databases, including Cochrane Central Register of Controlled Trials Repositories, PubMed, Embase, Web of Science, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan Fang Data. After screening eligible studies, we will perform a meta-analysis on the effect of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery. RESULTS The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This study will provide reliable evidence-based evidences for the effects of MBSR on alleviating anxiety and depression in patients after cervical cancer surgery. ETHICS AND DISSEMINATION Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/EXUM3.
Collapse
Affiliation(s)
- Xiaoju Yang
- Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, Enshi, Hubei Province, China
| | - Li Huang
- Department of Infectious Disease, Enshi Tujia & Miao Autonomous Prefecture Center for Disease Control and Prevention, Enshi, Hubei Province, China
| | - Chunlin Li
- Radiology Center, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, Enshi, Hubei Province, China
| | - Ning Ji
- Department of Obstetrics and Gynaecology, Hubei Xianfeng County Hospital of Traditional Chinese Medicine, Enshi, Hubei Province, China
| | - Hongcheng Zhu
- Department of Obstetrics and Gynaecology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, Enshi, Hubei Province, China
| |
Collapse
|
4
|
Dharampuriya PR, Abend SL. Roadmap for Creating Effective Communication Tools to Improve Health Equity for Persons With Intellectual and Developmental Disabilities. FRONTIERS IN HEALTH SERVICES 2022; 2:859008. [PMID: 36925890 PMCID: PMC10012612 DOI: 10.3389/frhs.2022.859008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022]
Abstract
Persons with intellectual and developmental disabilities (IDD) live 20 fewer years than the average person and almost 40% of their deaths are from preventable causes. They suffer from well-documented disparities in health and healthcare, and much of this inequity is rooted in information transfer failures between patients, their caregivers, and their healthcare providers. Tools to improve communication between these stakeholders, such as health checks and hand-held health records, or health passports, have been implemented in Europe, Australia and Canada with mixed results, and there are no standard information tools currently in widespread use in the U.S. We review the evidence of the effectiveness of these tools, as well as their barriers to adoption, to inform proposed development of next-generation information transfer tools most useful to patients with IDD and their healthcare providers. The repair of health information transfer failures will be a major step toward achieving health equity for this population.
Collapse
Affiliation(s)
- Priyanka R Dharampuriya
- Lincoln Memorial University - DeBusk College of Osteopathic Medicine, Knoxville, TN, United States.,The Right Care Now Project, Inc., Westborough, MA, United States
| | - Susan L Abend
- The Right Care Now Project, Inc., Westborough, MA, United States
| |
Collapse
|
5
|
Walsh S, O'Mahony M, Hegarty J, Farrell D, Taggart L, Kelly L, Sahm L, Corrigan M, Caples M, Martin AM, Tabirca S, Corrigan MA, Lehane E. Defining breast cancer awareness and identifying barriers to breast cancer awareness for women with an intellectual disability: A review of the literature. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:1744629521999548. [PMID: 33769130 DOI: 10.1177/1744629521999548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Incidence rates for developing breast cancer are similar for women regardless of intellectual ability. However, women with an intellectual disability present with advanced breast cancers, which often have a poor prognosis. METHOD A structured narrative review of the literature was performed to explore the concepts of breast awareness and breast cancer awareness and subsequently, identify barriers to breast cancer awareness encountered by women with an intellectual disability. RESULTS A total of 22 studies involving people with varying levels of intellectual disability informed this review. The barriers to breast cancer awareness encountered by women with an intellectual disability include: lack of their understanding, the role of the carer and literacy issues. CONCLUSION Identifying the barriers to breast cancer awareness for women with an intellectual disability will help to facilitate breast cancer awareness which has the potential to result in better long-term outcomes through an early diagnosis of breast cancer.
