RESUMO
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 $6.4-$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.
Assuntos
Pessoas com Deficiência/psicologia , Promoção da Saúde/métodos , Qualidade de Vida , Autocuidado , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Centers for Disease Control and Prevention, U.S. , Currículo , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Estados Unidos , Adulto JovemRESUMO
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.
