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Buck AS, Chapman R, Krahn GL, Brown C, Gertz B, Havercamp SM. Research About Us, With Us: An Inclusive Research Case Study. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 62:260-273. [PMID: 39069297 DOI: 10.1352/1934-9556-62.4.260] [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: 03/27/2023] [Accepted: 09/25/2023] [Indexed: 07/30/2024]
Abstract
Inclusive research combines the expertise of academically trained researchers with the lived experience of individuals with disabilities to render results that are more accessible, accountable, and meaningful to the disability community. In this case study, adults with intellectual and developmental disabilities (IDD) contributed as co-researchers to a series of studies on mental health of adults with intellectual disability. The research model, specific engagement strategies, and lessons learned are shared. Feedback from members of the research team suggests that including adults with IDD as co-researchers benefited investigators, co-researchers with IDD, and project outcomes. Our case study emphasizes the valuable contributions of research partners with IDD and provides a model that may be adapted and utilized by researchers to enhance their practice.
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Affiliation(s)
- Andrew S Buck
- Andrew S. Buck, The Ohio State University Nisonger Center; Richard Chapman, Virginia Commonwealth University; Gloria L. Krahn, Oregon State University; Christine Brown, Braden Gertz, and Susan M. Havercamp, The Ohio State University Nisonger Center; and The Ohio State University Nisonger RRTC on Health and Function
| | - Richard Chapman
- Andrew S. Buck, The Ohio State University Nisonger Center; Richard Chapman, Virginia Commonwealth University; Gloria L. Krahn, Oregon State University; Christine Brown, Braden Gertz, and Susan M. Havercamp, The Ohio State University Nisonger Center; and The Ohio State University Nisonger RRTC on Health and Function
| | - Gloria L Krahn
- Andrew S. Buck, The Ohio State University Nisonger Center; Richard Chapman, Virginia Commonwealth University; Gloria L. Krahn, Oregon State University; Christine Brown, Braden Gertz, and Susan M. Havercamp, The Ohio State University Nisonger Center; and The Ohio State University Nisonger RRTC on Health and Function
| | - Christine Brown
- Andrew S. Buck, The Ohio State University Nisonger Center; Richard Chapman, Virginia Commonwealth University; Gloria L. Krahn, Oregon State University; Christine Brown, Braden Gertz, and Susan M. Havercamp, The Ohio State University Nisonger Center; and The Ohio State University Nisonger RRTC on Health and Function
| | - Braden Gertz
- Andrew S. Buck, The Ohio State University Nisonger Center; Richard Chapman, Virginia Commonwealth University; Gloria L. Krahn, Oregon State University; Christine Brown, Braden Gertz, and Susan M. Havercamp, The Ohio State University Nisonger Center; and The Ohio State University Nisonger RRTC on Health and Function
| | - Susan M Havercamp
- Andrew S. Buck, The Ohio State University Nisonger Center; Richard Chapman, Virginia Commonwealth University; Gloria L. Krahn, Oregon State University; Christine Brown, Braden Gertz, and Susan M. Havercamp, The Ohio State University Nisonger Center; and The Ohio State University Nisonger RRTC on Health and Function
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McDonald KE, Schwartz AE, Dinerstein R, Olick R, Sabatello M. Responsible inclusion: A systematic review of consent to social-behavioral research with adults with intellectual disability in the US. Disabil Health J 2024:101669. [PMID: 38960791 DOI: 10.1016/j.dhjo.2024.101669] [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: 11/22/2023] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND In recognition of their status as a health disparities population, there is growing emphasis on conducting research inclusive of adults with intellectual disability to generate new knowledge and opportunities to improve health and equity. Yet they are often excluded from research, and human research participant protection experts and researchers lack agreement on effective consent protocols for their inclusion. OBJECTIVE We sought to identify approaches to consent in US-based social-behavioral research with adults with intellectual disability. METHODS We conducted a systematic review on approaches to self-consent with adults with intellectual disability published between 2009 and 2023, identified via searching eight databases and reference list hand searches. We identified 13 manuscripts and conducted a thematic analysis. RESULTS Our analysis identified themes related to guiding principles, strategies to enhance informed and voluntary consent, approaches to consent capacity, involving individuals subject to guardianship, and strategies for expressing decisions and enhancing ongoing decisions. CONCLUSIONS Manuscripts largely reflected an emphasis on identifying approaches to consent that reflect disability rights principles to promote the right to be included and make one's own decisions based on assessment of relevant information, risks and benefits, and to employ reasonable modifications to achieve inclusion. To avoid the risks of exclusion and advance the responsible inclusion of adults with intellectual disability, we make recommendations to align consent approaches anchored in contemporary thinking about human research participant protections, including through integration with disability rights.
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Affiliation(s)
- Katherine E McDonald
- Public Health, Falk College, Syracuse University, 315-443-5313, 440 White Hall, Syracuse, NY 13244, USA.
| | - Ariel E Schwartz
- Institute on Disability, University of New Hampshire, 10 West Edge, Durham, NH 03824, USA.
| | | | - Robert Olick
- Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse, NY, USA
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Longhurst P, Todd J, Aspell JE, Swami V. Psychometric evaluation of a revised version of the body appreciation scale-2 for autistic adults (BAS-2A). Body Image 2024; 49:101706. [PMID: 38552369 DOI: 10.1016/j.bodyim.2024.101706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 05/31/2024]
Abstract
Emerging evidence points to unique conceptualisations of positive body image in autistic individuals. However, there are no existing measures of positive body image that have been developed or validated for use with autistic adults. To rectify this, we developed a revised version of the BAS-2 - the BAS-2A - and examined its factorial validity and psychometric properties in a sample of autistic adults from the United Kingdom. Based on the results of exploratory factor analysis and scale purification, we extracted a 12-item, unidimensional model of BAS-2A scores in a first split-subsample (n = 273). Confirmatory factor analysis supported the unidimensional model of BAS-2A scores in a second split-subsample (n = 277). BAS-2A scores presented adequate composite reliability, measurement invariance across gender identity, and patterns of construct validity. For both women and men, BAS-2A scores correlated positively with self-esteem, well-being, quality of life, and adaptive coping, and inversely with dietary restraint, weight/shape overvaluation, body dissatisfaction, and depression. Finally, BAS-2A scores demonstrated incremental validity, predicting self-esteem over-and-above body dissatisfaction. However, temporal stability of the BAS-2A over three weeks was not supported. These results support the BAS-2A as a psychometrically robust measure of body appreciation for use in autistic adults from the United Kingdom.
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Affiliation(s)
- Phaedra Longhurst
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom.
| | - Jennifer Todd
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| | - Jane Elizabeth Aspell
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
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Borgström Å. Young people with intellectual disability and the internet: Challenges and opportunities in qualitative research. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:598-612. [PMID: 35510829 PMCID: PMC10461729 DOI: 10.1177/17446295221095714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Conducting qualitative research on young people with intellectual disability and the Internet poses methodological challenges as well as opportunities. Based on memos from a qualitative study, this article focuses on identified gaps related to the challenges of informed consent, access to Internet arenas and using stimulus materials. Opportunities, in terms of flexibility and relationships, are discussed and problematized. The discussion shows that researchers may need to move out of their comfort zone and try nonconventional methods of data collection. It is important to be creative and innovative but also to look after the rights and interests of participants. Furthermore, take a non-directive approach and assume young people with intellectual disability to be experts on their own lives. Finally, the power imbalance between a researcher and participant should be considered and the researcher should ask him-/herself which perspective he/she wishes to present or 'whose side are we on?'
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Affiliation(s)
- Åsa Borgström
- Department of Social Work, Faculty of Social Science, University of Gothenburg, Gothenburg, Sweden
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Selander J, Wall E. The athletic work force: Sport as a key to employment for people with intellectual disabilities? Work 2023; 76:1407-1417. [PMID: 37393467 PMCID: PMC10741309 DOI: 10.3233/wor-220330] [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: 06/21/2022] [Accepted: 03/28/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND People with disabilities are employed at lower rates than non-disabled individuals and, among people with disabilities, those with intellectual disabilities have most difficulty finding and keeping employment. The reasons for the low labour participation among people with intellectual disabilities are many. Sport participation has a number of positive effects for the individual, and it is reasonable to hypothesise that sport participation favours labour-force participation for individuals with intellectual disabilities. OBJECTIVE The dual aim of the current study was to investigate labour market participation among Swedish athletes with intellectual disabilities attending Special Olympics Invitational Games, and to investigate these athletes' experiences regarding the effect of sport participation on finding and keeping a job. METHOD The study design includes two parallel data collections, a survey and an interview study. The survey was analysed using descriptive statistics and the interviews were analysed using content analysis. RESULTS The major result of the survey was the large number of individuals with intellectual disabilities who were in work: among men, 72% and, among women, 44%. This result was encouraging and differs from previous statistics on employment among Swedes with intellectual disabilities. The content analysis resulted in a first step in the categories manual work, individual sports and team sports, and in a second step, where the relation between sports and work was analysed, in two categories, namely indirect and direct relations between sport and work. CONCLUSION To improve chances for individuals with intellectual disabilities to find and keep a job, sports participation should be encouraged.
