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Hutchens J, Frawley J, Sullivan EA. Is self-advocacy universally achievable for patients? The experiences of Australian women with cardiac disease in pregnancy and postpartum. Int J Qual Stud Health Well-being 2023; 18:2182953. [PMID: 36821349 PMCID: PMC9970247 DOI: 10.1080/17482631.2023.2182953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
PURPOSE Patient self-advocacy is valued and promoted; however, it may not be readily accessible to all. This analysis examines the experiences of women in Australia who had cardiac disease in pregnancy or the first year postpartum through the lenses of self-advocacy and gender, specifically seeking to elaborate on the contexts, impacts, barriers, and women's responses to the barriers to self-advocacy. METHOD A qualitative study design was used. Twenty-five women participated in semi-structured in-depth interviews. Data were analysed using thematic analysis. RESULTS Analysis of findings generated the following themes: 1) Silent dream scream, 2) Easier said than done, 3) Crazy-making, and 4) Concentric circles of advocacy. Regardless of women's personal attributes, knowledge and experience, self-advocating for their health was complex and difficult and had negative cardiac and psychological outcomes. CONCLUSION While the women encountered significant barriers to self-advocating, they were resilient and ultimately developed strategies to be heard and to advocate on their own behalf and that of other women. Findings can be used to identify ways to support women to self-advocate and to provide adequately resourced and culturally safe environments to enable healthcare professionals to provide person-centred care.
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Affiliation(s)
- Jane Hutchens
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia,CONTACT Jane Hutchens School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Jane Frawley
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
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Bell S, Bergeron R, Murray PJ, Gazaway S, Hagan Thomas T. Describing Self-Advocacy in Underrepresented Women With Advanced Cancer. Oncol Nurs Forum 2023; 50:725-734. [PMID: 37874756 DOI: 10.1188/23.onf.725-734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
PURPOSE To describe the self-advocacy experiences of women from underrepresented groups who have advanced breast or gynecologic cancer. PARTICIPANTS & SETTING To be eligible for the study, participants had to self-identify as vulnerable, which was defined as a member of a group considered at risk for poor cancer outcomes and underrepresented in clinical research. METHODOLOGIC APPROACH This descriptive, longitudinal, qualitative study consisted of one-on-one interviews of women within three months of an advanced breast or gynecologic cancer diagnosis. FINDINGS 10 participants completed 25 interviews. The average age of participants was 60.2 years (range = 38-75 years). Three major themes emerged: (a) speaking up and speaking out, (b) interacting with the healthcare team, and (c) relying on support from others. IMPLICATIONS FOR NURSING Women with advanced cancer who are from underrepresented groups self-advocated in unique ways, learning over time the importance of how to communicate their needs and manage their healthcare team. Future research should incorporate these findings into tailored self-advocacy interventions.
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Affiliation(s)
- Sarah Bell
- University of Pittsburgh Medical Center Magee-Womens Hospital
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Thomas TH, Bender C, Donovan HS, Murray PJ, Taylor S, Rosenzweig M, Sereika SM, Brufsky A, Schenker Y. The feasibility, acceptability, and preliminary efficacy of a self-advocacy serious game for women with advanced breast or gynecologic cancer. Cancer 2023; 129:3034-3043. [PMID: 37243943 DOI: 10.1002/cncr.34887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Cancer clinicians and systems aim to provide patient-centered care, but not all patients have the self-advocacy skills necessary to ensure their care reflects their needs and priorities. This study examines the feasibility, acceptability, and preliminary efficacy of a self-advocacy serious game (an educational video game) intervention in women with advanced breast or gynecologic cancer. METHODS Women with recently diagnosed (<3 months) metastatic breast or advanced gynecologic cancer were randomized 2:1 to receive a tablet-based serious game (Strong Together) (n = 52) or enhanced care as usual (n = 26). Feasibility was based on recruitment, retention, data completion, and intervention engagement. Acceptability was assessed via a postintervention questionnaire and exit interview. Preliminary efficacy was assessed on the basis of change scores from baseline to 3 and 6 months in self-advocacy (Female Self-Advocacy in Cancer Survivorship Scale) using intention-to-treat analysis. RESULTS Seventy-eight women (55.1% with breast cancer; 44.9% with gynecologic cancer) were enrolled. Feasibility was demonstrated by satisfactory recruitment (69% approach-to-consent rate; 93% enroll-to-randomize rate), retention (90% and 86% at 3 and 6 months, respectively; 85% data completion), and intervention engagement (84% completed ≥75% of the game). Participants endorsed the intervention's (75%) and trial's (87%) acceptability. Participants in the intervention group experienced significant improvements in self-advocacy at 3 and 6 months compared to participants in the control group. CONCLUSIONS Strong Together is feasible and acceptable among women with advanced breast or gynecologic cancer. This intervention demonstrates promising evidence of clinical efficacy. A future confirmatory trial is warranted to test the efficacy of the intervention for patient and health system outcomes.
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Affiliation(s)
- Teresa Hagan Thomas
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine Bender
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Heidi S Donovan
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
| | - Patty Jo Murray
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah Taylor
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
- Division of Hematology/Oncology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Margaret Rosenzweig
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adam Brufsky
- University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
- Division of Hematology/Oncology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yael Schenker
- Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Pickering DM, Gill P, Reagon C. A kaleidoscope of well-being to authentically represent the voices of children and young people with complex cerebral palsy: a case study series. Disabil Rehabil 2023:1-15. [PMID: 37098804 DOI: 10.1080/09638288.2023.2194680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
PURPOSE This paper authentically represents the voices of non-verbal children with cerebral palsy using a case study design. Policy suggests that children should have the right to play and leisure opportunities, however non-verbal children with cerebral palsy have fewer choices. Additionally, children with communication, learning and mobility limitations are usually excluded from research. The aim of this research was to capture the voices of non-verbal children by exploring their well-being impact in terms of their experiences and choices about their level of participation in recreational activities. METHODS A qualitative case series study included interviews, observations, photographs and diaries. Where possible, the diaries were completed by both caregivers and children. Data were analysed thematically, and the lens of positioning theory applied. RESULTS Seven children aged nine to sixteen years participated. The findings showed how equipment, people and environments enabled or hindered the children's participation. The children also advocated as champions for their own well-being. Positioning theory was applied across the data and was adapted offering a way to better understand the children's well-being responses. CONCLUSION The findings demonstrate how these children were able to self-advocate, demonstrating their well-being by their intentional behaviours from their level of participation in a recreational activity.
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Affiliation(s)
- Dawn M Pickering
- Physiotherapy, School of Healthcare Studies, Cardiff University, Heath Park, UK
| | - Paul Gill
- Adult Nursing, Northumbria University, Newcastle, UK
| | - Carly Reagon
- Occupational Therapy, School of Healthcare Sciences, Cardiff University, Cardiff, UK
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Betts K, Creechan L, Cawkwell R, Finn-Kelcey I, Griffin C, Hagopian A, Hartley D, Manalili MAR, Murkumbi I, O’Donoghue S, Shanahan C, Stenning A, Zisk AH. Neurodiversity, Networks, and Narratives: Exploring Intimacy and Expressive Freedom in the Time of Covid-19. Soc Incl 2023; 11:60-71. [PMID: 37674610 PMCID: PMC7615036 DOI: 10.17645/si.v11i1.5737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
The Narratives of Neurodiversity Network (NNN) is a neurodivergent academic, creative, and educator collective that came together with allies during the Covid-19 pandemic to create a network centred around emerging narratives about neurodiversity and exploring new ways of learning and socialising. The network focuses on exploring the roles of written, spoken, and visual narratives across cultural locations about neuro-atypical experiences in generating improved agency and self-advocacy for those who have been subject to pathologization through neuro-normativity and intersecting oppression. During the last year, widening access to digital platforms has provided a space to explore these issues outside of traditional academic spaces. We run a monthly "Salon," our mixed-media "reading, listening, and watching" group, in an effort to find positive representation within contemporary culture. Discussions have moved beyond mimesis and into a consideration of how narrative and storyworlds can question the supposed naturalness of certain ways of being in and perceiving the world. This article interrogates the network's core principles of nonhierarchical co-production, including the roles of creativity, community, identity, and emancipatory research which were animated by the new techno-social context. We consider the cultural lives of neurodiversity in the West and beyond, including ethical and aesthetic dimensions. We share a faith in the power of storytelling to inform new social identities for neurodivergent people and to inform scientific understandings of atypical cognition. In exploring this, we speak through a porous first-person plural narrator, to unsettle the idea that there is a hegemonic "we" speaking on behalf of all neurodivergent people.