Collapse
Affiliation(s)
| | | | | | | | | | - Louise Kelly
- Cork Breast Research Centre-Cork University Hospital, Ireland
| | | | | | | | | | | | - Mark A Corrigan
- Cork Breast Research Centre-Cork University Hospital, Ireland
| | | |
Collapse
|
6
|
Pearson J, Payne D, Yoshida K, Garrett N. Access to and engagement with cervical and breast screening services for women with disabilities in Aotearoa New Zealand. Disabil Rehabil 2020; 44:1984-1995. [PMID: 32931340 DOI: 10.1080/09638288.2020.1817158] [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: 12/24/2022]
Abstract
PURPOSE To describe access to and engagement with cervical and breast screening services for women who are Deaf or live with a physical or sensory disability in Aotearoa New Zealand (NZ). METHOD We carried out an online survey on a convenience sample of 84 women. Tests of association were undertaken between socio-demographics and cervical and breast screening; and between disability type, and health outcomes and barriers to screening respectively. Participants also reported specific barriers to screening. RESULTS Living without family/partner and unemployment were associated with never having a cervical smear. Non-English preferred language, and urban residence were related to lower levels of breast self-examination; having insufficient income was related to never having a mammogram. Disability type was not related to either smear or mammogram on eligibility, uptake ever, or uptake timeframe. A higher proportion of those with multiple disability types experienced service environment barriers to having a cervical smear. Specific barriers to screening covered accessibility, service environment, and information. CONCLUSIONS This study, unique in Aotearoa, provides insights into disabled women's access to and engagement with screening services and suggests factors that may inhibit or facilitate participation. Women with multiple disabilities may be disadvantaged in the seeking and delivery of screening.Implications for rehabilitationRehabilitation and other practitioners need to be attuned to how women living with multiple disabilities may be disadvantaged in the seeking of, and, more importantly, the delivery of breast or cancer screening.Practitioners need to discuss with disabled women what supports or resources they need to have screening procedures, and to advocate for these supports for their clients.Practitioners need to ensure accessibility that encompasses the whole screening journey from the initial invitation to the obtaining of results.For practitioners to be able to provide equitable service delivery, the government and institutional policies and procedures that are developed must take into consideration the multiple needs of women living with disabilities.
Collapse
Affiliation(s)
- Janet Pearson
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Deborah Payne
- Department of Nursing, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Karen Yoshida
- Department of Physical Therapy, Social & Behavioural Health Sciences Division, Rehabilitation Sciences Institute, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nicholas Garrett
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
7
|
Powell RM, Parish SL, Mitra M, Rosenthal E. Role of family caregivers regarding sexual and reproductive health for women and girls with intellectual disability: A scoping review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:131-157. [PMID: 31808223 PMCID: PMC9016753 DOI: 10.1111/jir.12706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/10/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND While people with intellectual disability (ID) face disparities relating to sexual and reproductive health (SRH) services, little is known about the role of family caregivers who assist women and girls with ID access SRH services. This scoping review examined the findings of studies to elucidate the role of family caregivers with regard to SRH for women and girls with ID. METHOD We used Arksey and O'Malley's six-stage scoping framework, with Levac, Colquhoun and O'Brien's revisions, to evaluate identified sources. We searched three electronic databases, six ID journals and reference lists in full-text articles. Inclusion criteria included (1) primary and secondary source research studies in peer-reviewed journals; (2) published in English; (3) all research methodologies (i.e. qualitative, quantitative, mixed methods and systematic reviews or commentaries); (4) published between 2000 and 2016; and (5) studies from any country. RESULTS The search yielded 2062 studies; 57 articles met inclusion criteria. Most studies employed purposive, convenience or criterion sampling. Participants included people with ID, family caregivers, paid caregivers and health-care professionals. Findings were summarised thematically: (1) menstruation and menopause; (2) vaccinations and preventive screenings; (3) supporting sexuality and healthy relationships; (4) coordinating with health-care providers and (5) contraception and sterilisation. CONCLUSIONS Findings from this scoping review underscore the need for more and better-quality research, including how family caregivers assist women and girls with ID access perinatal and preventive SRH services and sexual abuse education. Family caregivers, women and girls with ID and health-care providers need increased access to information about SRH.
Collapse
Affiliation(s)
- R M Powell
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - S L Parish
- The College of Health Professions, Virginia Commonwealth University, Richmond, Virginia
| | - M Mitra
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - E Rosenthal
- School Psychology, College of Education, Lehigh University Bethlehem, Pennsylvania
| |
Collapse
|
8
|
Abstract
GOALS We aimed to assess use of colorectal cancer screening (CRCS) as per United States Preventive Task Force guidelines among people with mobility disability using a nationally representative data set. BACKGROUND Individuals with mobility disability have decreased access to health care services, but the impact of mobility disability on CRCS has not been investigated. STUDY Data from the 2013 National Health Interview Survey were used to estimate sociodemographic characteristics of adults with mobility disability, prevalence of CRCS, and odds of CRCS given mobility disability among Americans aged 50 to 75. RESULTS In total, 56.8% of the entire sample (n=81,953,585) were up-to-date with CRCS. Mobility disability was not associated with CRCS status on univariable analysis but was significantly associated after adjustment for covariates including age and comorbidities, with an inverse relationship between the degree of mobility disability and odds of CRCS. Odds ratio for CRCS given progressively severe disability were 0.78 (0.66 to 0.93), 0.71 (0.53 to 0.94), 0.65 (0.31 to 1.19). CONCLUSIONS The present study indicates reduced CRCS among people with mobility disability and highlights the need for CRCS to be especially targeted toward this group. Future research should identify the specific systemic, social, and/or physical barriers to CRCS for this subgroup so that they can be addressed.
