Meg Ann Traci

Assessing Secondary Conditions among Adults with Developmental Disabilities: A Preliminary Study.

Pope (1992) asserted that there was a significant need to examine secondary conditions among individuals with development disabilities. In the present study we focused on that need. The development of a secondary conditions surveillance instrument is described, as are the results of a pilot survey conducted with adults receiving state developmental disabilities program supports and with their direct-care service providers. Results of a pilot survey are presented to illustrate how survey data might be used to improve systems of services and supports to enhance the health and participation of adults with developmental disabilities in community life.

Disability and health behavior change

OBJECTIVE/HYPOTHESIS We conducted a review of four health behavior change (HBC) theories (Health Belief, Theory of Planned Behavior, Social Cognitive, and Transtheoretical) to consider how these theories conceptually apply to people with disabilities. METHODS We identified five common constructs across HBC theories and examined how these commonalities fit within the International Classification of Function (ICF). RESULTS Four of the HBC constructs appear to be Personal Factors within the ICF, while the fifth represents Environmental Factors. CONCLUSIONS Using the ICF framework to understand disability and HBC, we propose that including a sense of meaning as another personal factor will further develop HBC theories that lead to more effective HBC interventions for people with disabilities.

Nutrition Education and Support Program for Community-Dwelling Adults with Intellectual Disabilities.

To test the efficacy, acceptability, and appropriateness of a nutrition education and support program, 4 community-based group homes for adults with intellectual or developmental disabilities participated in a pilot intervention with extended baseline period and pre-post-test design. Adults (N = 32) with intellectual or developmental disabilities, 20 direct service staff, 4 managers of group homes, and 2 health specialists at private service providers participated in the intervention, consisting of a system of nutrition supports in nutrition education and guidelines, menu and meal planning, grocery shopping, and cooking designed for the special needs of this population. Positive impacts were found using the program, including fidelity measures, food systems changes and acceptability to users, planned and served foods, and cost changes associated with implementation.

Prevention of secondary health conditions in adults with developmental disabilities: a review of the literature

PURPOSE To compile empirical findings regarding prevention strategies for secondary conditions experienced by adults with developmental disabilities. METHOD The PsycLit and PubMed databases were searched for articles addressing the 20 most pervasive secondary conditions and the prevention of secondary conditions in general. RESULTS Of more than 2000 articles examined, 25 met criteria for inclusion. None could be categorized as a primary approach to prevention, 19 involved secondary and six involved tertiary approaches. The majority included between one and ten participants. Nine studies involved the administration of treatment, three providing certain experiences, two chart review, and 11 a training approach. Injuries due to self-abuse, communication problems, dental hygiene problems, and problems with memory, persistence and mobility were addressed. CONCLUSION Little is known regarding the prevention of secondary conditions within this population. The authors stress the necessity to focus research efforts on greater understanding of the linkage between disability, rehabilitation and public health models.Purpose: To compile empirical findings regarding prevention strategies for secondary conditions experienced by adults with developmental disabilities. Method: The PsycLit and PubMed databases were searched for articles addressing the 20 most pervasive secondary conditions and the prevention of secondary conditions in general. Results: Of more than 2000 articles examined, 25 met criteria for inclusion. None could be categorized as a primary approach to prevention, 19 involved secondary and six involved tertiary approaches. The majority included between one and ten participants. Nine studies involved the administration of treatment, three providing certain experiences, two chart review, and 11 a training approach. Injuries due to self-abuse, communication problems, dental hygiene problems, and problems with memory, persistence and mobility were addressed. Conclusion: Little is known regarding the prevention of secondary conditions within this population. The authors stress the necessity to focus research efforts on greater understanding of the linkage between disability, rehabilitation and public health models.

A preliminary assessment of the nutrition and food-system environment of adults with intellectual disabilities living in supported arrangements in the community

This preliminary study characterized the adequacy of planned diets in two community-based, supported-living arrangements for adults with intellectual/developmental disabilities in Montana. The goals were to clarify the residents’ nutritional risks and to identify appropriate areas and means for intervention. Observations, interviews, and analyses of menus, shopping lists, and grocery receipts led to conclusions about the residents’ dietary adequacy. We conclude that the food systems, with their strong (and unhealthful) food traditions, lend themselves to systematic environmental changes, including targeted practice guidelines and support materials, to improve the diets and food habits.

Integration of chronic disease and disability and health state programs in Montana

This paper describes the strategies used in one state, Montana, to improve the health of individuals at risk for or living with chronic conditions associated with disability. These strategies demonstrate capacity to intervene at individual and environmental levels, and reveal opportunities for public health professionals to collaborate with independent living and long term care partners. In this paper we attempt to outline some of the challenges inherent in these collaborations and suggest strategies to overcome them.

Living Well with a Disability, a Self-Management Program

Approximately 56.7 million persons in the United States have functional impairments that can lead to disability. As a group, persons with disabilities show disparities in measures of overall health when compared with the general population. Much of this can be attributed to secondary conditions rather than to the impairment itself. Persons with disabilities can prevent and manage many of the conditions that contribute to these disparities. The Living Well with a Disability program was developed to support persons with disabilities to manage their health. The curriculum helps participants achieve early success in self-management of quality-of-life goals to build confidence for making health behavior changes; it includes 11 chapters that facilitators use to conduct an orientation session and 10 weekly, 2-hour sessions. The program has been implemented by 279 community-based agencies in 46 states. On the basis of the data from the field trial, these community applications have served approximately 8,900 persons since 1995, resulting in an estimated savings of

Nutrition and Adults With Intellectual or Developmental Disabilities: Systematic Literature Review Results*

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How Do Deaf and Hearing Mothers Regain Eye Contact When Their Infants Look Away

28.8 million for health care payers. Persons with disabilities have unique needs that can be addressed through multiple levels of intervention to reduce health disparities. The Living Well with a Disability program is a promising intervention that has demonstrated improvements in health-related quality of life and health care use.