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Affiliation(s)
- Kerri Betts
- School of Languages, Cultures and Societies, University of Leeds, UK
| | - Louise Creechan
- Department of English Studies, Durham University, UK
- Institute for Medical Humanities, Durham University, UK
| | | | | | - C.J. Griffin
- Department of English and Comparative Literary Studies, University of Warwick, UK
| | - Alice Hagopian
- School of Modern Languages, University of St Andrews, UK
| | - David Hartley
- Department of Creative Writing, University of Manchester, UK
| | | | - Inika Murkumbi
- Department of Social Anthropology, University of Cambridge, UK
| | | | - Cassandra Shanahan
- Department Literature and Creative Writing, Macquarie University, Australia
| | | | - Alyssa Hillary Zisk
- Department of Neuroscience, University of Rhode Island, USA
- AssistiveWare, The Netherlands
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Rumrill PD, Rumrill SP, Wickert K, Sheppard-Jones K, Baumunk M, Roessler RT. A "win-win" perspective on workplace accommodations: RETAIN Kentucky's self-advocacy guide to promote successful return to work and stay at work outcomes for workers with disabilities. Work 2023; 74:3-10. [PMID: 36463483 DOI: 10.3233/wor-223651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Research has long documented the low cost and effectiveness of most workplace accommodations to enable qualified people with disabilities to seek, secure, and maintain employment. OBJECTIVE AND METHOD RETAIN Kentucky's return to work and stay at work intervention involves focused training for participants on requesting needed accommodations from their employers. RESULTS In this article, we describe the win-win approach to reasonable accommodations, which serves as the basis for helping Kentuckians with disabilities identify and request on-the-job supports to aid in their efforts to remain in the workforce. CONCLUSIONS Workers with disabilities are more likely to stay in the workforce and continue making valuable contributions to the national and global economies if they have effective accommodations and other employment supports available to them.
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Scior K, Cooper R, Fenn K, Poole L, Colman S, Ali A, Baum S, Crabtree J, Doswell S, Jahoda A, Hastings R, Richardson L. 'Standing up for Myself' (STORM): Development and qualitative evaluation of a psychosocial group intervention designed to increase the capacity of people with intellectual disabilities to manage and resist stigma. J Appl Res Intellect Disabil 2022; 35:1297-1306. [PMID: 35785506 PMCID: PMC9795919 DOI: 10.1111/jar.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/21/2022] [Accepted: 04/28/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND People with intellectual disabilities are at risk of experiencing stigma and require the skills and confidence to deal with stigma in their daily lives. METHOD Development and piloting of a 5-session manualised psychosocial group intervention designed to increase the capacity of people with intellectual disabilities aged 16+ to manage and resist stigma. Ten pre-existing groups (N = 67) in third sector and education settings participated. Interviews with participants (n = 26), facilitators (n = 9) and significant others (n = 7) 2-4 months after the intervention assessed perceived impact. RESULTS Perceived benefits of the intervention for participants included increased understanding, improved connections with others, drive for advocacy, increased activity and self-efficacy, and opportunity to process difficult events and emotions. Differential impact depending on individuals' pre-existing self-advocacy skills was noted. CONCLUSIONS This early-stage study indicates that further evaluation is merited to examine feasibility and outcomes of the STORM intervention.
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Affiliation(s)
- Katrina Scior
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Rebecca Cooper
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Kristina Fenn
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Laurie Poole
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Sophie Colman
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Afia Ali
- Division of PsychiatryUniversity College LondonLondonUK
| | - Sandra Baum
- Psychological Services for People with Learning DisabilitiesOxleas NHS Foundation TrustLondonUK
| | - Jason Crabtree
- Community Learning Disability ServiceEast London NHS Foundation TrustLondonUK
| | - Sophie Doswell
- Neurodevelopmental pathwaySouth London and Maudsley NHS Foundation TrustLondonUK
| | - Andrew Jahoda
- Institute of Health and Wellbeing, University of GlasgowGlasgowUK
| | - Richard Hastings
- Centre for Educational Development Appraisal and ResearchUniversity of WarwickCoventryUK
| | - Lisa Richardson
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
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Lee JE, Kim D, Kahana E, Kahana B. Feasibility and acceptability of the community-based program: Plan Ahead. Aging Ment Health 2022; 27:811-819. [PMID: 35285774 DOI: 10.1080/13607863.2022.2046692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES In this article, we assess the feasibility and acceptability and the effect of the Plan Ahead for community dwelling older adults. In addition, we investigated the effects of the program. In addition, we aimed to examine whether the completion of the specific Future Care Planning depended on the participants' competence level. METHODS In this single group feasibility study, trained facilitators delivered the program to a sample of 234 community-residing older adults. Participants completed both pre, post assessments about the acceptability of the program and their completion of the recommended future care planning activities. RESULTS Based on participant's report on the usefulness and satisfaction of the program after the completion of the program, we found that participants reported high levels of acceptance of the program. Participation rates also confirmed the feasibility of the program. In terms of effects of program implementation, statistically significant changes were noted for several outcomes, such as resource building and FCP activities. In particular, we found that these gains were particularly robust for participants in the low competence group. CONCLUSION Pilot program results suggest the feasibility of a short community program enhancing proactive planning for future care needs among older adults residing in their community.
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Affiliation(s)
- Jeong Eun Lee
- Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - Dahee Kim
- Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - Eva Kahana
- Department of Sociology, Case Western Reserve University, Cleveland, OH, USA
| | - Boaz Kahana
- Department of Psychology, Cleveland State University, Cleveland, OH, USA
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Hawley L, Morey C, Sevigny M, Ketchum J, Simpson G, Harrison-Felix C, Tefertiller C. Enhancing Self-Advocacy After Traumatic Brain Injury: A Randomized Controlled Trial. J Head Trauma Rehabil 2022; 37:114-124. [PMID: 33935227 PMCID: PMC8628308 DOI: 10.1097/htr.0000000000000689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the efficacy of a novel intervention aimed at enhancing self-advocacy in individuals living with traumatic brain injury (TBI). SETTING Community. PARTICIPANTS Sixty-seven (35 allocated to treatment, 32 to control) community-dwelling adults 9 months or more post-TBI (mean of 8.9 years postinjury); previously discharged from inpatient or outpatient TBI rehabilitation; able to travel independently in the community, indicating a level of independence needed to engage in self-advocacy. DESIGN Longitudinal randomized 2-arm controlled trial (NCT no. 03385824). Computer-generated block randomization allocated participants to treatment/intervention or control/no-intervention. All outcome assessments completed by blinded study staff. INTERVENTION A manualized group intervention, Self-Advocacy for Independent Life (SAIL), addressing the self-efficacy beliefs, knowledge, and skills for self-advocacy following TBI. MAIN OUTCOME MEASURES The Self-Advocacy Scale (SAS) (primary); General Self-Efficacy Scale (GSE); Personal Advocacy Activity Scale (PAAS); Satisfaction With Life Scale (SWLS). RESULTS The treatment group showed significantly greater improvement than controls from baseline to posttreatment on the primary measure (SAS) of self-efficacy specific to self-advocacy after TBI (effect size = 0.22). Similar improvements were found on secondary measures of general self-efficacy and satisfaction with life from baseline to posttreatment. However, significant between-groups gains for primary and secondary measures were not maintained over 6- and 12-week follow-up. CONCLUSIONS Individuals living with chronic TBI sequelae can increase self-efficacy specific to self-advocacy, general self-efficacy, and satisfaction with life, through a TBI-specific intervention aimed at empowering individuals to advocate for their own needs and wishes. Sustaining gains over time may require ongoing community collaboration and support. This could involve community-based systems of self-advocacy education, resources, and peer support.