Collapse
|
9
|
Parish SL, Son E, Powell RM, Igdalsky L. Reproductive Cancer Treatment Hospitalizations of U.S. Women With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 56:1-12. [PMID: 29389260 DOI: 10.1352/1934-9556-56.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is a dearth of existing research on the treatment of reproductive cancers among women with intellectual and developmental disabilities (IDD). This study analyzed the 2010 Healthcare Cost and Utilization Project Nationwide Inpatient Sample and compared the prevalence of reproductive cancer treatment hospitalization discharges among women with and without IDD. Discharges linked to women with IDD had higher incidences of cancer of the uterus and lower prevalence of cancer of the cervix. Moreover, discharges linked to women with IDD indicated these women were younger, had longer hospital stays, and were more likely to have public insurance coverage. Therefore, further research and targeted interventions to increase cancer prevention and screening are urgently needed.
Collapse
Affiliation(s)
- Susan L Parish
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | - Esther Son
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | - Robyn M Powell
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | - Leah Igdalsky
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| |
Collapse
|
10
|
Bird M, Wright RL, Frost CJ. Enhancing women's health: A call for social work research. SOCIAL WORK IN HEALTH CARE 2016; 55:732-751. [PMID: 27700861 DOI: 10.1080/00981389.2016.1205706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This article presents a critical synthesis of the social work empirical literature on women's health. In light of recent policy changes that directly affect women's health and social work, the authors conducted a literature review of recent publications (2010-2015) regarding social work and women's health nationally. Despite frequent accounts cited in the literature, there has been no comprehensive review of issues involving women's health and social work in the United States. The purpose of this review is to examine the current social work literature addressing women's health at the national (U.S.) level. This research presents a summary description of the status of the social work literature dealing with women's health, specifically 51 articles published between 2010 and 2015. Our search highlights the need for social work research to fill gaps and more fully address the needs of women across the lifespan.
Collapse
Affiliation(s)
- Melissa Bird
- a School of Social Work , University of Southern California , Los Angeles , California , USA
| | - Rachel L Wright
- b Department of Social Work , Appalachian State University , Boone , North Carolina , USA
| | - Caren J Frost
- c College of Social Work , University of Utah , Salt Lake City , Utah , USA
| |
Collapse
|
11
|
Scott HM, Havercamp SM. Systematic Review of Health Promotion Programs Focused on Behavioral Changes for People With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:63-76. [PMID: 26824134 DOI: 10.1352/1934-9556-54.1.63] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
People with intellectual disability (ID) experience high rates of chronic health problems and poor overall health compared to people without disabilities. Recent attention to health risk behaviors such as poor diet, lack of physical activity, and underuse of health care has led to the development of several programs intended to reduce disparities in this population through health promotion programs. A review of the literature was conducted focusing on programs developed to target behavioral changes in the person with ID. Thirteen studies, evaluating 10 different health promotion programs, were found. Programs varied significantly in design, targeted health change, and demonstrated effectiveness. Components of each program are systematically reviewed and recommendations made for future programs based upon the current evidence.
Collapse
Affiliation(s)
- Haleigh M Scott
- Hayleigh M. Scott and Susan M. Havercamp, The Ohio State University, Columbus, Ohio
| | - Susan M Havercamp
- Hayleigh M. Scott and Susan M. Havercamp, The Ohio State University, Columbus, Ohio
| |
Collapse
|
12
|
Iezzoni LI, Kurtz SG, Rao SR. Trends in Pap Testing Over Time for Women With and Without Chronic Disability. Am J Prev Med 2016; 50:210-9. [PMID: 26372417 DOI: 10.1016/j.amepre.2015.06.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 06/18/2015] [Accepted: 06/30/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Data from 20 years ago--shortly after passage of the Americans with Disabilities Act--showed that women with significant mobility disability had 40% lower Pap test rates than other women. METHODS To examine whether disability disparities in Pap test rates have diminished over time, this study analyzed National Health Interview Survey responses from selected years between 1998 and 2010 from women aged 21-65 years without histories of cervical cancer or hysterectomy. Seven chronic disability types were identified using self-reported functional impairments or participation limitations. Self-reported Pap testing within the previous 3 years was studied. Bivariable analyses and multivariable logistic regression analyses controlling for sociodemographic variables were conducted in 2014. RESULTS Rates of all chronic disability types increased over time. Pap test rates remained relatively constant over time for all women, holding around 84%-87%. Bivariable analyses found statistically significantly lower rates of Pap testing for women with disability compared with nondisabled women. Multivariable analyses failed to find consistent evidence of lower Pap test rates among women across disability types compared with nondisabled women. In 2010, the AOR for reporting Pap testing for women noting the most severe movement difficulty compared with nondisabled women was 0.35 (95% CI=0.15, 0.79). However, the AOR for this disability type varied over time. CONCLUSIONS Little has changed over time in Pap test rates for all women. Women with certain disabilities continue to experience disparities compared with nondisabled women in receipt of this important screening test.
