Changing the Paradigm in Public Health and Disability through a Knowledge Translation Center

Access to health knowledge for health equality: a multi-phase review focused on disability-health

BACKGROUND

The existing evidence base indicates increased interest in knowledge translation (KT), or, the dissemination of research to ensure uptake and impact. Given this definition, this study aimed to review existing scholarship on knowledge translation (KT) of health research to people living with disabilities (PLWD), and assess the current state of accessibility of health knowledge for people living with disabilities.

METHODS

Given existing heterogeneity in literature as well as a number of varying definitions for both disability and knowledge translation, a reflexive, three-phase approach was utilized to improve methodological soundness. Phase I recognizes that existing review-style studies have been conducted on disability-KT. An existing systematic review on KT specific to the field of rehabilitation and physical medicine was analyzed to assess potential best practices towards inclusivity and accessibility for people living with disability. Phase II used the Center on Knowledge Translation for Disability and Rehabilitation Research (KTDRR) database as an information-source with high-specificity to disability-health KT. Phase III sought to rapidly assess the current landscape of systematic reviews relevant to disability-health KT, with four systematic reviews meeting the inclusion criteria across Cochrane, Psycinfo, CINAHL, PubMed, Web of Science, and EMBASE.

RESULTS

The current landscape of disability-health KT is primarily targeted at health professionals who serve PLWD. PLWD are included in KT, mostly as key informants, or as study participants in KT-studies designed as health interventions. Multiple systematic reviews on disability-health KT exist, presenting vastly different foci which prevent assessment of best practices.

CONCLUSIONS

KT efforts are abundant and can be seen across health research related to disabilities, generating considerable literature and systematic reviews. With regards to meeting the public health objective of equalizing and enhancing access to health knowledge, future knowledge translation efforts intending to provide PLWD with up-to-date health research can be of significant value.

A Disability-Inclusive Healthcare-to-Well-Being Translational Science Framework

The recent World Health Organization report on disability noted that people with disabilities (PWD) have many unmet health and rehabilitation needs, face numerous barriers to accessing healthcare and specialized services, and have overall worse health than people without disability. In view of this urgency to better identify and address health inequities systematically, we convened an expert panel of 14 stakeholders to develop a strategic plan that addresses this issue. The panel identified two major obstacles to quality healthcare services for PWD: (1) lack of coordination between the various healthcare sectors and community well-being programs and (2) substantial challenges finding and accessing healthcare services that meet their specific needs. The expert stakeholder panel noted that well-being self-management programs (both online and in person) that are easily accessible to PWD are critically needed. PWD must transition from being cared for as patients to individuals who are able to self-manage and self-advocate for their own health and well-being plans and activities. The proposed strategic plan offers providers and local communities a framework to begin addressing accessible and appropriate healthcare-to-well-being services and programs for PWD in managing their health in partnership with their healthcare providers.

Exploring the impact of COVID-19 on families of children with developmental disabilities: A community-based formative study

Background

COVID-19 continues to disproportionately impact families of children with developmental disabilities (DD). There is an urgent need to understand these families' experiences, particularly those that face economic or social marginalization. This qualitative study sought to identify the experiences of families of children with DD during the COVID-19 pandemic.

Methods

Using phenomenology, in-depth interviews (IDIs) were conducted with caregivers and health care providers of children with DD living in a large urban Canadian city. Interviews were recorded, transcribed, and coded using inductive coding methods by two independent coders. Transcripts were analyzed within and across stakeholder groups using thematic analysis.

Results

A total of 25 IDIs were conducted in 2020. 3 main themes and 7 sub-themes emerged related to the experiences of parents and health care providers for children with DD: families reported difficulty adhering to public health measures leading to isolation and increased parental stress; restricted access to in-person services worsened behaviour and development; and worsened household financial security in already marginalized families.

Conclusions

Our study demonstrates that families of children with DD have been negatively impacted by the evolving environment from the COVID-19 pandemic, and even more so in those who face social and economic challenges. Public health restrictions have impaired the daily lives of these families and our study suggests that limitations to accessing in-person services may have long-lasting impacts on the well-being of families of children with DD. It is imperative that the unique needs of these families be considered and centred for future interventions.

Examining the Impacts of the Coronavirus Pandemic and Social Distancing on the Health of People With Mobility Disabilities

Objective

To understand the effects of the coronavirus pandemic on the health and participation of people with mobility disabilities living in the community.

Methods

Participants responded to a survey designed to assess the effects of the coronavirus pandemic on their health and access to health care. Participants identified if various life situations were worsened, unchanged, or improved during the pandemic. Participants could provide further information on their improved or worsened lived experience in open-ended questions.

Results

A total of 39 people with mobility disabilities responded to the survey. Results indicate that many experienced a worsening of life situations related to health, including access to medications, health care services, and transportation.

Conclusions

Results show that many experiences were caused by the lack of appropriate policies, rather than the pandemic itself. Therefore, there is a need to modify pandemic preparedness plans and other policies to meet the needs of people with disabilities.

Measurement of Factors Affecting the Perception of People with Disabilities in the Workplace

The issue of employing people with disabilities is crucial from both a social and economic perspective, and is often influenced by the social perception of this group of people. In this article, we attempted to examine attitudes towards the disabled in eight European countries by using one of the most popular tools that measures the perception of such people in everyday life—the Attitudes to Disability Scale (ADS) developed by the WHOQOL Group. We checked the general attitude towards disability according to the ADS scale and the specific perception of disability in the workplace using a scale created ad hoc. The research was conducted in 2019 using the CAWI (computer-assisted web interview) method on representative samples of Internet users, whereas the analysis methods included the measurement reliability analysis, confirmatory factor analysis (CFA) and structural equation modelling (SEM). The obtained results allow for the acceptance of the measurement model of the ADS scale in the societies of the analyzed countries. No significant differences were found between models created for people with a disability experience (a group from the WHOQOL Group research) and without such experience. The measurement using the original ADS scale factor structure is of good reliability, whereas CFA is of good fit. We also examined the impact of ADS scale factors on the perception of people with disabilities in the workplace using the SEM model, and obtained good fit of the model. The results show that the dimensions of perception, such as inclusion, discrimination and prospects, affect the evaluation of people with disabilities in the workplace.

Emerging Trends in Health Promotion for People with Disabilities

The need among people with disabilities to improve their own health and prevent/manage secondary conditions requires a better balance between reactive and anticipatory care.