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Affiliation(s)
- Lenore Hawley
- Research Department, Craig Hospital, Englewood, Colorado (Mss Hawley and Morey, Mr Sevigny, and Drs Ketchum, Harrison-Felix, and Tefertiller); and John Walsh Centre for Rehabilitation Research, Sydney School of Medicine, The University of Sydney, Sydney, New South Wales, Australia (Dr Simpson)
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Perez Jolles M, Rivera D, Jacobs G, Thomas KC, Schneiderman JU, Wenzel S. Views on health activation and support services among formerly homeless adults living in Permanent Supportive Housing in the United States. Health Soc Care Community 2022; 30:154-164. [PMID: 33894078 DOI: 10.1111/hsc.13384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/01/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
Individuals who have experienced chronic homelessness often have unmet physical and mental health needs and experiences of trauma and stigma. This study aimed to measure, for the first time, health activation (self-advocacy and empowerment) levels among formerly homeless adults living in Permanent Supportive Housing or PSH (referred to hereafter as residents). In addition, residents' experiences accessing health services, and their sense of health activation and efforts to manage their health within PSH settings, were explored. A mixed-methods study was conducted in Southern California (October 2018-June 2019) using a validated survey and interviews with a randomly selected group of residents (n = 61) from three PSH agencies. Activation levels were measured using the Patient Activation Measure. Descriptive and univariate survey analyses were conducted. Interview data was analysed using NVivo. Two coders coded all transcripts, and team meetings were held to reach consensus. Results showed most residents were female (64%), racial and ethnic minorities (66%), on average 54-year-olds, with 37 months of PSH residency, and 43% were taking some action to manage their health (intermediate activation level). Challenges accessing care were due to breakdowns in care, unpleasant experiences with providers, low health literacy and feeling overwhelmed by co-occurring chronic conditions. Health activation related to knowing when to take care of their health on their own and when to seek care. Unique challenges emerged related to PSH, such as lack of resident control within the housing setting and limited personnel responding to health emergencies. These challenges were magnified because residents live alone, per PSH requirements.
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Affiliation(s)
- Monica Perez Jolles
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Dean Rivera
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Gabrielle Jacobs
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Kathleen C Thomas
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Asheville, NC, USA
- Division of Research, UNC Health Sciences at MAHEC, Asheville, NC, USA
| | - Janet U Schneiderman
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Suzanne Wenzel
- Richard M. and Ann L. Thor Professor in Urban Social Development, USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Sekine S, Kobayashi K, Ochiai R, Higaki T. Content validity of the Japanese version of the health literacy and resiliency scale for youth with chronic illness. Front Pediatr 2022; 10:978079. [PMID: 36479281 PMCID: PMC9720298 DOI: 10.3389/fped.2022.978079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
Health literacy, which is the ability to find, understand, and use information as well as services to make informed health-related decisions and actions, is essential for ensuring that youths with chronic diseases adapt to and live with their illnesses. However, in Japan, an appropriate approach for measuring health literacy levels among children is yet to be developed. The Health Literacy and Resiliency Scale for Youth (HLRS-Y) was developed by Kathy Bradley-Klug and her colleagues to assess health literacy, resiliency, and self-advocacy/support among youths aged between 13 and 21 years with chronic illnesses in the United States of America (United States). In this study, we aimed to develop a Japanese version of the HLRS-Y and evaluate its content validity. After receiving approvals from the original authors, four nurse researchers with expertise in pediatric nursing translated the scale into Japanese (forward translation). Afterwards, the appropriateness of each expression was examined by a pediatrician. Next, an English native speaker translated the expressions into English (back-translation). We reported the back-translated version of the scale to the original authors to confirm its accuracy. The scale's content validity index (CVI) was evaluated by health professionals working in the fields of pediatric, transitional, and adult health care. The participants rated the items using a four-point scale. Each item was evaluated for a minimum item-level content validity index (I-CVI) value of 0.78. The scale's total and subscale validities were evaluated using a minimum scale-level content validity index based on an average (S-CVI/Ave) value of 0.90. Eleven participants responded to an online survey for evaluating content validity. Of the 36 items, 34 met the I-CVI criteria. Two items did not exceed the criteria's value, but they approximated it. The values of the S-CVI/Ave were 0.96, thereby satisfying the criteria's requirements. Based on the results, it was confirmed that the Japanese version of the HLRS-Y had good content validity. Future studies should examine the factor validity, known group validity, and reliability of this scale.
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Affiliation(s)
- Saya Sekine
- Department of Child Health Nursing, Graduate School of Nursing Sciences, St. Luke's International University, Tokyo, Japan
| | - Kyoko Kobayashi
- Department of Child Health Nursing, Graduate School of Nursing Sciences, St. Luke's International University, Tokyo, Japan
| | - Ryota Ochiai
- Department of Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Takashi Higaki
- Department of Regional Pediatrics and Perinatology Center for Transition to Adult Congenital Health Disease, Graduate School of Medicine, Ehime University, Ehime, Japan
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Corley EM, Terse P, Paulosky KE, Karsalia M, Nemirovsky A, Malik RD. Patient Frustration with Pelvic Organ Prolapse Education Met with Resilient Response. Neurourol Urodyn 2021; 41:409-415. [PMID: 34783394 DOI: 10.1002/nau.24837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/04/2021] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Limited patient understanding due to challenges in physician-patient communication and inadequate patient education materials (PEMs) can result in poor outcomes after pelvic organ prolapse (POP) repair. Our objective was to identify how patients learned about POP and review their perception of available educational tools. METHODS Patients with a history of POP were recruited using ResearchMatch and invited to participate in a virtual semi-structured interview where they were shown a website, brochure, and video pertaining to POP. Information regarding patient preference for PEMs was obtained. The interviews were transcribed, coded, and qualitative data analysis was performed using grounded theory methodology. RESULTS Qualitative analysis of interviews of 13 participants averaging 58 years old yielded several preliminary themes including: insufficient information to guide treatment decisions, preference for multimodal, dynamic, and comprehensive materials, and lack of support leading to avoidance of care, misinformation, and self-advocacy mechanisms. Emerging concepts included: lack of complete information regarding POP treatment resulted in misinformation, stress and desperation, distrust of healthcare providers leading to feelings of isolation, desire of support groups, and loss of follow up, and a desire for well-organized, detailed, multimodal, and destigmatizing materials as a guide to their disease process, prevention and risk factors, its natural progression, and treatment decisions. Participants developed self-reliant strategies for making treatment decisions, including the use of online resources, advice from friends, and independent search for more specialized physicians. CONCLUSIONS Women with POP reported a lack of information and support which resulted in the generation of self-coping mechanisms. This led to significant anxiety surrounding their diagnosis and treatment and poor satisfaction. Developing a reproducible methodology to create evidence-based PEMs will significantly decrease patient misinformation, apprehension, and use of inaccurate sources of information.
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Affiliation(s)
| | - Pranaya Terse
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Kayla E Paulosky
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Moli Karsalia
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Amy Nemirovsky
- School of Medicine, University of Maryland, Baltimore, Maryland, USA.,Department of Surgery, Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rena D Malik
- School of Medicine, University of Maryland, Baltimore, Maryland, USA.,Department of Surgery, Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Tenorio M, Aparicio A, Arango PS, Fernández AK, Fergusson A, Turull J, Pizarro R. PaísDI: Feasibility and effectiveness of an advocacy program for adults with intellectual disability and their stakeholders' groups in Chile. J Appl Res Intellect Disabil 2021; 35:633-638. [PMID: 34658112 DOI: 10.1111/jar.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with intellectual disability in Chile face individual and collective barriers to social participation. Lack of knowledge about their rights and tools for effective self-advocacy seem to be key elements that need to be improved to facilitate participation. METHOD We present PaísDI, a 16 h long manualised program created by self-advocates in collaboration with an interdisciplinary team, with four modules: rights and intellectual disability, leadership in intellectual disability, effective communication and financial considerations of social projects. This quasi-experimental study had 349 participants, divided in three groups: people with intellectual disability, relatives and professionals. Feasibility and effectiveness where measured. RESULTS The program is shown to be viable and effective, especially in its impact on self-perception for self-advocacy activities. CONCLUSION The discussion highlights Chile's historic debt in creating policies that promote self-determination, knowledge and the empowerment of people with intellectual disability, to bolster their participation as citizens.