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Affiliation(s)
- John Selander
- Rehabilitation Science, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Erika Wall
- Sociology, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
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Inclusive Research and Intellectual Disabilities: Moving Forward on a Road Less Well-Travelled. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In reflecting on the title of the special issue: Inclusive Research: A road less or more well-travelled, this paper reviews the strengths of inclusive research that have augmented the global knowledge about the lives of people with intellectual disabilities across the lifespan. The successes of inclusive research are outlined with the respective ongoing individual challenges discussed. Authors will draw upon their own experiences of inclusive research, together with the seminal and current literature, as well as the dialogue between them. The conclusions of the article are in the form of recommendations aimed at increasing the traffic on the road of inclusive research through: 1. expanding its purpose and parameters across all forms of disability research; 2. developing systems for sustaining inclusive research as a funded model; 3. creating capacity to enable people with intellectual disabilities to be employed as researchers directing research projects; and 4. establishing bridges and crossroads with policy and practice through its findings.
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St John BM, Hickey E, Kastern E, Russell C, Russell T, Mathy A, Peterson B, Wigington D, Pellien C, Caudill A, Hladik L, Ausderau KK. Opening the door to university health research: recommendations for increasing accessibility for individuals with intellectual disability. Int J Equity Health 2022. [PMID: 36088334 DOI: 10.1186/s12939-022-01730-4/tables/2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Advances in health equity rely on representation of diverse groups in population health research samples. Despite progress in the diversification of research samples, continued expansion to include systematically excluded groups is needed to address health inequities. One such group that is infrequently represented in population health research are adults with intellectual disability. Individuals with intellectual disability experience pervasive health disparities. Representation in population health research is crucial to determine the root causes of inequity, understand the health of diverse populations, and address health disparities. The purpose of this paper was to develop recommendations for researchers to increase the accessibility of university health research and to support the inclusion of adults with intellectual disability as participants in health research. METHODS A comprehensive literature review, consultation with the university ethics review board, and review of United States federal regulations was completed to identify barriers to research participation for individuals with intellectual disability. A collaborative stakeholder working group developed recommendations and products to increase the accessibility of university research for participants with intellectual disability. RESULTS Eleven key barriers to research participation were identified including gaps in researchers' knowledge, lack of trust, accessibility and communication challenges, and systematic exclusion among others. Together the stakeholder working group compiled seven general recommendations for university health researchers to guide inclusion efforts. Recommendations included: 1) address the knowledge gap, 2) build community partnerships, 3) use plain language, 4) simplify consent and assent processes, 5) establish research capacity to consent, 6) offer universal supports and accommodations, and 7) practice accessible dissemination. In addition, four products were created as part of the stakeholder working group to be shared with researchers to support the inclusion of participants with intellectual disability. 1) Supports I Need Checklist, 2) Plain language glossary of health and research terms, 3) Understanding Consent and Assent in Plain Language, 4) Easy-Read Paper Template. CONCLUSION Community members and individuals with intellectual disability want to be included in research and are eager to engage as research participants. It is the responsibility of the researcher to open the door to university health research. The recommendations discussed in this paper could increase accessibility for a broader range of research participants and, in particular, promote the inclusion of individuals with intellectual disability to advance health equity in population health research.
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Affiliation(s)
- Brittany M St John
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA.
| | - Emily Hickey
- Waisman Center, University of Wisconsin, Madison, WI, USA
| | | | - Chad Russell
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA
| | - Tina Russell
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA
| | - Ashley Mathy
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA
- Special Olympics Wisconsin, Madison, WI, USA
| | - Brogan Peterson
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA
- Special Olympics Wisconsin, Madison, WI, USA
| | | | - Casey Pellien
- Institutional Review Board, University of Wisconsin at Madison, Madison, WI, USA
| | - Allison Caudill
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA
| | - Libby Hladik
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA
| | - Karla K Ausderau
- Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI, USA
- Waisman Center, University of Wisconsin, Madison, WI, USA
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St. John BM, Hickey E, Kastern E, Russell C, Russell T, Mathy A, Peterson B, Wigington D, Pellien C, Caudill A, Hladik L, Ausderau KK. Opening the door to university health research: recommendations for increasing accessibility for individuals with intellectual disability. Int J Equity Health 2022; 21:130. [PMID: 36088334 PMCID: PMC9464400 DOI: 10.1186/s12939-022-01730-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/17/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Advances in health equity rely on representation of diverse groups in population health research samples. Despite progress in the diversification of research samples, continued expansion to include systematically excluded groups is needed to address health inequities. One such group that is infrequently represented in population health research are adults with intellectual disability. Individuals with intellectual disability experience pervasive health disparities. Representation in population health research is crucial to determine the root causes of inequity, understand the health of diverse populations, and address health disparities. The purpose of this paper was to develop recommendations for researchers to increase the accessibility of university health research and to support the inclusion of adults with intellectual disability as participants in health research. METHODS A comprehensive literature review, consultation with the university ethics review board, and review of United States federal regulations was completed to identify barriers to research participation for individuals with intellectual disability. A collaborative stakeholder working group developed recommendations and products to increase the accessibility of university research for participants with intellectual disability. RESULTS Eleven key barriers to research participation were identified including gaps in researchers' knowledge, lack of trust, accessibility and communication challenges, and systematic exclusion among others. Together the stakeholder working group compiled seven general recommendations for university health researchers to guide inclusion efforts. Recommendations included: 1) address the knowledge gap, 2) build community partnerships, 3) use plain language, 4) simplify consent and assent processes, 5) establish research capacity to consent, 6) offer universal supports and accommodations, and 7) practice accessible dissemination. In addition, four products were created as part of the stakeholder working group to be shared with researchers to support the inclusion of participants with intellectual disability. 1) Supports I Need Checklist, 2) Plain language glossary of health and research terms, 3) Understanding Consent and Assent in Plain Language, 4) Easy-Read Paper Template. CONCLUSION Community members and individuals with intellectual disability want to be included in research and are eager to engage as research participants. It is the responsibility of the researcher to open the door to university health research. The recommendations discussed in this paper could increase accessibility for a broader range of research participants and, in particular, promote the inclusion of individuals with intellectual disability to advance health equity in population health research.
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Affiliation(s)
- Brittany M. St. John
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA
| | - Emily Hickey
- grid.14003.360000 0001 2167 3675Waisman Center, University of Wisconsin, Madison, WI USA
| | | | - Chad Russell
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA
| | - Tina Russell
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA
| | - Ashley Mathy
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA ,Special Olympics Wisconsin, Madison, WI USA
| | - Brogan Peterson
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA ,Special Olympics Wisconsin, Madison, WI USA
| | | | - Casey Pellien
- grid.14003.360000 0001 2167 3675Institutional Review Board, University of Wisconsin at Madison, Madison, WI USA
| | - Allison Caudill
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA
| | - Libby Hladik
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA
| | - Karla K. Ausderau
- grid.14003.360000 0001 2167 3675Department of Kinesiology, Occupational Therapy Program, 2120 Medical Sciences Center, University of Wisconsin at Madison, WI 53706, 1300 University Avenue, Madison, WI USA ,grid.14003.360000 0001 2167 3675Waisman Center, University of Wisconsin, Madison, WI USA
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Walsh S, Hegarty J, Lehane E, Farrell D, Taggart L, Kelly L, Sahm L, Corrigan M, Caples M, Martin AM, Tabirca S, Corrigan MA, O'Mahony M. Determining the need for a breast cancer awareness educational intervention for women with mild/moderate levels of intellectual disability: A qualitative descriptive study. Eur J Cancer Care (Engl) 2022; 31:e13590. [PMID: 35393746 PMCID: PMC9539590 DOI: 10.1111/ecc.13590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/11/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Following a review of the existing body of literature, this study aimed to explore the need for a breast cancer awareness intervention specifically targeted at women with mild/moderate levels of intellectual disability (ID) and provide perspectives on the preferred processes and content underpinning an intervention. METHODS A qualitative, descriptive design using semi-structured, individual (n = 5) and focus group (n = 5) interviews were used to engage with a non-probability, purposive sample of key stakeholders (n = 25) including women with mild/moderate levels of ID, caregivers and healthcare professionals. Data were analysed using qualitative content analysis. RESULTS Findings highlighted that an educational intervention should focus on breast awareness as opposed to breast cancer awareness. Additionally, findings identified that a combined breast awareness and healthy living intervention could be effective. However, the intervention needs to have a multimodal, hands-on, person-centred approach to learning which is underpinned by theory. Furthermore, integrating the caregivers and healthcare professionals into the intervention is recommended. CONCLUSION Findings from this study provide a foundation for developing and implementing a theoretically underpinned, multimodal, breast awareness and healthy living educational intervention for women with mild/moderate levels of ID.
