Disability and receipt of clinical preventive services among women

Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey 08854, USA.
Women s Health Issues (Impact Factor: 1.61). 11/2006; 16(6):286-96. DOI: 10.1016/j.whi.2006.09.002
Source: PubMed


More individuals are surviving catastrophic injuries and living longer with persistent disability; however, their receipt of clinical preventive services is not well understood as compared with those without disabilities given the dual focus of care on both primary prevention and the prevention of secondary complications related to their disabilities.
Longitudinal analyses of 1999-2002 Medical Expenditure Survey (MEPS). Study sample consisted of 3,183 community-dwelling women aged 51-64 years and followed for 2 full years. Women with disabilities were defined as having reported any limitation in any area of activity of daily living in 2 years. Recommended clinical preventive services were defined as receiving the following at the recommended intervals: colorectal, cervical, and breast cancer; cholesterol screening; and influenza immunization. chi(2) tests and multiple logistic regressions were used to examine variations in use of clinical preventive services.
Overall, 23% of the women in the study (n = 835) were disabled. Disabled women, however, were less likely to receive mammography and Pap smears within the recommended intervals. However, disabled women were more likely to receive influenza immunization, cholesterol screening, and colorectal screening within the recommended intervals. Among the disabled, usual source of care and health insurance remained significant predictors of receipt of clinical preventive services across all types,
Disabled women were less likely to receive some of the cancer screening services, suggesting a need for targeted interventions to promote breast cancer and cervical cancer screening. Increased access to health care insurance and health care providers may also help.

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    • "A great proportion of aboriginal people reside in rural areas, and the medical vehicles that provide Pap smear tests regularly visit these areas to offer health care services, thereby improving the Pap smear test usage rate among aboriginal women. The Pap smear test usage rate of the married population was substantially greater than that of the unmarried population, which is consistent with the findings reported in previous studies [6,22,27]. This phenomenon may be because of the common misconception held by the public and physicians that unmarried people do not or seldom engage in sexual activity and, thus, are less susceptible to cervical cancer. "
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    ABSTRACT: Background This study examines the Pap smear usage conditions and relevant influential factors for 18,204 women aged 30 years and above with intellectual disabilities, using nationwide data from 2008. Methods The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of Pap smear testing by women with intellectual disabilities. Chi-square test was used to assess the correlation between Pap smear test usage and several variables. Logistic regression analysis was employed to explore the factors that influence Pap smear test usage. Results The results show that 4.83% (n =880) of women with intellectual disabilities underwent Pap smear tests. Pap smear test usage rates exhibit a declining trend with increases in age. Factors that significantly influence Pap smear test use include age, urbanization level of resident area, monthly salary, aboriginal status, marital status, existence of DM, severity of disability. Conclusions The women with intellectual disabilities had a low use rate of Pap smear test, which is significantly less than the 28.8% usage rate for the general population of women aged 30 years and above.
    BMC Health Services Research 06/2014; 14(1):240. DOI:10.1186/1472-6963-14-240 · 1.71 Impact Factor
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    • "Health disparities for intellectual and developmental disabilities (I/DD) often exist, including poorer health, unmet health needs, and problematic access to primary and preventive health services [1] [2] [3] [4] [5] [6] including preventive oral health services and severe oral health disparities. The safety net to offset these disparities in oral health is lacking in a comprehensive system of care [7]. "
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    ABSTRACT: Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP) students. Phase 2 includes evaluation of GNP students' perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3.
    04/2012; 2012:157874. DOI:10.1155/2012/157874
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    • "Intrapersonal factors include barriers to communication with clinicians or clinic staff and insufficient clinician knowledge about disabilities (Nosek et al., 1995). Environmental factors that influence receipt of CPS by WWD include transportation, health insurance coverage, and accommodation in the health care setting (Mele, Archer, & Pusch, 2005; Nosek et al., 1995; Scheer, Kroll, Neri, & Beatty, 2003; Smeltzer, 2006; Wei et al., 2006). Many physicians' offices are not equipped with scales accessible to people with disabilities, especially wheelchair users (Graham & Mann, 2008). "
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    ABSTRACT: This article describes the development of Promoting Access to Health Services (PATHS), an intervention to promote regular use of clinical preventive services by women with physical disabilities. The intervention was developed using intervention mapping (IM), a theory-based logical process that incorporates the six steps of assessment of need, preparation of matrices, selection of theoretical methods and strategies, program design, program implementation, and evaluation. The development process used methods and strategies aligned with the social cognitive theory and the health belief model. PATHS was adapted from the workbook Making Preventive Health Care Work for You, developed by a disability advocate, and was informed by participant input at five points: at inception through consultation by the workbook author, in conceptualization through a town hall meeting, in pilot testing with feedback, in revision of the curriculum through an advisory group, and in implementation by trainers with disabilities. The resulting PATHS program is a 90-min participatory small-group workshop, followed by structured telephone support for 6 months.
    Health Promotion Practice 11/2010; 13(1):106-15. DOI:10.1177/1524839910382624 · 0.55 Impact Factor
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