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Affiliation(s)
- Marcela Tenorio
- School of Psychology, Universidad de los Andes, Santiago, Chile.,Millennium Institute for Caregiving Research, Santiago, Chile
| | - Andrés Aparicio
- Millennium Institute for Caregiving Research, Santiago, Chile
| | - Paulina Sofía Arango
- School of Psychology, Universidad de los Andes, Santiago, Chile.,Millennium Institute for Caregiving Research, Santiago, Chile
| | | | | | - Jaime Turull
- Millennium Institute for Caregiving Research, Santiago, Chile
| | - Ricardo Pizarro
- Millennium Institute for Caregiving Research, Santiago, Chile
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14
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Leadbitter K, Buckle KL, Ellis C, Dekker M. Autistic Self-Advocacy and the Neurodiversity Movement: Implications for Autism Early Intervention Research and Practice. Front Psychol 2021; 12:635690. [PMID: 33912110 PMCID: PMC8075160 DOI: 10.3389/fpsyg.2021.635690] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
The growth of autistic self-advocacy and the neurodiversity movement has brought about new ethical, theoretical and ideological debates within autism theory, research and practice. These debates have had genuine impact within some areas of autism research but their influence is less evident within early intervention research. In this paper, we argue that all autism intervention stakeholders need to understand and actively engage with the views of autistic people and with neurodiversity as a concept and movement. In so doing, intervention researchers and practitioners are required to move away from a normative agenda and pay diligence to environmental goodness-of-fit, autistic developmental trajectories, internal drivers and experiences, and autistic prioritized intervention targets. Autism intervention researchers must respond to these debates by reframing effectiveness, developing tools to measure autistic prioritized outcomes, and forming partnerships with autistic people. There is a pressing need for increased reflection and articulation around how intervention practices align with a neurodiversity framework and greater emphasis within intervention programmes on natural developmental processes, coping strategies, autonomy, and well-being.
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Affiliation(s)
- Kathy Leadbitter
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Karen Leneh Buckle
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom.,The Autscape Organisation, Coventry, United Kingdom
| | - Ceri Ellis
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Martijn Dekker
- The Autscape Organisation, Coventry, United Kingdom.,The European Council of Autistic People, Prague, Czechia
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15
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Abstract
Covid-19 has been an unprecedented time for social work as a profession and even more so for marginalized communities. This paper shares the reflections of three self-advocates (persons labelled/with intellectual disabilities engaged in advocacy and activism), a social worker, and a social work educator and researcher. It is intended as a rallying cry for social work to rethink how we deliver services to ensure that people who have already been made vulnerable through oppressive ableist practices and assumptions are not put at greater disadvantage at times like Covid-19. Hearing directly from self-advocates, we learn of their exclusion from pandemic planning, and of the ways that physical and social distancing protocols have worked to exacerbate the isolation, marginalization and inequities that people labelled/with intellectual disabilities have experienced over the years. We are called upon to more actively focus on advocacy efforts with people labelled/with intellectual disabilities to increase their involvement in planning, as well as access to supports, and to ensure that they do not remain "the left behind of the left behind" .
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Affiliation(s)
- Ann Fudge Schormans
- Ann Fudge Schormans, School of Social Work,
325 Kenneth Taylor Hall, McMaster University, 1280 Main Street West, Hamilton,
Ontario L8S 4L8, Canada.
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16
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Syan A, Lam JYY, Huang CGL, Smith MSM, Darnay K, Hawke LD, Henderson J. The Wellness Quest: A health literacy and self-advocacy tool developed by youth for youth mental health. Health Expect 2021; 24:659-669. [PMID: 33636052 PMCID: PMC8077157 DOI: 10.1111/hex.13214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/19/2021] [Accepted: 01/23/2021] [Indexed: 11/27/2022] Open
Abstract
Background Less than 20% of youth who experience mental health difficulties access and receive appropriate treatment. This is exacerbated by barriers such as stigma, confidentiality concerns and lack of mental health literacy. A youth team developed the Wellness Quest: a health literacy tool to enable help‐seeking youth to advocate for themselves. Objective To evaluate the content, presentation and utility of the Wellness Quest tool among youth. Participants Participants aged 14 to 26. Methods A youth research team conducted five focus groups and one online survey to evaluate the Wellness Quest tool. Thematic analysis was used to analyse the qualitative data, and descriptive statistics were used to explore the survey results. Main results Overall evaluations of the Wellness Quest were positive: participants felt it would be useful during their mental health help‐seeking journey. Participants expressed the need for information about services for specific populations, such as Indigenous, immigrants, refugees and 2SLGBTQ + youth. They expressed that the tool should be available in complementary online and print versions. Discussion Improving mental health literacy may improve mental health by enabling youth and those who support them to recognize and respond to signs of distress and understanding where and how to get help. The Wellness Quest tool may equip youth with the knowledge to make informed decisions and advocate for their own mental health, thereby facilitating help‐seeking among youth. Patient or public contribution Youth as service users led all stages of the project, from designing and conducting the study and analysing the data to writing the manuscript.
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Affiliation(s)
- Asavari Syan
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Janice Y Y Lam
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | | | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Joanna Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
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17
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Abstract
Researchers define self-advocacy as the ability of an individual with cancer to overcome challenges in getting their preferences, needs, and values met. While imperative in all health care settings, self-advocacy is especially important in cancer care. The goal of this article is to present a conceptual framework for self-advocacy in cancer. We review foundational studies in self-advocacy, define the elements of the conceptual framework, discuss underlying assumptions of the framework, and suggest future directions in this research area. This framework provides an empirical and conceptual basis for studies designed to understand and improve self-advocacy among women with cancer.
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Affiliation(s)
- Teresa H Thomas
- School of Nursing, University of Pittsburgh, Pennsylvania (Drs Thomas, Donovan, Rosenzweig, and Bender); and Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, Pennsylvania (Dr Schenker)
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18
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Hall Pistorio K, Kearney KB, Eshman S, Thomas K, Carey G. Using a Literacy Based Behavioral Intervention to Teach College Students with Intellectual and Developmental Disabilities to Request a Classroom Accommodation. Behav Modif 2020; 45:349-369. [PMID: 33372556 DOI: 10.1177/0145445520982978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Many individuals with an intellectual and developmental disabilities (IDD) are attending postsecondary education programs, yet they are not always proficient in using self-advocacy skills, such as requesting an academic accommodation. Access to these accommodations is vital for success in the postsecondary settings. Literacy based behavioral interventions (LBBIs) use a combination of print, visuals, and rehearsal and are an effective tool for teaching a range of skills including job skills to this population, but have not been investigated with a self-advocacy skill. In this study, a pre-service teacher was taught to deliver an LBBI to postsecondary students with IDD so they would learn to request and use a free online tool to record class lectures. Results showed that students were able to master the skill with the pre-service teacher delivered LBBI and maintain the skill after removal of the LBBI.