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Affiliation(s)
- Susan Walsh
- Catherine McCauley School of Nursing and Midwifery, University College Cork, Cork
| | - Josephine Hegarty
- Catherine McCauley School of Nursing and Midwifery, University College Cork, Cork
| | - Elaine Lehane
- Catherine McCauley School of Nursing and Midwifery, University College Cork, Cork
| | - Dawn Farrell
- Department of Nursing and Healthcare Sciences, Institute of Technology Tralee, Tralee, Ireland
| | - Laurence Taggart
- Institute of Nursing and Health, Ulster University, Jordanstown, UK
| | - Louise Kelly
- Department of Academic Surgery, Cork Breast Research Centre-Cork University Hospital, Cork, Ireland
| | - Laura Sahm
- School of Pharmacy, University College Cork, Cork, Ireland
| | | | - Maria Caples
- Catherine McCauley School of Nursing and Midwifery, University College Cork, Cork
| | - Anne Marie Martin
- Catherine McCauley School of Nursing and Midwifery, University College Cork, Cork
| | - Sabin Tabirca
- Department of Computer Science, University College Cork, Cork, Ireland
| | - Mark A Corrigan
- Department of Academic Surgery, Cork Breast Research Centre-Cork University Hospital, Cork, Ireland
| | - Mairin O'Mahony
- Catherine McCauley School of Nursing and Midwifery, University College Cork, Cork
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McDonald KE, Gibbons C, Conroy N, Olick RS. Facilitating the inclusion of adults with intellectual disability as direct respondents in research: Strategies for fostering trust, respect, accessibility and engagement. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:170-178. [PMID: 34559449 PMCID: PMC8688267 DOI: 10.1111/jar.12936] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 07/09/2021] [Accepted: 08/18/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Adults with intellectual disability experience disparities in social determinants of health and health outcomes. While new knowledge can advance health equity, adults with intellectual disability are frequently excluded from being direct respondents in research. Their inclusion requires addressing scientific and ethical challenges that contribute to their exclusion. METHOD We describe our multi-phased process, inclusive of community-engagement, to develop a self-report survey for adults with intellectual disability and share findings from an institutional ethnography conducted to identify strategies for facilitating inclusion. We also assessed indicators of the quality of these strategies. RESULTS We identified building trust, showing respect, designing in accessibility, maximising flexibility and allowing individualised accommodations as strategies that foster inclusion. Multiple indicators validate the effectiveness of these strategies. CONCLUSIONS Researchers can promote first-person decision-making and direct research participation by focusing on promoting accessibility, trust, respect and engagement.
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Affiliation(s)
- Katherine E. McDonald
- Department of Public Health and Associate Dean of Research, Falk College, Syracuse University, 444 White Hall, Syracuse, New York, 13244, USA
| | - Colleen Gibbons
- Department of Public Health, Falk College, Syracuse University; Center for Court Innovation, Syracuse, New York, 13204, USA
| | - Nicole Conroy
- Department of Human Development and Family Science, Falk College, Syracuse University; Human Development and Family Studies, University of Vermont, Burlington, Vermont, 05405, USA
| | - Robert S. Olick
- Center for Bioethics and Humanities, Upstate Medical University, Syracuse, New York, 13210, USA
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Meys E, Hermans K, Maes B. Using an ecological approach to grasp the complexity of social inclusion around a person with a disability. Disabil Health J 2021; 14:101152. [PMID: 34175256 DOI: 10.1016/j.dhjo.2021.101152] [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: 11/20/2020] [Revised: 03/16/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Mapping social inclusion often focuses merely on a specific aspect of interpersonal relationships or community participation and is often executed from one perspective (either the person with a disability or a proxy). OBJECTIVE This paper explores whether the ecological model of Simplican, Leader, Kosciulek and Leahy (2015) can serve as a basis to develop an instrument that maps a variety of influencing enabling and disabling variables on both interpersonal relations and community participation, including the input of persons with a disability, network members and professionals. METHODS Directed content analysis was used to apply the ecological model to 14 cases of persons with a disability in independent supported living. RESULTS The ecological model proved to be a useful framework to map enabling and disabling factors of social inclusion in individual cases. Additions were made to the model, including adding a new level of 'dynamics' to grasp the dynamic reality of social inclusion. Different informants gave partly overlapping information, but the integration of the three perspectives was an added value for understanding social inclusion in all its complexities. CONCLUSIONS This paper serves as a first step in developing an in-depth instrument to map social inclusion.
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Affiliation(s)
- Evy Meys
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
| | - Koen Hermans
- KU Leuven, LUCAS, Centre for Care Research and Consultancy, Leuven, Belgium
| | - Bea Maes
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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McCarthy M, Bates C, Elson N, Hunt S, Milne-Skillman K, Forrester-Jones R. 'Love makes me feel good inside and my heart is fixed': What adults with intellectual disabilities have to say about love and relationships. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:955-965. [PMID: 34033223 DOI: 10.1111/jar.12893] [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: 10/05/2020] [Revised: 02/18/2021] [Accepted: 04/13/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Adults with intellectual disabilities have historically been hindered, rather than supported, in their desire to form loving relationships. This paper sought to explore with them what kinds of support they wanted in the 21st Century. METHOD Semi-structured in-depth interviews were conducted with 40 adults with intellectual disabilities in the United Kingdom. RESULTS Participants placed a high value on having a partner and being supported to maintain and develop a loving relationship. The factors which constrained them in achieving this included a lack of social opportunities, barriers created by social care services and limits on them exercising autonomy. Facilitating factors included access to specialist dating agencies, strong family and staff support and opportunities to learn about relationships. CONCLUSIONS The importance of a loving relationship as a source of pleasure and meaning in the lives of adults with intellectual disabilities who are often disadvantaged in many other spheres of life is emphasised.
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Affiliation(s)
| | - Claire Bates
- Tizard Centre, University of Kent, Canterbury, UK
| | - Nicola Elson
- Tizard Centre, University of Kent, Canterbury, UK
| | - Siobhan Hunt
- Tizard Centre, University of Kent, Canterbury, UK
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Williamson HJ, Armin JS, Stakely E, Nasimi B, Joseph DH, Meyers J, Baldwin JA. Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities. ANNALS OF INTERNATIONAL OCCUPATIONAL THERAPY 2021; 4:e158-e165. [PMID: 34676309 PMCID: PMC8528383 DOI: 10.3928/24761222-20201202-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. METHODS This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members identified as Indigenous. RESULTS Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. CONCLUSION The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD.
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Hill EA, Fairley DM, Williams LJ, Spanò G, Cooper SA, Riha RL. Prospective Trial of CPAP in Community-Dwelling Adults with Down Syndrome and Obstructive Sleep Apnea Syndrome. Brain Sci 2020; 10:E844. [PMID: 33198148 PMCID: PMC7696635 DOI: 10.3390/brainsci10110844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/31/2020] [Accepted: 11/05/2020] [Indexed: 11/30/2022] Open
Abstract
Adults with Down syndrome (DS) are predisposed to obstructive sleep apnoea (OSA), but the effectiveness and acceptability of continuous positive airway pressure treatment (CPAP) in this group has rarely been formally assessed. This study was designed as a pilot randomised, parallel controlled trial for one month, continuing as an uncontrolled cohort study whereby the control group also received the intervention. Symptomatic, community-dwelling DS individuals exhibiting ≥10 apnoeas/hypopneas per hour in bed on a Type 3 home sleep study were invited to participate in this study, with follow-up at 1, 3, 6, and 12 months from baseline. Measurements of sleepiness, behaviour, cognitive function and general health were undertaken; the primary outcome was a change in the pictorial Epworth Sleepiness Scale (pESS) score. Twenty-eight participants (19 male) were enrolled: age 28 ± 9 year; body mass index 31.5 ± 7.9 kg/m2; 39.6 ± 32.2 apnoeas/hypopneas per hour in bed; pESS 11 ± 6/24. The pilot randomised controlled trial at one month demonstrated no change between the groups. At 12 months, participant (p = 0.001) pESS and Disruptive (p < 0.0001), Anxiety/Antisocial (p = 0.024), and Depressive (p = 0.008) behaviour scores were reduced compared to baseline. Improvement was noted in verbal (p = 0.001) and nonverbal intelligence scores (p = 0.011). General health scores also improved (p = 0.02). At the end of the trial, 19 participants continued on treatment. Use of CPAP in adults with DS and OSA led to a number of significant, sustained improvements in sleepiness and behavioural/emotional outcomes at 12 months.
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Affiliation(s)
- Elizabeth A Hill
- Sleep Research Unit, Centre for Clinical Brain Sciences, University of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK; (E.A.H.); (D.M.F.)
| | - Donna M Fairley
- Sleep Research Unit, Centre for Clinical Brain Sciences, University of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK; (E.A.H.); (D.M.F.)
| | - Linda J Williams
- Centre for Population Health Sciences, Usher Institute, Old Medical School, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK;
| | - Goffredina Spanò
- Down Syndrome Research Group, Department of Psychology, University of Arizona, Tucson, AZ 85721, USA;
| | - Sally-Ann Cooper
- Mental Health and Wellbeing Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 0XH, UK;
| | - Renata L Riha
- Sleep Research Unit, Centre for Clinical Brain Sciences, University of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK; (E.A.H.); (D.M.F.)
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Wagner L, Frisch M, Turner-Brown L, Andrews S, Edwards A, Moultrie R, Alvarez Rivas A, Wheeler A, Raspa M. Preferences for the research use of electronic health records among young adults with fragile X syndrome or autism spectrum disorder. Disabil Health J 2020; 13:100927. [PMID: 32360031 PMCID: PMC7541430 DOI: 10.1016/j.dhjo.2020.100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Health researchers are increasingly using electronic health records (EHRs) to study the health care needs of people with neurodevelopmental disorders (NDDs). However, little is known about the preferences of people with NDDs for sharing EHRs for research. OBJECTIVE To explore preferences for sharing EHRs for research among young adults ages 18-40 who make their own legal decisions and who have autism spectrum disorder (ASD), fragile X syndrome (FXS), or no NDDs. METHODS We conducted a qualitative study with seven focus groups: 2 ASD groups, 3 FXS groups, and 2 no-NDD groups. We asked participants about factors that could affect their willingness to share their EHRs for research: type of organization, type of information, study purpose, duration, contact frequency, return of results, benefits, and risks. We analyzed the qualitative data using directed content analysis. RESULTS Participants with NDDs valued personally relevant and directly beneficial EHR research. Participants with NDDs expressed willingness to share sensitive data if the study was personally relevant. Most participants wanted to receive results, but only participants with FXS indicated it would affect their willingness to participate. Participants were concerned about privacy risks, discrimination, researcher misconduct, and financial conflicts of interest. CONCLUSION This study provides initial evidence suggesting that young adults with NDDs prefer EHR research that is personally relevant, benefits themselves and their communities, and is conducted in the context of trusting, reciprocal participant-researcher relationships. The findings point to the need for researchers to improve the informed consent process and to better engage individuals with NDDs in research.