Collapse
Affiliation(s)
- Lisa I Iezzoni
- Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts.
| | - Stephen G Kurtz
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Sowmya R Rao
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts; Center for Healthcare Organization and Implementation Research (CHOIR), Bedford Veterans Affairs Medical Center, Bedford, Massachusetts
| |
Collapse
|
13
|
Brown HK, Plourde N, Ouellette-Kuntz H, Vigod S, Cobigo V. Brief report: cervical cancer screening in women with intellectual and developmental disabilities who have had a pregnancy. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:22-27. [PMID: 26359630 DOI: 10.1111/jir.12225] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/06/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Women with intellectual and developmental disabilities (IDD) have lower cervical cancer screening rates than women without IDD. Key barriers to screening uptake include physician or caregiver assumptions that screening is unnecessary because women with IDD are not sexually active. Our objective was to compare cervical cancer screening rates in women with and without IDD who had had a pregnancy. METHOD We conducted a population-based retrospective cohort study using linked Ontario (Canada) health and social services administrative data. We identified 20- to 64-year-old women with (N = 5033) and without (N = 527 437) IDD who had had a pregnancy. We examined the occurrence of cervical cancer screening between April 1, 2007 and March 31, 2010. We compared screening rates in women with and without IDD using logistic regression, controlling for age, region of residence, neighbourhood income quintile and morbidity level. RESULTS Women with IDD who had had a pregnancy were more likely than those without IDD to be young, to live in the lowest neighbourhood income quintile, to live in rural areas and to have high or very high morbidity. Even after controlling for these factors, women with IDD were less likely than women without IDD to be screened (67.7% vs. 77.0%; adjusted odds ratio 0.61; 95% confidence interval 0.58-0.65). CONCLUSIONS Even among women who have had a pregnancy and are therefore known to have been sexually active, women with IDD face significant disparities in cervical cancer screening. Strategies to promote equitable uptake of cervical cancer screening for women with IDD need to be implemented.
Collapse
Affiliation(s)
- H K Brown
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - N Plourde
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - H Ouellette-Kuntz
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - S Vigod
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - V Cobigo
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
14
|
Ng N, Sandberg M, Ahlström G. Prevalence of older people with intellectual disability in Sweden: a spatial epidemiological analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:1155-1167. [PMID: 26306552 DOI: 10.1111/jir.12219] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 07/22/2015] [Accepted: 07/29/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The expected increase in longevity of individuals with intellectual disabilities (ID) in many countries of the world is a direct result of medical and social advances, which have also extended the longevity of the general population. It is important to assess the need for social services for people with ID across different administrative levels to ensure sufficient resources are allocated to where they are most needed. This study estimates the annual prevalence of older people with ID from 2004 to 2012 and in different counties and municipalities in Sweden, by sex and age group; identifies proxy indicators related to the care of older people with ID in different counties in 2012 in Sweden and analyses the spatial distribution and clustering of municipalities with a high prevalence of older people with ID. METHODS Individuals with ID were identified through the national register based on the Swedish Act concerning Support and Service for Persons with Certain Functional Impairments (the LSS act) and the national death register. This study focuses on older individuals aged 55+ during the period of 2004-2012. The estimated prevalence was calculated at the county and municipality level and plotted on a municipality-level map. Moran's I statistics was used to identify any spatial clustering of municipalities with a large number of individuals with ID. RESULTS The prevalence of ID among older individuals aged 55+ in Sweden increased from 2004 to 2012. The prevalence was consistently higher among men, and the gender gap increased slightly in recent years. Age-specific prevalence estimates showed ID to be higher in younger age groups, and the gender gap decreased in older age groups. The prevalence was higher in northern counties in Sweden (over 500 individuals per 100 000 population aged 55+). Higher prevalence areas were clustered in northern municipalities, whereas municipalities with high prevalence of older individuals with ID in the middle and southern regions of Sweden demonstrated a more widespread distribution. CONCLUSIONS The existence of clusters of counties with a high prevalence of older individuals with ID necessitates further assessment of how resources have been allocated to different counties and municipalities in Sweden. Investigations of the quality of social services provided to individuals with ID across different counties in Sweden are warranted. It is important to ensure that high quality supports are being provided to older individuals with ID in order to grant them the same right to healthy ageing as their counterparts living without ID throughout their life course.
Collapse
Affiliation(s)
- N Ng
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Sweden
| | - M Sandberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - G Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| |
Collapse
|