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Affiliation(s)
| | | | | | - Kelly Thomas
- Florida Atlantic University, Boca Raton, FL, USA
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19
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Ivzori Y, Sachs D, Reiter S, Schreuer N. Transition to Employment Program (SUPER) for Youth at Risk: A Conceptual and Practical Model. Int J Environ Res Public Health 2020; 17:ijerph17113904. [PMID: 32486404 PMCID: PMC7312591 DOI: 10.3390/ijerph17113904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 11/16/2022]
Abstract
This article describes the development, implementation, and evaluation of the transdisciplinary “Successful Pathways to Employment for youth at Risk” (SUPER) program to raise the transition readiness of youth at risk (YAR) from school into participation in adults’ responsibilities and employment. More than 10% of adolescents are at risk of dropping out of school following poor academic attainments. Schools appraise academic merit but do not develop relevant educational programs to prepare youth to transition into adult working life. The SUPER program addresses a range of knowledge and skills required for this transition. Sixty YAR from three high schools participated in the 18-week SUPER program. Comparing the pre- and postintervention results revealed that the students’ engagement with responsibilities, objective knowledge about the work world, and self-rated self-advocacy skills improved as did their supervisor-rated work performance capacity. This study confirms the contribution of the SUPER model. Its concepts, tools, principles, and community labor-market involvement through workplace internships were effective and could apply in other contexts. The SUPER model provides evidence-based knowledge translation that can bring conceptual and practical changes towards successful transition and participation of YAR in adult working roles.
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Affiliation(s)
- Yonat Ivzori
- The Israeli Ministry of Education, Jerusalem 91911, Israel ;
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
| | - Dalia Sachs
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
| | - Shunit Reiter
- Department of Special Education, Faculty of Education, University of Haifa, Haifa 3498838, Israel;
| | - Naomi Schreuer
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
- Correspondence: ; Tel.: +97-248249477
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20
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Tilley E, Strnadová I, Danker J, Walmsley J, Loblinzk J. The impact of self-advocacy organizations on the subjective well-being of people with intellectual disabilities: A systematic review of the literature. J Appl Res Intellect Disabil 2020; 33:1151-1165. [PMID: 32458590 DOI: 10.1111/jar.12752] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND A high sense of subjective well-being has been associated with more prosocial behaviours, better health, work productivity and positive relationships. The aim of this systematic review was to explore what impact self-advocacy has on the subjective well-being of people with intellectual disabilities. METHOD The authors reviewed articles focusing on the perspectives of adults with intellectual disabilities engaged with self-advocacy groups. Searches were performed in PsychINFO, Web of Science, SCOPUS, MEDLINE and CIHNL databases, resulting in 16 articles meeting the inclusion criteria. A framework synthesis approach was used to extract data deductively based on the Dynamic Model of Wellbeing. RESULTS While self-advocacy has a positive impact on all domains of the Dynamic Model of Wellbeing, negative impacts associated with participation in a self-advocacy group were also reported. CONCLUSIONS The benefits of participating in self-advocacy groups on the well-being of individuals with intellectual disabilities outweigh the disadvantages.
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Affiliation(s)
- Elizabeth Tilley
- Faculty of Wellbeing, Education and Language Studies, The Open University Milton Keynes, Milton Keynes, UK
| | - Iva Strnadová
- School of Education, University of New South Wales, Sydney, NSW, Australia
| | - Joanne Danker
- School of Education, University of New South Wales, Sydney, NSW, Australia
| | - Jan Walmsley
- The Open University Milton Keynes, Milton Keynes, UK
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21
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Thompson C, McDonald J, Kidd T, Falkmer T, Bölte S, Girdler S. "I don't want to be a patient": Peer mentoring partnership fosters communication for autistic university students. Scand J Occup Ther 2020; 27:625-640. [PMID: 32180486 DOI: 10.1080/11038128.2020.1738545] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Despite recognition of the benefits of post-school education in improving life outcomes for autistic adults their university completion rates remain low.Aim: To explore the experiences of undergraduate autistic university students participating in specialist peer mentoring (SPM) to identify active ingredients in the peer mentoring process and to examine the impact of SPM on social communication.Material and method: A total of 30 (8 female; M age = 22.3; SD = 6.7) undergraduate autistic university students engaged in SPM participated in this study. A quantitative pre-test post-test design examined changes in autistic traits. In parallel, the experiences of participating in SPM were explored through semi-structured interviews.Results: Improvements were noted at post-test on the Social Responsiveness Scale-2 total score p = 0.02), and its Social Communication, (p = 0.03) and Social Motivation (p = 0.03) sub-scales. Four themes emerged from the interviews: Developing Partnership and Understanding, Modelling and Practising Communication, Psychological Support and Grading and Planning Skills.Conclusions: These results indicated that the mentor-mentee partnership was a crucial active ingredient of SPM. This partnership appeared to modify social cognition and motivation for autistic university students through modelling and practising communication.Significance: These results demonstrate that SPM can support participation at university for autistic university students.
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Affiliation(s)
- C Thompson
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - J McDonald
- Counselling and Disability Services, Curtin University, Perth, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - T Kidd
- School of Psychology, Curtin University, Perth, Australia.,Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - T Falkmer
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - S Bölte
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet and Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - S Girdler
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
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22
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Taylor S, Wilson E, Murfitt K, Balandin S. Communication access in the retail environment for people with complex communication needs. Disabil Rehabil 2020; 43:3189-3198. [PMID: 32126184 DOI: 10.1080/09638288.2020.1733108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To identify what facilitates retail communication access for people with complex communication needs, and the impact of communication in this context on social inclusion.Materials and method: Seven adults with lifelong or acquired complex communication needs who used augmentative and alternative communication devices (AAC) and nine retailers participated in interviews to determine factors that contributed to communication access and inclusion. Interview data were analysed using the grounded theory method within an ecological model of social inclusion.Results: Retail participants did not differentiate between disabilities and their lack of understanding of complex communication needs was a barrier to inclusion. Participants with complex communication needs had received little preparation from speech-language pathologists on how to use AAC effectively when shopping. Communication access was achieved predominantly through participants' individual self-advocacy.Conclusions: Organisational and systemic measures are needed to better inform retailers about their responsibilities toward people who use AAC. Business prioritisation of communication access, government programs that differentiate and support people with lesser-known disabilities such as complex communication needs, and speech-language pathology support to use AAC in the retail environment is likely to improve communication access and social inclusion.Implications for rehabilitationThere is an urgent need to consider.Social policy that differentiates people with complex communication needs and contributes to public awareness of their communication needs.Directly-delivered training for retailers on adjustments for communication access for people with CCN.Support from local disability advocates, speech-language pathologists and disability services for self-advocacy with retailers by people with CCN.Early training aimed at all stakeholders by speech-language therapists in the use of speech generating devices when retail shopping.
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Affiliation(s)
- Susan Taylor
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia
| | - Erin Wilson
- Faculty of Business and Law, Swinburne University of Technology, Hawthorn, Australia
| | - Kevin Murfitt
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia
| | - Susan Balandin
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Australia
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23
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Fenn K, Scior K. The psychological and social impact of self-advocacy group membership on people with intellectual disabilities: A literature review. J Appl Res Intellect Disabil 2019; 32:1349-1358. [PMID: 31210394 DOI: 10.1111/jar.12638] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 04/08/2019] [Accepted: 05/28/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is no one agreed definition of self-advocacy, but it can be taken to include actions and concepts such as standing up for one's rights and self-determination. METHOD A review of studies examining the psychological and social impact of self-advocacy group membership on people with intellectual disabilities was conducted. Systematic searches of electronic databases (PsycINFO, Scopus, Web of Science and ProQuest's Sociology Database), and manual searches of reference lists and citations, identified 12 studies. RESULTS "Empowerment" and "increased confidence" were frequently reported outcomes. "Belonging," increased opportunities for social connections and changed self-identity were also key themes. CONCLUSIONS Limitations of the review included difficulty categorizing outcomes, and limitations of the evidence base included a lack of quantitative studies. Implications of the review include an observation that the role of self-advocates in the research literature could be extended to the co-construction of research agendas.