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Affiliation(s)
- Laura Wagner
- RTI International, Research Triangle Park, NC, United States.
| | - MaryKate Frisch
- University of North Carolina TEACCH Autism Program, Chapel Hill, NC, United States.
| | - Lauren Turner-Brown
- University of North Carolina TEACCH Autism Program, Chapel Hill, NC, United States.
| | - Sara Andrews
- RTI International, Research Triangle Park, NC, United States.
| | - Anne Edwards
- RTI International, Research Triangle Park, NC, United States.
| | | | - Alexandra Alvarez Rivas
- University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC, United States.
| | - Anne Wheeler
- RTI International, Research Triangle Park, NC, United States.
| | - Melissa Raspa
- RTI International, Research Triangle Park, NC, United States.
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16
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Giesbers SAH, Hendriks AHC, Hastings RP, Jahoda A, Tournier T, Embregts PJCM. Family-based social capital of emerging adults with and without mild intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:757-769. [PMID: 32743943 PMCID: PMC7540391 DOI: 10.1111/jir.12764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/15/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Family is recognised as an important context for the self-development of young adults in emerging adulthood, although very little research has addressed the perspective of young people with intellectual disability about their families by using self-report. This study examined how emerging adults with mild intellectual disability define their family support networks, compared with definitions of students without intellectual disability, within a social capital theoretical framework. METHODS Fifty-three participants with mild intellectual disability and 53 students without intellectual disability were interviewed individually using the Family Network Method - Intellectual Disability (FNM-ID). Data from the FNM-ID relate to key social network measures on how individuals define their family groups, and how they perceive existing supportive relationships within their families. Participants with mild intellectual disability and students were compared on the FNM-ID social network measures. RESULTS Participants with mild intellectual disability reported fewer family members who they considered significant to them than students without intellectual disability. They were less likely to include peers (i.e. friends and partners) and siblings in their significant family networks, had fewer relationships with family members in which they received or gave support, had fewer reciprocal support relationships and had a less central position in their family network. DISCUSSION The family-based social capital of emerging adults with mild intellectual disability differed from that of students without intellectual disability. They may remain more dependent on their natural family for emotional support as their supportive networks have not necessarily made the transition to networks with emotionally close peer relationships.
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Affiliation(s)
- S. A. H. Giesbers
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
- Dichterbij Innovation and ScienceGennepthe Netherlands
| | - A. H. C. Hendriks
- School of Pedagogical and Educational Science, Faculty of Social SciencesRadboud University NijmegenNijmegenthe Netherlands
| | - R. P. Hastings
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClaytonAustralia
| | - A. Jahoda
- Psychological MedicineUniversity of GlasgowGlasgowUK
| | - T. Tournier
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
- ASVZSliedrechtthe Netherlands
| | - P. J. C. M. Embregts
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
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17
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Wheeler AC, Wylie A, Raspa M, Villagomez A, Miller K, Edwards A, DeRamus M, Appelbaum PS, Bailey DB. Decisional Capacity for Informed Consent in Males and Females with Fragile X Syndrome. J Autism Dev Disord 2020; 50:1725-1747. [PMID: 30825084 DOI: 10.1007/s10803-019-03930-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although informed consent is critical for all research, there is increased ethical responsibility as individuals with intellectual or developmental disabilities (IDD) become the focus of more clinical trials. This study examined decisional capacity for informed consent to clinical trials in individuals with fragile X syndrome (FXS). Participants were 152 adolescents and adults (80 males, 72 females) with FXS who completed a measure of decisional capacity and a comprehensive battery of neurocognitive and psychiatric measures. Females outperformed males on all aspects of decisional capacity. The ability to understand aspects of the clinical trial had the strongest association with the ability to appreciate and reason about the decision. Scaffolding improved understanding, suggesting researchers can take steps to improve decisional capacity and the informed consent process.
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Affiliation(s)
- Anne C Wheeler
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA.
| | - Amanda Wylie
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Melissa Raspa
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Adrienne Villagomez
- Children's Hospital Colorado, Anschutz Medical Campus, 13123 East 16th Avenue, Aurora, CO, 80045, USA.,Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Renee Lynne Court, Carrboro, NC, 27714, USA
| | - Kylee Miller
- Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.,Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Renee Lynne Court, Carrboro, NC, 27714, USA
| | - Anne Edwards
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Margaret DeRamus
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Renee Lynne Court, Carrboro, NC, 27714, USA
| | - Paul S Appelbaum
- Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 122, New York, NY, 10032, USA
| | - Donald B Bailey
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
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Doherty AJ, Jones SP, Chauhan U, Gibson J. Eating well, living well and weight management: A co-produced semi-qualitative study of barriers and facilitators experienced by adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2020; 24:158-176. [PMID: 29764278 DOI: 10.1177/1744629518773938] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Adults with intellectual disabilities in England experience health inequalities. They are more likely than their non-disabled peers to be obese and at risk of serious medical conditions such as heart disease, stroke and type 2 diabetes. This semi-qualitative study engaged adults with intellectual disabilities in a co-production process to explore their perceived barriers and facilitators to eating well, living well and weight management. Nineteen participants with intellectual disabilities took part in four focus groups and one wider group discussion. They were supported by eight of their carers or support workers. Several barriers were identified including personal income restrictions, carers' and support workers' unmet training needs, a lack of accessible information, inaccessible services and societal barriers such as the widespread advertising of less healthy foodstuffs. A key theme of frustration with barriers emerged from analysis of participants' responses. Practical solutions suggested by participants included provision of clear and accessible healthy lifestyle information, reasonable adjustments to services, training, 'buddying' support systems or schemes and collaborative working to improve policy and practice.
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Affiliation(s)
- A J Doherty
- School of Nursing, Faculty of Health & Wellbeing, University of Central Lancashire, UK
| | - S P Jones
- School of Nursing, Faculty of Health & Wellbeing, University of Central Lancashire, UK
| | - U Chauhan
- MacKenzie Chair in Primary Care Medicine, Faculty of Clinical and Biomedical Sciences, University of Central Lancashire
| | - Jme Gibson
- School of Nursing, Faculty of Health & Wellbeing, University of Central Lancashire, UK
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19
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Giesbers SAH, Hendriks AHC, Hastings RP, Jahoda A, Tournier T, Embregts PJCM. Social Capital and the Reciprocal Nature of Family Relationships: The Perspective of Individuals With Mild Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:170-185. [PMID: 32357108 DOI: 10.1352/1944-7558-125.3.170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Even though family plays a significant role in the lives of people with intellectual disability, little research has included their own views about their families. This study examined how 138 people with mild intellectual disability describe their family group, with a focus on the reciprocal nature of the emotional support in relationships with family members. Participants reported "significant" family members beyond the nuclear family, and parents were seen as the main provider of support. Only half of participants had a support relationship with siblings and just 13% of participants reported partners. About 30% of support was reciprocal, and reciprocity varied greatly with the types of family connection (e.g., siblings, peers). Implications for future research as well as practice are discussed.
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Affiliation(s)
- Sanne A H Giesbers
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Alexander H C Hendriks
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Richard P Hastings
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Andrew Jahoda
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Tess Tournier
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Petri J C M Embregts
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
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20
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Dinora P, Schoeneman A, Dellinger-Wray M, Cramer EP, Brandt J, D'Aguilar A. Using video vignettes in research and program evaluation for people with intellectual and developmental disabilities: A case study of the Leadership for Empowerment and Abuse Prevention (LEAP) project. EVALUATION AND PROGRAM PLANNING 2020; 79:101774. [PMID: 32032894 DOI: 10.1016/j.evalprogplan.2019.101774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/19/2019] [Accepted: 12/14/2019] [Indexed: 06/10/2023]
Abstract
People with intellectual and developmental disabilities (IDD) are often excluded from meaningful participation in research and program evaluation for various reasons, including protocols and measures that are inaccessible for people with varying cognitive and communication abilities. Emancipatory research models emphasize the importance of inclusive research practices. Video vignettes are a promising tool for research and program evaluation with people with IDD because they are standardized, they use visual imagery rather than relying on written or verbal communication, and they allow for distance from sensitive topics. The Leadership for Empowerment and Abuse Prevention (LEAP) project used video vignettes to evaluate a healthy relationship program for people with IDD. The authors discuss the process of piloting various protocols and measures, which then ultimately led to the use of video vignettes in the evaluation.
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Affiliation(s)
- Parthenia Dinora
- Virginia Commonwealth University, School of Education-Partnership for People with Disabilities, 700 East Franklin Street, Richmond, VA, 23284, United States.
| | - Andrew Schoeneman
- University of Richmond, School of Professional and Continuing Studies, 490 Westhampton Way, Univ. of Richmond, VA, 23173, United States.
| | - Molly Dellinger-Wray
- Virginia Commonwealth University, School of Education-Partnership for People with Disabilities, 700 East Franklin Street, Richmond, VA, 23284, United States.
| | - Elizabeth P Cramer
- Virginia Commonwealth University, School of Social Work, 1000 Floyd Ave., Richmond, VA, 23284, United States.
| | - Jack Brandt
- Virginia Commonwealth University, School of Education-Partnership for People with Disabilities, 700 East Franklin Street, Richmond, VA, 23284, United States.
| | - Allison D'Aguilar
- Virginia Commonwealth University, School of Education, 901 Floyd Ave, Richmond, VA, 23284, United States.
