Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater attention to the training of health care providers. Gaps in the literature include the lack of intervention trials, replications of successful approaches, and data that allow for better comparisons between people with IDD and without IDD living in the same communities. Implications for future research needed to reduce health disparities for people with IDD include: better monitoring and treatment for chronic conditions common in the general population that are also experienced by people with IDD, an enhanced understanding of how to promote health among those in the IDD population who are aging, addressing the health needs of people with IDD who are not part of the disability service system, developing a better understanding of how to include people with IDD in health and wellness programs, and improving methods for addressing the healthcare needs of members of this group in an efficient and cost-effective manner, either through better access to general medical care or specialized programs.
This study examined the impact of environmental factors and caregiver attitudes on exercise participation in adults with cerebral palsy using a social-cognitive model. The sample included 83 adults with cerebral palsy (47.0% males and 53.0% females). Hierarchical regression analysis was conducted with exercise frequency as the dependent variable. Independent variables included personal characteristics of persons with cerebral palsy (age, level of mental retardation, health status, mobility, and arm/hand limitation), type of residence, exercise facility access, and caregiver-perceived benefits of exercise for people with cerebral palsy. The significant determinants of exercise participation were the caregiver's perceived benefits of exercise for persons with cerebral palsy and the type of residence. When caregivers perceived greater benefits of exercise, adults with cerebral palsy were likely to exercise more frequently. Non-nursing home residents were more likely to exercise than nursing home residents. This difference was related to differences in the caregivers' perceived benefits of exercise and not because of the personal characteristics of the residents or access to the exercise facility. Results of this study point to the need to inform and educate caregivers about the benefits and importance of exercise for adults with cerebral palsy.
Results support the efficacy of a HealthMatters Program in CBOs to improve health among adults with intellectual disabilities. A need exists for CBOs to include health promotion in their mission and vision statement and job descriptions.
A mail survey was distributed to a random sample of 497 both blue- and white-collar workers employed at a large manufacturing company to measure dimensions of worksite health climate: organizational and interpersonal support, and health norms. Statistically significant differences were observed for nearly all aspects of the dimensions with white-collar workers having more positive perceptions than blue-collar workers. The study suggests that future research explore how these perceptions may be enhanced and what role they may play in promoting worker health.
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