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Affiliation(s)
| | - Katrina Scior
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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24
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Watchman K, Janicki MP, Udell L, Hogan M, Quinn S, Beránková A. Consensus statement of the International Summit on Intellectual Disability and Dementia on valuing the perspectives of persons with intellectual disability. J Intellect Disabil 2019; 23:266-280. [PMID: 29343166 DOI: 10.1177/1744629517751817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The International Summit on Intellectual Disability and Dementia covered a range of issues related to dementia and intellectual disability, including the dearth of personal reflections of persons with intellectual disability affected by dementia. This article reflects on this deficiency and explores some of the personal perspectives gleaned from the literature, from the Summit attendees and from the experiences of persons with intellectual disability recorded or scribed in advance of the two-day Summit meeting. Systemic recommendations included reinforcing the value of the involvement of persons with intellectual disability in (a) research alongside removing barriers to inclusion posed by institutional/ethics review boards, (b) planning groups that establish supports for dementia and (c) peer support. Practice recommendations included (a) valuing personal perspectives in decision-making, (b) enabling peer-to-peer support models, (c) supporting choice in community-dwelling arrangements and (d) broadening availability of materials for persons with intellectual disability that would promote understanding of dementia.
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Affiliation(s)
| | | | | | | | - Sam Quinn
- University of the West of Scotland, Scotland
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25
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Hagan TL, Gilbertson-White S, Cohen SM, Temel JS, Greer JA, Donovan HS. Symptom Burden and Self-Advocacy: Exploring the Relationship Among Female Cancer Survivors. Clin J Oncol Nurs 2019; 22:E23-E30. [PMID: 29350706 DOI: 10.1188/18.cjon.e23-e30] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although patient self-advocacy is a critical component of patient-centered care, the association between symptom burden and self-
advocacy has received little attention.
. OBJECTIVES This analysis evaluates the degree to which self-advocacy is associated with symptom burden among women with a history of cancer.
. METHODS Participants completed online or paper questionnaires. Descriptive statistics and ordinary least squares regression models were used to analyze the association between the three dimensions of self-advocacy and two dimensions of symptom burden. FINDINGS Participants reported moderate levels of symptom burden. Fatigue, disturbed sleep, and memory problems were most common. Informed decision making was positively associated with symptom burden and participants' burden across the three most severe symptoms. Effective communication was negatively associated with total symptom burden and the degree to which symptoms interfered with daily life.
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26
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Strnadová I, Johnson K, Walmsley J. "… but if you're afraid of things, how are you meant to belong?" What belonging means to people with intellectual disabilities? J Appl Res Intellect Disabil 2018; 31:1091-1102. [PMID: 29761916 DOI: 10.1111/jar.12469] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND A policy commitment to social inclusion has brought about some positive changes in the lives of people with intellectual disabilities; yet many also continue to experience social isolation, poverty and abuse. The authors introduce a framework for belonging from the literature and then present a study exploring the views of people with intellectual disabilities about belonging. These are discussed in relation to the framework identified from the literature. METHOD Three focus groups with 24 participants with intellectual disabilities were conducted in New South Wales and Victoria (Australia). The authors used inductive content analysis to identify four meanings of belonging: (i) belonging in relation to place, (ii) as being part of a community, (iii) as having relationships and (iv) as identity. Also discussed are commonly experienced barriers to belonging identified by participants. CONCLUSIONS Implications for policy, service provision and practice are discussed.
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Affiliation(s)
- Iva Strnadová
- Faculty of Arts & Social Sciences, School of Education, University of New South Wales, Sydney, Australia
| | - Kelley Johnson
- Faculty of Arts & Social Sciences, University of New South Wales, Sydney, Australia
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27
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Hotez E, Shane-Simpson C, Obeid R, DeNigris D, Siller M, Costikas C, Pickens J, Massa A, Giannola M, D'Onofrio J, Gillespie-Lynch K. Designing a Summer Transition Program for Incoming and Current College Students on the Autism Spectrum: A Participatory Approach. Front Psychol 2018; 9:46. [PMID: 29487547 PMCID: PMC5816926 DOI: 10.3389/fpsyg.2018.00046] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/11/2018] [Indexed: 01/13/2023] Open
Abstract
Students with Autism Spectrum Disorder (ASD) face unique challenges transitioning from high school to college and receive insufficient support to help them navigate this transition. Through a participatory collaboration with incoming and current autistic college students, we developed, implemented, and evaluated two intensive week-long summer programs to help autistic students transition into and succeed in college. This process included: (1) developing an initial summer transition program curriculum guided by recommendations from autistic college students in our ongoing mentorship program, (2) conducting an initial feasibility assessment of the curriculum [Summer Transition Program 1 (STP1)], (3) revising our initial curriculum, guided by feedback from autistic students, to develop a curriculum manual, and (4) pilot-testing the manualized curriculum through a quasi-experimental pre-test/post-test assessment of a second summer program [Summer Transition Program 2 (STP2)]. In STP2, two autistic college students assumed a leadership role and acted as "mentors" and ten incoming and current autistic college students participated in the program as "mentees." Results from the STP2 pilot-test suggested benefits of participatory transition programming for fostering self-advocacy and social skills among mentees. Autistic and non-autistic mentors (but not mentees) described practicing advanced forms of self-advocacy, specifically leadership, through their mentorship roles. Autistic and non-autistic mentors also described shared (e.g., empathy) and unique (an intuitive understanding of autism vs. an intuitive understanding of social interaction) skills that they contributed to the program. This research provides preliminary support for the feasibility and utility of a participatory approach in which autistic college students are integral to the development and implementation of programming to help less experienced autistic students develop the self-advocacy skills they will need to succeed in college.
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Affiliation(s)
- Emily Hotez
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States.,College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States
| | - Christina Shane-Simpson
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,College of Staten Island, New York, NY, United States.,University of Wisconsin-Stout, Menomonie, WI, United States
| | - Rita Obeid
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,Lehman College, City University of New York, New York, NY, United States
| | | | - Michael Siller
- Emory University School of Medicine, Atlanta, GA, United States
| | | | - Jonathan Pickens
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,College of Staten Island, New York, NY, United States
| | - Anthony Massa
- College of Staten Island, New York, NY, United States
| | | | | | - Kristen Gillespie-Lynch
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,College of Staten Island, New York, NY, United States
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28
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Abstract
Self-advocacy plays an important role in facilitating the empowerment of people with intellectual and developmental disabilities (IDD), and helps people with IDD develop the skills necessary for the participant direction of services. The purpose of this study was to examine Medicaid Home and Community Based Services (HCBS) 1915(c) waivers across the nation to determine how states were utilizing self-advocacy services for people with IDD. Findings revealed approximately half of waivers provided self-advocacy services; however, less than .01% of waiver spending was projected for stand-alone self-advocacy services. States need to expand the provision of self-advocacy services for people with IDD in order to strengthen their ability to direct their waiver services and exercise their rights.
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Affiliation(s)
- Carli Friedman
- Carli Friedman, CQL | The Council on Quality and Leadership
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Gillespie-Lynch K, Bublitz D, Donachie A, Wong V, Brooks PJ, D’Onofrio J. "For a Long Time Our Voices have been Hushed": Using Student Perspectives to Develop Supports for Neurodiverse College Students. Front Psychol 2017; 8:544. [PMID: 28458645 PMCID: PMC5394111 DOI: 10.3389/fpsyg.2017.00544] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/24/2017] [Indexed: 11/25/2022] Open
Abstract
Although the challenges that autistic students face adapting to college are often pronounced, they are similar to the challenges that students with other disabilities face (e.g., difficulties with social interaction, self-advocacy, and executive functioning). However, extant evaluations of services for autistic college students are very limited despite an emerging literature examining supports for college students with a range of other disabilities. Given that many autistic students do not self-identify as autistic in college, and consequently might avoid autism-specific services, autistic students might benefit from services that are designed to support a broad range of neurodiverse students, or services that are structured according to the principles of Universal Design. In order to develop such services, we assessed the self-reported needs of autistic college students and their peers with other disabilities. Guided by needs assessments and feedback from students, we developed and evaluated two semesters of mentor-led group programming for autistic college students and students with other disabilities. The first semester of the program focused on social skills; after receiving feedback from participants, the curriculum for the second semester focused on self-advocacy. Participation in social-skills groups was associated with decreased anxiety and autism symptoms. Participation in self-advocacy groups was associated with increased perceived social support from friends, academic self-efficacy, and more accurate definitions of self-advocacy. This research suggests that supports for neurodiverse college students should be developed with their input and should include opportunities to engage with diverse peers.