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21
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Kong C, Efrem M, Campbell M. Education versus screening: the use of capacity to consent tools in psychiatric genomics. JOURNAL OF MEDICAL ETHICS 2020; 46:137-143. [PMID: 31563871 DOI: 10.1136/medethics-2019-105396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
Informed consent procedures for participation in psychiatric genomics research among individuals with mental disorder and intellectual disability can often be unclear, particularly because the underlying ethos guiding consent tools reflects a core ethical tension between safeguarding and inclusion. This tension reflects important debates around the function of consent tools, as well as the contested legitimacy of decision-making capacity thresholds to screen potentially vulnerable participants. Drawing on human rights, person-centred psychiatry and supported decision-making, this paper problematises the use of consent procedures as screening tools in psychiatric genomics studies, particularly as increasing normative emphasis has shifted towards the empowerment and participation of those with mental disorder and intellectual disabilities. We expound on core aspects of supported decision-making, such as relational autonomy and hermeneutic competence, to orient consent procedures towards a more educative, participatory framework that is better aligned with developments in disability studies. The paper concludes with an acknowledgement of the pragmatic and substantive challenges in adopting this framework in psychiatric genomics studies if this participatory ethos towards persons with mental disorder and intellectual disability is to be fully realised.
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Affiliation(s)
- Camillia Kong
- School of Law, Birkbeck University of London Institute for Criminal Policy Research, School of Law, London, UK
| | - Mehret Efrem
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Megan Campbell
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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22
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Holen-Rabbersvik E, Haugland S, Omland HO, Fredwall TE, Hansen LA. Fra behovskartlegging til innovasjon for personermed utviklingshemming. TIDSSKRIFT FOR OMSORGSFORSKNING 2019. [DOI: 10.18261/issn.2387-5984-2019-03-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kong C, Singh I. The ethics of global psychiatric genomics: Multilayered challenges to integrating genomics in global mental health and disability-A position paper of the Oxford Global Initiative in Neuropsychiatric GenEthics (NeuroGenE). Am J Med Genet B Neuropsychiatr Genet 2019; 180:533-542. [PMID: 30523674 DOI: 10.1002/ajmg.b.32697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/18/2018] [Indexed: 12/12/2022]
Abstract
Psychiatric genomics has the potential to radically improve the prevention and early intervention of serious mental and neurodevelopmental disorders worldwide. However, little work has been done on the ethics of psychiatric genomics-an oversight that could result in poor local uptake, reduced practical/clinical application, and ethical violations in this rapidly developing area of scientific research. As part of the Global Project of the Stanley Center for Psychiatric Research, the Global Initiative in Neuropsychiatric GenEthics (NeuroGenE) based at the University of Oxford aims to embed ethical inquiry within scientific investigation and engage with fundamental ethical questions around a psychiatric genomics approach to mental and neurodevelopmental disorder. This position paper sets out the core aims of the NeuroGenE research programme and explores the importance of a crosscutting research orientation in this field based on multidisciplinary methodologies which can ensure that efforts to translate and apply global psychiatric genomics in public policy and clinical practice are ethically grounded strategies, respectful of different cultures and contexts.
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Affiliation(s)
- Camillia Kong
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Ilina Singh
- Department of Psychiatry and Oxford Uehiro Centre, University of Oxford, Warneford Hospital, Oxford, United Kingdom
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Park JY, Park EY. The Rasch Analysis of Rosenberg Self-Esteem Scale in Individuals With Intellectual Disabilities. Front Psychol 2019; 10:1992. [PMID: 31572254 PMCID: PMC6751397 DOI: 10.3389/fpsyg.2019.01992] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/14/2019] [Indexed: 01/20/2023] Open
Abstract
Background The purpose of this study was to examine the psychometric properties of the Rosenberg Self-Esteem Scale for individuals with intellectual disabilities (ID) using the Rasch model and to determine whether the scale is valid and reliable for use with this population. Methods Rasch analysis was carried out on data from 223 respondents to the 8th Panel Survey on Employment for the Disabled conducted by the Korea Employment Agency for the Disabled. The validity and reliability of scale items were verified through analyses of item fit, item difficulties, the rating scale, and separation indices. Results Item infit mean square values were found to range between 0.71 and 1.25, and item outfit mean square values between 0.71 and 1.26. Additionally, item difficulties were appropriate; Item 4 was the most difficult item, while Item 10 was the easiest item. The 4-point rating scale was appropriate, and the separation indices were at an acceptable level. Conclusion Based on these results, the validity and reliability of the Rosenberg Self-Esteem Scale for use with individuals with ID were verified. Thus, this scale can be regarded as a useful tool for evaluating the level of self-esteem of individuals with ID.
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Affiliation(s)
- Ju-Young Park
- Department of Rehabilitation, College of Medical Sciences, Jeonju University, Jeonju, South Korea
| | - Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, Jeonju, South Korea
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Giesbers SAH, Hendriks L, Jahoda A, Hastings RP, Embregts PJCM. Living with support: Experiences of people with mild intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:446-456. [PMID: 30362653 PMCID: PMC7379989 DOI: 10.1111/jar.12542] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/15/2018] [Accepted: 10/04/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND To enhance social inclusion of people with intellectual disability, policy is aimed at increasing informal support networks. Nevertheless, staff continue to play a vital role in their support networks. METHOD Six individuals with mild intellectual disability, living in community-based settings, were interviewed following a semi-structured format. In-depth accounts of participants' support experiences were established using Interpretative Phenomenological Analysis. RESULTS Three main themes were identified: relationships with staff placed within a personal history, relationships with staff within an organisational context, and staff support and interviewees' place in the world. CONCLUSIONS Relationships with staff were often one of the closest and most significant social relationships participants had. As living in the community had not necessarily led to meaningful inclusion for participants, the findings point at the important role of staff in supporting and facilitating friendships and close relationships of people with intellectual disability.
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Affiliation(s)
- Sanne A H Giesbers
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Dichterbij Innovation and Science, Gennep, The Netherlands
| | - Lex Hendriks
- School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands
| | - Andrew Jahoda
- Psychological Medicine, University of Glasgow, Glasgow, UK
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK.,Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic., Australia
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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St John B, Mihaila I, Dorrance K, DaWalt LS, Ausderau KK. Reflections From Co-Researchers With Intellectual Disability: Benefits to Inclusion in a Research Study Team. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 56:251-262. [PMID: 30024848 PMCID: PMC6348152 DOI: 10.1352/1934-9556-56.5.251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Participatory action research methodologies may empower and protect marginalized individuals; however, they remain underutilized. Limited studies have investigated the impact of participatory action research, specifically on individuals with intellectual disability (ID). This study examines (1) the perspectives of co-researchers with ID on their involvement in the research process and (2) the feasibility of their inclusion based on perspectives of research staff (academic faculty and graduate students without ID). Three co-researchers with ID were interviewed regarding their research participation. Thematic analysis of interviews identified four themes: (1) Shared Experience of Disability, (2) Teaching and Guidance, (3) Acquisition of Skills and Knowledge, and (4) Value of Participation. Research staff reviewed field notes and identified benefits and challenges to feasibility of including co-researchers with ID. Inclusion of co-researchers with ID was found to be both meaningful and feasible.
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Affiliation(s)
- Brittany St John
- Brittany St. John, University of Wisconsin - Madison, Department of Kinesiology, Occupational Therapy Program
| | - Iulia Mihaila
- Iulia Mihaila, University of Wisconsin - Madison, Department of Human Development and Family Studies
| | - Katelyn Dorrance
- Katelyn Dorrance, Leann Smith DaWalt, University of Wisconsin - Madison Waisman Center, and
| | - Leann Smith DaWalt
- Katelyn Dorrance, Leann Smith DaWalt, University of Wisconsin - Madison Waisman Center, and
| | - Karla K Ausderau
- Karla K. Ausderau, University of Wisconsin - Madison, Department of Kinesiology, Occupational Therapy Program and University of Wisconsin - Madison Waisman Center
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Giesbers SAH, Tournier T, Hendriks L, Hastings RP, Jahoda A, Embregts PJCM. Measuring emotional support in family networks: Adapting the Family Network Method for individuals with a mild intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:94-105. [PMID: 30004149 PMCID: PMC7379605 DOI: 10.1111/jar.12512] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 11/29/2022]
Abstract
Background Informal supportive networks of individuals with intellectual disability have become increasingly important. The aim of this paper is to describe how the Family Network Method – Intellectual Disability (FNM‐ID) offers a way to gather the perspective of people with mild intellectual disability on their family support. Method The FNM is designed to explore how individuals define their family contexts, and more specifically how they perceive existing supportive relationships in these contexts. Results By carefully piloting ways of questioning people with mild intellectual disability, systematic adaptations were made to the original FNM. Data obtained by the FNM‐ID can be analysed using social network analysis. Thereby, the FNM‐ID provides rich, theoretically significant information on emotional support in the family networks of individuals with mild intellectual disability. Conclusions The FNM‐ID is a useful and successfully adapted tool for other researchers and professionals to systematically explore the family support experiences of individuals with mild intellectual disability.
