Craving inclusion: a systematic review on the experiences and needs of people with disability eating out.

Purpose: To systematically review the research relating to views and experiences of people with disability eating out in cafés, restaurants, and other settings; and identify factors that impede or enhance accessibility of eating out experiences, inform future inclusive research, and guide policy development.Materials and Methods: This study involved systematic search and review procedures with qualitative metasynthesis of the barriers to and facilitators for participation and inclusion in eating/dining-out activities. In total, 36 studies were included.Results: Most studies reviewed related to people with physical or sensory disability eating out, with few studies examining the dining experiences of adults with intellectual or developmental disability, swallowing disability, or communication disability. People with disability encountered negative attitudes and problems with physical and communicative access to the venue. Staff lacked knowledge of disability. Improvements in the design of dining spaces, consultation with the disability community, and staff training are needed.Conclusion: People with disability may need support for inclusion in eating out activities, as they encounter a range of barriers to eating out. Further research within and across both a wide range of populations with disability and eating out settings could guide policy and practice and help develop training for hospitality staff.

Some people with disability require support for increased self-determination and self-advocacy to access eating out experiences satisfactorily.Goals and strategies to increase access and participation in eating out activities for people with disability should include attention to the environment and hospitality venues and to staff training.Rehabilitation professionals have a role in training hospitality staff about disability access and inclusion in eating out activities.To enhance community inclusion and participation, rehabilitation professionals could focus more on the skills and strategies needed for people with disability to participate in eating out activities.Rehabilitation professionals could implement a range of facilitators that might strengthen participation in eating out activities for people with disability.

A systematic review of the health literacy of adults with lifelong communication disability: Looking beyond accessing and understanding information.

OBJECTIVE: To determine the a) extent to which people with lifelong communication disability are included in health literacy research, b) level of health literacy of people with lifelong communication disability, c) methods applied to measure the health literacy of people with lifelong communication disability, d) barriers and facilitators mediating the health literacy of people with lifelong communication disability, and e) outcomes of health literacy interventions for people with lifelong communication disability. METHODS: We searched for studies relating to health literacy, people with lifelong communication disability, and key areas of the Sørensen et al. (2012) health literacy model (i.e., accessing, understanding, appraising, applying health information, personal/environmental/systemic barriers and facilitators). RESULTS: Analysis of 60 studies demonstrated that this population is not well represented. Insufficient research exists to inform statements on level of health literacy or methods used to measure health literacy of this population. Barriers and facilitators appear consistent with those applicable to the general population. Health literacy intervention outcomes were variable. CONCLUSION: Significant gaps exist in the research which has primarily focused on people with intellectual disability accessing and understanding health information. PRACTICE IMPLICATIONS: Findings can inform policies, practice, and future research on health literacy and people with lifelong communication disability.

Can I Get There? Can I Play? Can I Stay? Creating an Inclusive Playspace Guide in Australia.

Playspaces bring children and adults together for fun and social interaction but are rarely designed for the inclusion of all community members. In Australia, local government authorities (councils) are responsible for parks and playspaces. The New South Wales state government launched their inclusive playspaces policy in 2017. A guideline document was proposed but a guideline does not guarantee implementation. Consequently, an inclusive design process for developing the guide became the strategy. The task was to develop a guide that explained the concepts of inclusion and universal design within the playspace context. The project took an iterative and collaborative approach to the design of the guide. Intended users were those involved in creating playspaces, not playspace users per se. The participatory governance structure involved three levels of collaboration: a small steering group of experts, a larger group with key stakeholders, and a wider group of stakeholders and interested persons. This collegial and participative process consisted of a series of meetings and workshops which fostered learning and ideation for all participants. Through this process three underpinning concepts emerged: Can I get there? Can I play? Can I stay? The process educated and informed stakeholders, encouraged participants to contribute to the outcomes and provided community-led guidance for those contracted to design the guideline. The result was an inclusive playspace guide that recognized the design guidance required by council personnel in the context of universal design. The process and governance structure provides a good working model to build on. The success of the guideline was recognized with a national award from the Institute of Landscape Architects for Community Contribution. The purpose of this paper is not to comment on or evaluate the outcome of the guidelines. Rather, it is to document the inclusive and participatory governance structure and iterative process from a professional participant perspective.

Indicators of job quality in the Australian aged care workforce: A scoping review.

OBJECTIVE: As governments grapple with ageing populations, there is a need to understand more about the aged care workforce and how it is managed. METHODS: We undertook a scoping review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Scopus and PubMed were used to identify papers published between 2010 and 2020. We mapped the breadth and scale of the evidence base according to the QuInnE indicators of job quality. RESULTS: Out of 642 titles and abstracts that were screened, 122 were selected. Outcomes were measured across a range of domains, including wages, employment quality, education and training, working conditions, work/life balance and consultative participation and collective representation. These were distributed unevenly, revealing evidence gaps. CONCLUSIONS: We identified significant knowledge gaps regarding Australia's aged care workforce at a time when the sector is coming under fresh scrutiny and projections indicate that it will face critical labour shortfalls going forward.