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Affiliation(s)
- Kristen Gillespie-Lynch
- Department of Psychology, College of Staten Island and The Graduate Center, The City University of New York, New YorkNY, USA
| | - Dennis Bublitz
- Department of Psychology, College of Staten Island and The Graduate Center, The City University of New York, New YorkNY, USA
| | - Annemarie Donachie
- Department of Psychology, College of Staten Island, The City University of New York, New YorkNY, USA
| | - Vincent Wong
- Department of Psychology, College of Staten Island, The City University of New York, New YorkNY, USA
| | - Patricia J. Brooks
- Department of Psychology, College of Staten Island and The Graduate Center, The City University of New York, New YorkNY, USA
| | - Joanne D’Onofrio
- Center for Student Accessibility, College of Staten Island, The City University of New York, New YorkNY, USA
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Redmond E, Richardson J. Supporting Disabled People's Independence With Digital Skills in the Community. Stud Health Technol Inform 2017; 242:864-869. [PMID: 28873898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This presentation discusses research by Good Things Foundation with community organisations supporting disabled people within the national Online Centres network, to explore the barriers to digital inclusion (DI) they face. The research informed a handbook to help similar organisations get disabled people online.
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Abstract
The aim of this qualitative study was to explore the perception of women regarding long-term effects of childbirth education on future health-care decision making. This qualitative study used a purposive sample of 10 women who participated in facilitated focus groups. Analysis of focus group narratives provided themes in order of prevalence: (a) self-advocacy, (b) new skills, (c) anticipatory guidance, (d) control, (e) informed consent, and (f) trust. This small exploratory study does not answer the question of whether childbirth education influences future health-care decision making, but it demonstrates that the themes and issues from participants who delivered 15-30 years ago were comparable to current findings in the literature.
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Reindl MS, Waltz M, Schippers A. Personalization, self-advocacy and inclusion: An evaluation of parent-initiated supported living schemes for people with intellectual and developmental disabilities in the Netherlands. J Intellect Disabil 2016; 20:121-136. [PMID: 26864287 DOI: 10.1177/1744629516631449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/17/2016] [Indexed: 06/05/2023]
Abstract
This study focused on parent-initiated supported living schemes in the South of the Netherlands and the ability of these living schemes to enhance participation, choice, autonomy and self-advocacy for people with intellectual or developmental disabilities through personalized planning, support and care. Based on in-depth interviews with tenants, parents and caregivers, findings included that parent-initiated supported housing schemes made steps towards stimulating self-advocacy and autonomy for tenants. However, overprotective and paternalistic attitudes expressed by a significant number of parents, as well as structural constraints affecting the living schemes, created obstacles to tenants' personal development. The study calls for consideration of interdependence as a model for the relationship of parents and adult offspring with disabilities. The benefits and tensions inherent within this relationship must be taken into consideration during inclusive community building.
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Power A, Bartlett R, Hall E. Peer advocacy in a personalized landscape: The role of peer support in a context of individualized support and austerity. J Intellect Disabil 2016; 20:183-193. [PMID: 26920751 DOI: 10.1177/1744629516634561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 06/05/2023]
Abstract
Whilst personalization offers the promise of more choice and control and wider participation in the community, the reality in the United Kingdom has been hampered by local council cuts and a decline in formal services. This has left many people with intellectual disabilities feeling dislocated from collective forms of support (Needham, 2015). What fills this gap and does peer advocacy have a role to play? Drawing on a co-researched study undertaken with and by persons with intellectual disabilities, we examined what role peer advocacy can play in a context of reduced day services, austerity and individualized support. The findings reveal that peer advocacy can help people reconnect in the face of declining services, problem-solve issues and informally learn knowledge and skills needed to participate in the community. We argue that peer advocacy thus offers a vital role in enabling people to take up many of the opportunities afforded by personalization.
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Hann K, Pearson H, Campbell D, Sesay D, Eaton J. Factors for success in mental health advocacy. Glob Health Action 2015; 8:28791. [PMID: 26689456 PMCID: PMC4685298 DOI: 10.3402/gha.v8.28791] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition - Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. DESIGN The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. RESULTS Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. CONCLUSIONS The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings.
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Affiliation(s)
- Katrina Hann
- Mental Health Coalition - Sierra Leone, Freetown, Sierra Leone;
| | | | - Doris Campbell
- Mental Health Coalition - Sierra Leone, Freetown, Sierra Leone
| | - Daniel Sesay
- Mental Health Coalition - Sierra Leone, Freetown, Sierra Leone
| | - Julian Eaton
- CBM International, Lomé, Togo
- Centre for Global Mental Health, LSHTM, London School of Hygiene and Tropical Medicine, London, UK
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Anderson S, Bigby C. Self-Advocacy as a Means to Positive Identities for People with Intellectual Disability: 'We Just Help Them, Be Them Really'. J Appl Res Intellect Disabil 2015; 30:109-120. [PMID: 26514344 DOI: 10.1111/jar.12223] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stigma attached to having an intellectual disability has negative implications for the social identities and inclusion of people with intellectual disability. AIM The study explored the effects of membership of independent self-advocacy groups on the social identity of people with intellectual disability. METHOD Using a constructivist grounded theory methodology, semi-structured interviews were conducted with 25 members of six self-advocacy groups which varied in size, resources, location and policy context: two based in the Australian states of Victoria and Tasmania and four in the UK. RESULTS Collegiality, ownership and control by members characterized groups. They gave members opportunities for paid or voluntary work, skill development and friendship which contributed to their confidence and engagement with life. Possibilities for new more positive identities such as being an expert, a business-like person, a self-advocate and an independent person were opened up. Self-advocacy is an important means of furthering social inclusion of people with intellectual disability.
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Affiliation(s)
- Sian Anderson
- Living with Disability Research Centre, La Trobe University, Bundoora, Vic., Australia
| | - Christine Bigby
- Living with Disability Research Centre, La Trobe University, Bundoora, Vic., Australia
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Clarke R, Camilleri K, Goding L. What's in it for me? The meaning of involvement in a self-advocacy group for six people with intellectual disabilities. J Intellect Disabil 2015; 19:230-250. [PMID: 25688140 DOI: 10.1177/1744629515571646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND This article explores the experiences of six people with intellectual disabilities in the context of a self-advocacy group, identifying the benefits and difficulties of being part of the group. MATERIALS AND METHODS Six adults with intellectual disabilities were interviewed about their experiences. Each individual took part in two individual and two group interviews. The transcripts were analysed using thematic analysis. RESULTS Analysis revealed four themes, namely, being part of the group, self-esteem, self-determination and empowerment. CONCLUSION Being part of the group is central to the experience of self-esteem, self-development and empowerment. Responses allow the exploration of the interrelationship between individual, group and community. Consideration is given to models of disability and the evidence base in relation to personal and political outcomes of self-advocacy. Links are made with developing a sense of self, self-determination, interpersonal learning and building resilience. Implications for practice are discussed.
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Abstract
AIM To inform rehabilitation professionals' role in supporting transition to higher education through identification and description of disability related needs experienced by university students. METHODS Participants were recruited from a large research-intensive university in the southeastern United States and included 13 students eligible for university disability services, 9 university personnel, and 1 parent of a university student with a disability. Disabilities of study participants were invisible; all but one chose to disclose diagnostic information. Data from 15 individual interviews and 2 focus groups were analyzed for themes. RESULTS The Navigating Parallel Demands theme elucidates the ways disability related needs extended beyond the classroom to areas of health and wellness, social, and daily living. Navigation in Context describes personal and environmental circumstances surrounding processes used to meet a broad-range of demands. CONCLUSION University participation requires students with disabilities to navigate and manage a wide range of demands while securing appropriate supports. Findings inform rehabilitation professionals in providing anticipatory guidance when preparing students with invisible disabilities for postsecondary educational transitions.