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Affiliation(s)
- Sanne A H Giesbers
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Dichterbij Innovation and Science, Gennep, The Netherlands
| | - Tess Tournier
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,ASVZ, Sliedrecht, The Netherlands
| | - Lex Hendriks
- Faculty of Social Sciences, School of Pedagogical and Educational Science, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Andrew Jahoda
- Psychological Medicine, University of Glasgow, Glasgow, UK
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Felsher M, Wiehe SE, Gunn JKL, Roth AM. 'I Got it off my Chest': An Examination of how Research Participation Improved the Mental Health of Women Engaging in Transactional Sex. Community Ment Health J 2018; 54:171-179. [PMID: 28155031 DOI: 10.1007/s10597-017-0094-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/09/2017] [Indexed: 11/26/2022]
Abstract
Ecologic momentary assessment (EMA) is a form of close-ended diary writing. While it has been shown that participating in a study that incorporates EMA improves mental health of participants, no study to date has examined the pathways through which benefits may occur. For 4-weeks, twice-daily EMAs and weekly interviews captured mood, daily activities and HIV risk behavior of 25 women who engage in transactional sex. Qualitative analysis of exit interviews was performed to examine how participation impacted women's mental health. The majority of participants felt that EMAs heightened awareness of emotions and behavior. Most reported experiencing catharsis from the interviews; specifically, from having a non-judgmental, trusting listener. Participants felt responsible for completing tasks, a sense of accomplishment for completing the study, and altruism. This study demonstrates there are direct benefits associated with participation in an EMA and interview study.
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Affiliation(s)
- Marisa Felsher
- Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA, 19104, USA.
| | - Sarah E Wiehe
- Indiana University School of Medicine, Indiana University, 340 W 10th St. #6200, Indianapolis, IN, USA
| | - Jayleen K L Gunn
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave., Tucson, AZ, USA
| | - Alexis M Roth
- Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA, 19104, USA
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Smirnoff M, Wilets I, Ragin D, Adams R, Holohan J, Rhodes R, Winkel G, Ricc E, Clesca C, Richardson LD. A paradigm for understanding trust and mistrust in medical research: The Community VOICES study. AJOB Empir Bioeth 2018; 9:39-47. [PMID: 29368998 PMCID: PMC6092744 DOI: 10.1080/23294515.2018.1432718] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND To promote justice in research practice and rectify health disparities, greater diversity in research participation is needed. Lack of trust in medical research is one of the most significant obstacles to research participation. Multiple variables have been identified as factors associated with research participant trust/mistrust. A conceptual model that provides meaningful insight into the interplay of factors impacting trust may promote more ethical research practice and provide an enhanced, actionable understanding of participant mistrust. METHODS A structured survey was developed to capture attitudes toward research conducted in emergency situations; this article focuses on items designed to assess respondents' level of trust or mistrust in medical research in general. Community-based interviews were conducted in English or Spanish with 355 New York City residents (white 42%, African American 29%, Latino 22%). RESULTS Generally favorable attitudes toward research were expressed by a majority (85.3%), but many respondents expressed mistrust. Factor analysis yielded four specific domains of trust/mistrust, each of which was associated with different demographic variables: general trustworthiness (older age, not disabled); perceptions of discrimination (African American, Latino, Spanish language preference); perceptions of deception (prior research experience, African American); and perceptions of exploitation (less education). CONCLUSIONS The four domains identified in the analysis provide a framework for understanding specific areas of research trust/mistrust among disparate study populations. This model offers a conceptual basis for the design of tailored interventions that target specific groups to promote trust of individual researchers and research institutions as well as to facilitate broader research participation.
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Affiliation(s)
| | - I Wilets
- Icahn School of Medicine at Mount Sinai
| | | | | | - J. Holohan
- New York Presbyterian Weill Cornell Hospital
| | - R. Rhodes
- Icahn School of Medicine at Mount Sinai
| | - G. Winkel
- Icahn School of Medicine at Mount Sinai
| | | | - C. Clesca
- Icahn School of Medicine at Mount Sinai
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Abstract
Vulnerable groups are often excluded from clinical research on the basis of scientific, ethical and practical reasons. Although intended to protect vulnerable people and maintain study integrity, exclusion of vulnerable groups from research through use of standard exclusion criteria may not always be necessary and may result in findings that are not generalisable. Achieving a balance between the competing needs to protect vulnerable people and to make progress in our understanding of disorders and their management through research requires a reconsideration of exclusion criteria and consent processes to ensure vulnerable people are appropriately represented in clinical research. Reasons for development of broad exclusion criteria include both concrete barriers and intangible discouraging factors. This paper examines this situation and its consequences, perceived and real barriers to inclusion of vulnerable people in research, and suggests methods for overcoming these barriers and applying thoughtful exclusion criteria.
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Roth AM, Felsher M, Reed M, Goldshear JL, Truong Q, Garfein RS, Simmons J. Potential benefits of using ecological momentary assessment to study high-risk polydrug use. Mhealth 2017; 3:46. [PMID: 29184898 PMCID: PMC5682359 DOI: 10.21037/mhealth.2017.10.01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 08/30/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND While studies have documented both the feasibility and acceptability of using ecological momentary assessment (EMA) to study drug use, there is little empirical research assessing participants' perceptions of utilizing this technology-driven approach. METHODS Participants were English-speaking persons ≥18 years old who reported injection drug use and sequential (e.g., alcohol followed by opioid use) or simultaneous (i.e., injecting heroin and cocaine in one shot) polydrug use within 30 days recruited in San Diego, CA and Philadelphia, PA. Participants (N=36) completed two cell phone-based EMA simulations assessing mood, drug use, HIV risk behaviors, and daily activities, followed by semi-structured interviews that probed for potential benefits of participation over time. Qualitative analysis involved an iterative process of reviewing texts from the interviews to create a coding framework, which was then applied to all transcripts to identify themes. RESULTS Findings suggest participants may derive indirect benefits from participation in EMA studies including: improved self-worth from helping others; experiencing increased social support through utilization of the study-provided mobile device for non-research purposes; and most importantly, increased self-reflection, which could lead to therapeutic and intervention-like effects such as decreased substance use or reduced HIV risk. CONCLUSIONS Participants identified a variety of potential benefits from participating in a study that utilizes EMA. This research suggests that benefits are highly salient for individuals involved in studies of polydrug use.
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Affiliation(s)
- Alexis M. Roth
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Marisa Felsher
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Megan Reed
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Jesse L. Goldshear
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, USA
| | - Quan Truong
- Palo Alto Medical Foundation Research Institute, Mountain View, CA, USA
| | - Richard S. Garfein
- Department of Medicine, Division of Global Public Health, University of California, San Diego, USA
| | - Janie Simmons
- National Development and Research Institutes, Inc., New York, USA
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Hudson NA, Mrozik JH, White R, Northend K, Moore S, Lister K, Rayner K. Community football teams for people with intellectual disabilities in secure settings: “They take you off the ward, it was like a nice day, and then you get like medals at the end”. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:213-225. [DOI: 10.1111/jar.12359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Rose White
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
| | | | - Steve Moore
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
| | - Katherine Lister
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
| | - Kelly Rayner
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
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McDonald KE, Conroy NE, Olick RS, Panel TPEE. What's the Harm? Harms in Research With Adults With Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:78-92. [PMID: 28095059 PMCID: PMC5568892 DOI: 10.1352/1944-7558-122.1.78] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Scientific advances can improve the lives of adults with intellectual disability, yet concerns that research participation may impose harm impede scientific progress. What counts as harmful can be subjective and perceptions of harm may vary among stakeholders. We studied perspectives on the harmfulness of research events among adults with intellectual disability, family members and friends, disability service providers, researchers, and Institutional Review Board members. We found considerable variance. For example, adults with intellectual disability see exclusion from research as more harmful, but most psychosocial harms as less significant than others. All stakeholders agree that having someone else make the participation decision is harmful. Findings provide insights into the concept of harm and ethical research with adults with intellectual disability.
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Affiliation(s)
| | - Nicole E Conroy
- Katherine E. McDonald and Nicole E. Conroy, Syracuse University
| | - Robert S Olick
- Robert S. Olick, SUNY Upstate Medical University; and the
| | - The Project Ethics Expert Panel
- Project ETHICS Expert Panel. Project ETHICS Expert Panel includes Anna Carroll, Marty Cuddy, Micah Fialka-Feldman, Dan Flanigan, Pat Fratangelo, Lance Gonzalez, Michael Kennedy, Kathleen King, Chris Mansfield, Deb McGowan, Rachel Romer, Margaret Turk, Shquria Velez, Pamela Walker, and Priscilla Worral
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McDonald KE, Conroy NE, Olick RS. Is It Worth It? Benefits in Research With Adults With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:440-453. [PMID: 27893316 PMCID: PMC5568891 DOI: 10.1352/1934-9556-54.6.440] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Including adults with intellectual disability in research promotes direct benefits to participants and larger societal benefits. Stakeholders may have different views of what count as benefits and their importance. We compared views on benefits in research with adults with intellectual disability among adults with intellectual disability, family and friends, service providers, researchers, and institutional review board members. We found that adults with intellectual disability value direct and indirect research benefits, and want to participate in research that offers them. Other stakeholders generally see less value in direct benefits and predict more tempered interest in research participation as compared to adults with intellectual disability. To promote respectful research participation, research policy and practice should incorporate the views of adults with intellectual disability.