The influence of the built environment in enacting a household model of residential aged care for people living with a mental health condition: A qualitative post-occupancy evaluation.

This study undertakes a spatial analysis of an Australian aged care setting where residents receive person-centred support in a specially-designed home-like environment. Focus groups were conducted with staff to explore the impact of the built environment in a new residential aged care setting that has implemented a Household Model of care for people living with mental health conditions. Drawing on Actor-Network Theory and proxemics, we mapped how the built environment supports improved behaviours and care practices in four areas: food preparation and dining, sleep and self-care, site layout, and relationships.

Individualized Apartment Accommodation for People With Intellectual Disability: Protocol for a Qualitative Study Examining the Well-Being and Support Outcomes Linking Housing and Health.

BACKGROUND: Understanding the outcomes associated with both receiving and providing support to people with intellectual disability in specific settings can facilitate the alignment of health providers, community care providers, architects, and urban planners to strengthen levels of autonomy and community participation of people with intellectual disability living in the community. This study explores the impact of providing support (available 24 hours a day) for people with intellectual disability in a high-density apartment. It seeks the perspectives of people with intellectual disability who have moved into an apartment from a group home (where 4-6 people with disability live), their families, and support staff. It will enable comparison between two models of supported accommodation, group homes and individualized apartments, in a community setting. OBJECTIVE: The aims of this study are to explore the impact of an individualized apartment model of supported accommodation in a high-density setting on the well-being, autonomy, and participation of people with intellectual disability living and receiving support; the experience of providing care or support; and how this setting impacts the logistics of how quality support is provided. METHODS: Qualitative research methods were employed as the primary means of collecting and analyzing data. There are two main sources of data in this study: (1) semistructured interviews with participants in up to 3 waves (pre, post 1, and post 2) and (2) pre- and postoccupancy evaluation data on the design, layout, and location details of the built environments. Coded interview data will be paired with pre- and postoccupancy evaluations of the two accommodation settings. RESULTS: As of May 2020, we have recruited 55 participants. There have been 96 interviews conducted in 2 waves with people who have moved into supported accommodation, families, and staff. Collected data are currently being analyzed. We expect the results of the trial to be published in a peer-reviewed journal in late 2020. CONCLUSIONS: This paper sets out a study of an alternative housing and support model for people with intellectual disability. It will capture personal experiences of people with intellectual disability receiving support in an apartment compared to their experiences in a group home. It will also capture the experiences of support staff working in the new setting and reveal how this differs from a group home setting. The inclusion of pre (group home) and post (apartment integrated into a community setting) measures addresses evaluative and comparative questions around the nature and impacts of the small-scale apartment and support model for both those who live and receive support, and those who support them. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/18248.

Prevalence of intellectual disability in New South Wales, Australia: a multi-year cross-sectional dataset by Local Government Area (LGA).

The presented dataset relates to a research project titled "My Home My Community" undertaken at University of Technology Sydney (UTS) which has been funded by the National Disability Insurance Agency (NDIA) Australia. The dataset reports estimated prevalence rates of Intellectual Disability in NSW by local government area (LGA) from 2010 - 2015. The dataset is a re-examination of a cohort of 92, 542 people with intellectual disability from a larger linked research dataset built by the Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW. The dataset in this paper is presented in a multi-year cross-sectional format. The cohort of people with Intellectual Disability was analysed to estimate, quantify and visualise where people with intellectual disability live in New South Wales (NSW). The cohort analysed in this dataset had been generated in an earlier project undertaken by the UNSW-based authors. This dataset was generated to share with local governments in Australia and has the potential to be more widely used in a range of health policy and planning research, and city and regional planning research environments. It represents one of the only datasets currently available in Australia on Intellectual Disability describing prevalence rates at a local government area level. This dataset allows for population comparisons in other Australian states and internationally and can be examined in combination with other social and economic datasets to continue to build evidence about disability, planning and geography.

Housing Design and Community Care: How Home Modifications Reduce Care Needs of Older People and People with Disability.

The extent to which housing design can minimise levels of community caregiving has remained largely unmeasured. This paper reports the potential for home modifications to reduce caregiving in the peoples' homes, particularly older people and people with a disability. It contributes to new knowledge in understanding how housing can play a role in community caregiving and acknowledges the role of the built environment in managing care levels in ageing societies. This paper analyses self-reported care data from 157 Australian community care recipients (average age: 72 years) who had received home modifications within the past 6 months. A before/after comparison of care provided revealed that home modifications reduced hours of care provided by 42% per week. More detailed analysis revealed that the positive association of home modifications with care reduction is stronger with informal care (46% reduction) followed by formal care (16% reduction). These results suggest the role that home modifications, and housing design in general, play in reducing care needs in a community setting.