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Affiliation(s)
- Consuelo M Kreider
- a 1 Department of Occupational Therapy , College of Public Health and Health Professions, University of Florida , Gainesville, Florida, USA
| | - Roxanna M Bendixen
- b 2 Department of Occupational Therapy, School of Health and Rehabilitation Sciences , University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Barbara J Lutz
- c 3 School of Nursing , University of North Carolina at Wilmington , Wilmington, North Carolina, USA
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Dryden EM, Desmarais J, Arsenault L. Effectiveness of the IMPACT:Ability program to improve safety and self-advocacy skills in high school students with disabilities. J Sch Health 2014; 84:793-801. [PMID: 25388596 DOI: 10.1111/josh.12211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 05/30/2014] [Accepted: 06/25/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Individuals with disabilities experience higher rates of abuse than the nondisabled. Few evidence-based prevention interventions have been published despite a need for such work. This study evaluated IMPACT Ability, a safety and self-advocacy training for individuals with cognitive and/or physical disabilities. METHODS A quasi-experimental design was used to assess change in safety and self-advocacy knowledge, confidence, and behaviors among special education high school students in Boston, MA. Instruments were interviewer-administered at 3 time points. Analysis of covariance (ANCOVA) was used to compare change between the intervention (N = 21) and wait-list (N = 36) groups. Repeated measures analysis was used to test change in the complete sample (N = 57). RESULTS Students were diverse (58% males, 82% nonwhite) with a range of disabilities. Significantly greater improvement in key outcomes, including safety and self-advocacy knowledge, confidence, and behavior, were observed in intervention students compared to the wait-list group. Results in the complete sample showed evidence of further improvements in students' sense of safety and general self-efficacy. CONCLUSIONS These findings are encouraging given the effects were demonstrated in a heterogeneous urban population. IMPACT Ability may be an effective safety and self-advocacy training for students with disabilities. Further research will be required to determine effectiveness within particular subpopulations of students.
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Affiliation(s)
- Eileen M Dryden
- Institute for Community Health, Harvard Medical School, 163 Gore St., Cambridge, MA 02141.
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Abstract
BACKGROUND A community-based occupational therapy program aims to provide client-centered and occupation-based interventions to at-risk youth. OBJECTIVE This pilot study explores how at-risk youth experiencing psychosocial and environmental barriers to occupation respond to client-centered and occupation-based occupational therapy in the community. METHOD One-on-one semi-structured interviews were conducted with five youth participants receiving individual therapy interventions through a community-based occupational therapy program. The transcript data were analyzed qualitatively. RESULTS Three themes emerged: (i) client-centered and occupation-based OT interventions, (ii) the youths' increased self-advocacy, and (iii) the enhancement of youths' perception of their future. CONCLUSION AND SIGNIFICANCE The youth in this study described OT interventions exemplifying client-centered and occupation-based therapy, a non-prescriptive approach that validates the individual and may prove especially effective in serving the at-risk youth population.
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Affiliation(s)
- Chi-Kwan Shea
- Occupational Therapy Department, Samuel Merritt University , Oakland, CA , USA
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Kramer JM, Roemer K, Liljenquist K, Shin J, Hart S. Formative evaluation of project TEAM (Teens Making Environment and Activity Modifications). Intellect Dev Disabil 2014; 52:258-272. [PMID: 25061770 DOI: 10.1352/1934-9556-52.4.258] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Research documents the negative impact of physical and social environmental barriers on engagement in school, work, and the community for youth with intellectual and /or developmental disabilities (IDD). Project TEAM (Teens making Activity and Environment Modifications) was designed to teach youth to systematically identify environmental barriers, generate modification strategies, and request accommodations. This formative evaluation used a mixed methods expansion design to investigate outcomes, activities, and experiences. Trainees had a significant increase in knowledge of environmental factors and modification strategies but no changes in applied problem-solving. 76% attained at least one goal as measured through goal attainment scaling. Intervention activities ranged in quality. Trainees enjoyed the interactive and applied aspects of Project TEAM but found some concepts and materials difficult to understand. Lessons learned from this comprehensive evaluation can inform future revisions to Project TEAM and may be equally relevant for other researchers evaluating programs targeting transition-age youth with IDD.
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Bellman S, Burgstahler S, Ladner R. Work-based learning experiences help students with disabilities transition to careers: a case study of University of Washington projects. Work 2013; 48:399-405. [PMID: 24284672 DOI: 10.3233/wor-131780] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This case study describes evidence-based practices employed by a collection of University of Washington projects that engage high school and postsecondary students with disabilities in work-based learning experiences such as industry and research internships, career development activities, job shadows, field trips, and mock interviews. The purpose of the article is two-fold. First, authors share best practices with others who wish to increase the participation of students with disabilities in work-based learning and thereby contribute to their academic and career success. The article discusses methods used to recruit students, employers and mentors, match students with specific opportunities, and prepare students for success. Second, authors share outcomes from studies regarding participation in these work-based learning opportunities, which include increased employment success, motivation to work toward a career, knowledge about careers and the workplace, job-related skills, ability to work with supervisors and coworkers, skills in self-advocating for accommodations, and perceived career options.
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Abstract
AIM To report an analysis of the concept of self-advocacy among individuals with cancer to clarify its meaning, to differentiate this meaning with related concepts, and to unify understanding of the concept in cancer research and practice. BACKGROUND Cancer survivors are increasingly required to assume an active role in their health care. A thorough analysis of how survivors advocate for themselves is a crucial aspect in supporting survivors' ability to engage and manage their care throughout all stages of cancer survivorship. DESIGN Walker and Avant's eight-step process of conducting a concept analysis was used. DATA SOURCES PubMed, PsycINFO, and CINAHL databases were searched for articles, reviews, editorials, and grey literature directly addressing self-advocacy. REVIEW METHODS A broad inquiry into the literature from 1960 to 2012 that produces a definition of self-advocacy. Model and contrary cases of self-advocacy demonstrate the concept's application and intricacies. RESULTS Antecedents to self-advocacy include particular personal characteristics, learned skills, and attainable support. The essential element of self-advocacy and what differentiates it from related concepts, is the internalization of these antecedent resources into self-advocacy thoughts and actions while incorporating personal values and priorities in a way that upholds the survivors' goals and beliefs. A full realization of self-advocacy facilitates a cancer survivor attaining a strong self-concept, sense of control, and adaptation to a life with cancer. CONCLUSIONS Self-advocacy is a process of internalizing skills and resources to act in a way that supports survivors' needs and goals.
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Affiliation(s)
- Teresa L Hagan
- Department of Acute and Tertiary Care, The University of Pittsburgh School of Nursing, PA, USA
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Affiliation(s)
- Corinna West
- Mental Health America of the Heartland, 739 Minnesota Avenue, Kansas City, KS 66101, USA.
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Nicolaidis C, Raymaker D, McDonald K, Dern S, Ashkenazy E, Boisclair C, Robertson S, Baggs A. Collaboration strategies in nontraditional community-based participatory research partnerships: lessons from an academic−community partnership with autistic self-advocates. Prog Community Health Partnersh 2011; 5:143-50. [PMID: 21623016 PMCID: PMC3319698 DOI: 10.1353/cpr.2011.0022] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed community defined by disability, experience issues in research similar to those expressed by more traditional minorities. OBJECTIVES We sought to build an academic-community partnership that uses CBPR to improve the lives of people on the autistic spectrum. METHODS The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) includes representatives from academic, self-advocate, family, and professional communities. We are currently conducting several studies about the health care experiences and well-being of autistic adults. LESSONS LEARNED We have learned a number of strategies that integrate technology and process to successfully equalize power and accommodate diverse communication and collaboration needs. CONCLUSIONS CBPR can be conducted successfully with autistic self-advocates. Our strategies may be useful to other CBPR partnerships, especially ones that cannot meet in person or that include people with diverse communication needs.
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