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Affiliation(s)
- Katherine E McDonald
- Katherine E. McDonald and Nicole E. Conroy, Syracuse University; Robert S. Olick, SUNY Upstate Medical University; and the Project ETHICS Expert Panel, which includes Anna Carroll, Marty Cuddy, Micah Fialka-Feldman, Dan Flanigan, Pat Fratangelo, Lance Gonzalez, Michael Kennedy, Kathleen King, Chris Mansfield, Deb McGowan, Rachel Romer, Margaret Turk, Shquria Velez, Pamela Walker, and Priscilla Worral
| | - Nicole E Conroy
- Katherine E. McDonald and Nicole E. Conroy, Syracuse University; Robert S. Olick, SUNY Upstate Medical University; and the Project ETHICS Expert Panel, which includes Anna Carroll, Marty Cuddy, Micah Fialka-Feldman, Dan Flanigan, Pat Fratangelo, Lance Gonzalez, Michael Kennedy, Kathleen King, Chris Mansfield, Deb McGowan, Rachel Romer, Margaret Turk, Shquria Velez, Pamela Walker, and Priscilla Worral
| | - Robert S Olick
- Katherine E. McDonald and Nicole E. Conroy, Syracuse University; Robert S. Olick, SUNY Upstate Medical University; and the Project ETHICS Expert Panel, which includes Anna Carroll, Marty Cuddy, Micah Fialka-Feldman, Dan Flanigan, Pat Fratangelo, Lance Gonzalez, Michael Kennedy, Kathleen King, Chris Mansfield, Deb McGowan, Rachel Romer, Margaret Turk, Shquria Velez, Pamela Walker, and Priscilla Worral
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Mengoni SE, Gates B, Parkes G, Wellsted D, Barton G, Ring H, Khoo ME, Monji-Patel D, Friedli K, Zia A, Irvine L, Durand MA. Wordless intervention for people with epilepsy and learning disabilities (WIELD): a randomised controlled feasibility trial. BMJ Open 2016; 6:e012993. [PMID: 28186943 PMCID: PMC5128894 DOI: 10.1136/bmjopen-2016-012993] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/01/2016] [Accepted: 08/25/2016] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To investigate the feasibility of a full-scale randomised controlled trial of a picture booklet to improve quality of life for people with epilepsy and learning disabilities. TRIAL DESIGN A randomised controlled feasibility trial. Randomisation was not blinded and was conducted using a centralised secure database and a blocked 1:1 allocation ratio. SETTING Epilepsy clinics in 1 English National Health Service (NHS) Trust. PARTICIPANTS Patients with learning disabilities and epilepsy who had: a seizure within the past 12 months, meaningful communication and a carer with sufficient proficiency in English. INTERVENTION Participants in the intervention group used a picture booklet with a trained researcher, and a carer present. These participants kept the booklet, and were asked to use it at least twice more over 20 weeks. The control group received treatment as usual, and were provided with a booklet at the end of the study. OUTCOME MEASURES 7 feasibility criteria were used relating to recruitment, data collection, attrition, potential effect on epilepsy-related quality of life (Epilepsy and Learning Disabilities Quality of Life Scale, ELDQOL) at 4-week, 12-week and 20-week follow-ups, feasibility of methodology, acceptability of the intervention and potential to calculate cost-effectiveness. OUTCOME The recruitment rate of eligible patients was 34% and the target of 40 participants was reached. There was minimal missing data and attrition. An intention-to-treat analysis was performed; data from the outcome measures suggest a benefit from the intervention on the ELDQOL behaviour and mood subscales at 4 and 20 weeks follow-up. The booklet and study methods were positively received, and no adverse events were reported. There was a positive indication of the potential for a cost-effectiveness analysis. CONCLUSIONS All feasibility criteria were fully or partially met, therefore confirming feasibility of a definitive trial. TRIAL REGISTRATION NUMBER ISRCTN80067039.
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Affiliation(s)
- Silvana E Mengoni
- Department of Psychology, Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Bob Gates
- Institute for Practice, Interdisciplinary Research and Enterprise (INSPIRE), University of West London, London, UK
| | - Georgina Parkes
- Learning Disabilities Services, Hertfordshire Partnership University NHS Foundation Trust, St Albans, UK
| | - David Wellsted
- Department of Psychology, Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Garry Barton
- Norwich Medical School and Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Howard Ring
- Department of Psychiatry, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Mary Ellen Khoo
- Research and Development, Hertfordshire Partnership University NHS Foundation Trust, St Albans, UK
| | - Deela Monji-Patel
- Research and Development, Hertfordshire Partnership University NHS Foundation Trust, St Albans, UK
- Division 4, Mental Health, NIHR Clinical Research Network: Eastern, UK
| | - Karin Friedli
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Asif Zia
- Learning Disabilities Services, Hertfordshire Partnership University NHS Foundation Trust, St Albans, UK
| | - Lisa Irvine
- Norwich Medical School and Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Marie-Anne Durand
- Department of Psychology, Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
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McDonald KE, Conroy NE, Kim CI, LoBraico EJ, Prather EM, Olick RS. Is Safety in the Eye of the Beholder? Safeguards in Research With Adults With Intellectual Disability. J Empir Res Hum Res Ethics 2016; 11:424-438. [PMID: 27307420 DOI: 10.1177/1556264616651182] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Human subjects research has a core commitment to participant well-being. This obligation is accentuated for once exploited populations such as adults with intellectual disability. Yet we know little about the public's views on appropriate safeguards for this population. We surveyed adults with intellectual disability, family members and friends, disability service providers, researchers, and Institutional Review Board (IRB) members to compare views on safeguards. We found many points of convergence of views, particularly for decision-making and participation. One trend is that adults with intellectual disability perceive greater safety in being engaged directly in recruitment, and recruitment by specific individuals. Researchers and IRB members need to consider community views to facilitate the safe and respectful inclusion of adults with intellectual disability.
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Affiliation(s)
| | | | | | | | | | - Robert S Olick
- 2 SUNY Upstate Medical University, Syracuse, New York City, USA
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Kirkendall A, Linton K, Farris S. Intellectual Disabilities and Decision Making at End of Life: A Literature Review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:982-994. [DOI: 10.1111/jar.12270] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Abbie Kirkendall
- Greenspun College of Urban Affairs School of Social Work University of Nevada at Las Vegas Las Vegas NV USA
| | - Kristen Linton
- Health Sciences Program California State University Channel Islands Camarillo CA USA
| | - Saritha Farris
- Beacon Pointe 2810 W. Charleston Blvd. Las Vegas NV 89102
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Braathen SH, Sanudi L, Swartz L, Jürgens T, Banda HT, Eide AH. A household perspective on access to health care in the context of HIV and disability: a qualitative case study from Malawi. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2016; 16:12. [PMID: 27036489 PMCID: PMC4818417 DOI: 10.1186/s12914-016-0087-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/22/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Equitable access to health care is a challenge in many low-income countries. The most vulnerable segments of any population face increased challenges, as their vulnerability amplifies problems of the general population. This implies a heavy burden on informal care-givers in their immediate and extended households. However, research falls short of explaining the particular challenges experienced by these individuals and households. To build an evidence base from the ground, we present a single case study to explore and understand the individual experience, to honour what is distinctive about the story, but also to use the individual story to raise questions about the larger context. METHODS We use a single qualitative case study approach to provide an in-depth, contextual and household perspective on barriers, facilitators, and consequences of care provided to persons with disability and HIV. RESULTS The results from this study emphasise the burden that caring for an HIV positive and disabled family member places on an already impoverished household, and the need for support, not just for the HIV positive and disabled person, but for the entire household. CONCLUSIONS Disability and HIV do not only affect the individual, but the whole household, immediate and extended. It is crucial to consider the interconnectedness of the challenges faced by an individual and a household. Issues of health (physical and mental), disability, employment, education, infrastructure (transport/terrain) and poverty are all related and interconnected, and should be addressed as a whole in order to secure equity in health.
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Affiliation(s)
- Stine Hellum Braathen
- />Department of Health, SINTEF Technology and Society, PB 124 Blindern, 0314 Oslo, Norway
| | - Lifah Sanudi
- />REACH Trust, P.O. Box 1597, Lilongwe, Malawi
- />Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602 South Africa
| | - Leslie Swartz
- />Department of Psychology, Stellenbosch University, Alan J Flisher Centre for Public Mental Health, Private Bag X1, Matieland, 7602 South Africa
| | - Thomas Jürgens
- />LHL International Tuberculosis Foundation, Grensen 3 (7th floor), 0159 Oslo, Norway
| | | | - Arne Henning Eide
- />Department of Health, SINTEF Technology and Society, PB 124 Blindern, 0314 Oslo, Norway
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Frankena TK, Naaldenberg J, Cardol M, Linehan C, van Schrojenstein Lantman-de Valk H. Active involvement of people with intellectual disabilities in health research - A structured literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 45-46:271-83. [PMID: 26280692 DOI: 10.1016/j.ridd.2015.08.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 07/10/2015] [Accepted: 08/04/2015] [Indexed: 05/27/2023]
Abstract
Actively involving people with intellectual disabilities (ID) in health research, also known as inclusive health research, is increasingly popular. Currently, insight into experiences of this type of research is scarce. To gain insight into this topic, a structured literature review was conducted focussing on (1) existing theories, (2) inclusive methods, (3) added value and (4) barriers and facilitators. Literature published between January 2000 and January 2014 was included covering keywords related to ID and inclusive health research. Searches were performed in Pubmed, CINAHL, PsycINFO, EMBASE and MEDLINE databases, resulting in 26 included papers. Papers were quality assessed and analysed using qualitative data analysis software. Four theories were often simultaneously addressed: participatory research, emancipatory research, inclusive research and Arnstein's ladder. Barriers and facilitators could be divided into preparing, undertaking and finalising phases of research. Authors indicated that their motivation to conduct inclusive health research was based on demands by policy and funding bodies or was based on ethical considerations (i.e., ethical notions and giving people with ID a voice). Upon completion, authors perceived increased quality and validity of their research and several benefits for stakeholders (i.e., people with ID, researchers and healthcare professionals). Overall, there was consistency in their perception of the most important aspects of inclusive health research. Based on the analysis of included papers, four recommendations of inclusive health research with people with ID were found. Inclusive health research should be: (1) tailoring to the specific study; (2) anticipating all stakeholders; (3) considering its added value; and (4) providing insight into its process.
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Affiliation(s)
- Tessa Kim Frankena
- Radboud university medical center, Department of Primary and Community Care - Intellectual Disabilities and Health, P.O. Box 9101 (route 68), 6500 HB Nijmegen, The Netherlands.
| | - Jenneken Naaldenberg
- Radboud university medical center, Department of Primary and Community Care - Intellectual Disabilities and Health, P.O. Box 9101 (route 68), 6500 HB Nijmegen, The Netherlands.
| | - Mieke Cardol
- University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, The Netherlands.
| | - Christine Linehan
- University College Dublin, School of Psychology, Newman Building, Belfield, Dublin 4, Ireland.
| | - Henny van Schrojenstein Lantman-de Valk
- Radboud university medical center, Department of Primary and Community Care - Intellectual Disabilities and Health, P.O. Box 9101 (route 68), 6500 HB Nijmegen, The Netherlands.
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Goldsmith L, Skirton H. Research involving people with a learning disability – methodological challenges and ethical considerations. J Res Nurs 2015. [DOI: 10.1177/1744987115591867] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aims of the original study referred to in this paper were to explore the information needs of people with learning disabilities with respect to consent for genomic tests, and to identify ways of facilitating informed consent for such tests. In this research methods review paper, we consider the ethical issues involved in recruitment for our study and describe the process of recruiting vulnerable participants via gatekeepers. We discuss the ethical issues under the themes ‘freedom from coercion’, ‘disclosure of information’ and ‘competence’. In conclusion, we acknowledge the paradox that exists in learning disability research: the importance of protecting members of a vulnerable group against the need to include people with a learning disability in order to gather the best possible evidence. However, a focus on wider inclusion will result in a more robust body of knowledge concerning the health and welfare of people with learning disabilities.
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Affiliation(s)
- Lesley Goldsmith
- School of Nursing and Midwifery, Faculty of Health and Human Sciences, University of Plymouth, UK
| | - Heather Skirton
- Faculty of Health and Human Sciences, University of Plymouth, UK
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McDonald KE, Schwartz NM, Gibbons CM, Olick RS. "You can't be cold and scientific": community views on ethical issues in intellectual disability research. J Empir Res Hum Res Ethics 2015; 10:196-208. [PMID: 25769310 PMCID: PMC4399491 DOI: 10.1177/1556264615575512] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Perceptions, attitudes, and ethical concerns related to conducting research with adults with intellectual disability hinder scientific innovation to promote health. Yet we lack an understanding of community views on effective research policy and practice. To address this knowledge void, we qualitatively studied the views of adults with intellectual disability and those who provide them support regarding research participation of adults with intellectual disability. We found substantial support for their inclusion, particularly given the possibility of benefits to adults with intellectual disability, researchers, and society. We also found concerns for potential harm and differing ideas on how to promote safety. Our findings emphasize the importance of their inclusion in research, and the need for policies and practices that promote respect and safety.
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Durham J, Brolan CE, Mukandi B. The Convention on the Rights of Persons with Disabilities: a foundation for ethical disability and health research in developing countries. Am J Public Health 2014; 104:2037-43. [PMID: 25211760 PMCID: PMC4202975 DOI: 10.2105/ajph.2014.302006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2014] [Indexed: 12/16/2022]
Abstract
The United Nations Convention on the Rights of Persons with Disabilities (CRPD) has foregrounded disability as a human rights and equity issue, elevating it to a priority global research area. Academics from Western universities are likely to play an increasing role in disability health research in developing countries. In such contexts, there is a need to bridge the gap between procedural ethics and the realities of disability research in cross-cultural contexts. We provide guidance on engaging in ethical disability health research that intersects with and upholds the CRPD. We highlight challenges and tensions in doing so, underscoring the need to be sensitive to the sociocultural and political context of disability that determines how ethical research should proceed. We conclude with 5 recommendations.
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Affiliation(s)
- Jo Durham
- Jo Durham, Claire E. Brolan, and Bryan Mukandi are with the University of Queensland, School of Population Health, Australian Centre of International and Tropical Health, Brisbane, Australia
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Northway R, Howarth J, Evans L. Participatory research, people with intellectual disabilities and ethical approval: making reasonable adjustments to enable participation. J Clin Nurs 2014; 24:573-81. [PMID: 25266081 DOI: 10.1111/jocn.12702] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2014] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES The aim of this paper is to explore how making reasonable adjustments to the process of securing ethical approval for research can facilitate the meaningful involvement of people with intellectual disabilities as members of a research team. This is achieved through critical reflection upon the approach taken within one participatory research study whose objective was to explore how people with intellectual disabilities understand abuse. BACKGROUND Internationally participatory research studies (in which active involvement of community members in all stages of the research process is sought) are becoming increasingly common in the context of health care and, more specifically, within research involving people with intellectual disabilities. However, whilst it is acknowledged that participatory research gives rise to specific ethical challenges, how (or if) involvement in securing ethical approval is facilitated, is not discussed in most research reports. The significance of this paper is that it seeks to address this gap by exploring how meaningful participation can be promoted by making reasonable adjustments. METHODS Within the study, the research team worked in collaboration with the ethics committee to identify potential barriers that could prevent the participation of members of the research team who had intellectual disabilities. Reasonable adjustments (such as redesigning forms) were made to the processes involved in securing ethical approval. CONCLUSIONS This study demonstrated that it is possible to ensure that ethical standards are upheld and the requirements of ethics committees met whilst also facilitating the meaningful involvement of people with intellectual disabilities. RELEVANCE TO CLINICAL PRACTICE The reasonable adjustments approach explored within this paper can be translated into the context of clinical practice: making changes to the way that services are delivered can promote greater involvement of people with intellectual disabilities in their own health care.
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Affiliation(s)
- Ruth Northway
- Faculty of Life Sciences and Education, University of South Wales, Wales, UK
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McDonald KE, Raymaker DM. Paradigm shifts in disability and health: toward more ethical public health research. Am J Public Health 2013; 103:2165-73. [PMID: 24134380 DOI: 10.2105/ajph.2013.301286] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Disability is often considered a health outcome disproportionately experienced by minority groups. It is also possible to view people with disabilities as a minority group that itself experiences health disparities. Calls to reduce these disparities necessitate the inclusion of people with developmental disabilities in research, although resulting ethical issues can thwart scientific progress. Using disability rights principles can help address ethical challenges and promote safe, respectful public health research. Examples include applying human rights frameworks, providing accommodations, attending to power, countering legacies of deficits-based models of disability, and transforming access to science more broadly. Collectively, these strategies can encourage broader engagement in safe, respectful, inclusive public health research aimed at promoting the health and well-being of people with developmental disabilities.
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Affiliation(s)
- Katherine E McDonald
- Katherine E. McDonald is with the Department of Public Health, Food Studies, and Nutrition and the Burton Blatt Institute, Syracuse University, Syracuse, NY. Dora M. Raymaker is with the Academic Autistic Spectrum Partnership in Research and Education and the Systems Science Program, Portland State University, Portland, OR
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Horner-Johnson W, Bailey D. Assessing Understanding and Obtaining Consent from Adults with Intellectual Disabilities for a Health Promotion Study. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2013; 10. [PMID: 24223054 DOI: 10.1111/jppi.12048] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
People with intellectual disabilities are often excluded from research, in part because they may be perceived as lacking capacity to provide informed consent. A requirement of informed decision making about research participation is ability to understand the study description and disclosures presented during the consent process. The authors' aims were to determine the extent to which study participants with intellectual disabilities were able to answer questions about key aspects of study disclosures, identify ways in which people who provided appropriate answers for all of the questions differed from those who had difficulty with one or more of the questions, and examine patterns of responses to see if certain issues were more difficult to understand than others. The authors piloted a short set of questions to assess the extent to which adults with intellectual disabilities were able to answer questions about key aspects of a health promotion study. More than half of study participants correctly answered all of the questions. For those not able to answer all questions, identifying potential risks of being in the study proved the most challenging. The findings indicate that many people with intellectual disabilities likely can provide their own consent to participate in low risk studies.
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Affiliation(s)
- Willi Horner-Johnson
- Institute on Development & Disability Oregon Health & Science University Portland, Oregon, USA
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McDonald K, Patka M. “There is No Black or White”: Scientific Community Views on Ethics in Intellectual and Developmental Disability Research. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2012. [DOI: 10.1111/j.1741-1130.2012.00348.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Mazna Patka
- Portland State University; Portland; Oregon; USA
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