Perceptions of Health and Disability Among Service Providers in AlabamaPerceptions of Health and Disability Among Service Providers in Alabama

Brian F. Geiger, Stephen L. Firsing III & Gary Edwards

University of Alabama at BirminghamUnited Cerebral Palsy of Greater Birmingham

American Association for Health Education, Research Coordinating BoardIndianapolis, IN

March 18, 2010

Funded by the Alabama Council on Developmental Disabilities & the National Network of Libraries of Medicine

18% of those with disabilities, versus 11% of those without disabilities went for at least one year without medical care

2004 National Organization on Disability/ Harris Survey of Americans with Disabilities

USDHHS goal: promote the health of people with disabilities, prevent secondary conditions, and eliminate disparities between people with and without disabilities in the U.S. population

USDHHS, Healthy People 2010

2

Background to the ProjectBackground to the Project

• AHRQ (2004) - health disparities disproportionately affect minority groups, people with disabilities, those with limited income and education, and rural residents

• Appleyard (2003) - “individuals with cognitive disabilities have difficulty using the Internet even after they have gained physical access.”

• Grants from ACDD and the National Network of Libraries of Medicine (NN/LM) funded a needs assessment and educational activities to increase access to health information and services

3

Background to the ProjectBackground to the Project

HealthyMe HealthyU ©2009 UCPGBHealthyMe HealthyU ©2009 UCPGB

Three aims:

1. To educate the medical community regarding how

to modify equipment and facilities to be more

accessible

2. To educate families/caregivers, consumers, and

case managers on personal health management

3. To educate professionals, consumers and families

to access and utilize digital resources for health

information

4

Project ActivitiesProject Activities

Composed (2) working groups to guide project activities including service providers, consumers, family and other caregivers

Designed needs assessments for 4 audiences Administered needs assessment in multiple

formats and languagesSummarized results and prioritized content of

training modulesDeveloped scripts for modules and solicited

peer review5

Researchers and working group members selected items from HINTS (2007), composed new items, revised content following review, translated into Spanish, offered printed and online formats

6

Item CategoryConsumers/ Caregivers

Service Providers/Students

Demographics 6 consumer;11 caregiver 6 provider; 5 student

Disability Characteristics 13 11

Internet Use 31 24

Health Care Access & Use 16 1

Quality of Care 24 10

Access to Information 18 19

Training Needs NA 8

Number of Survey Items by Item Type

Review of AssessmentReview of Assessment

Statewide dissemination through agency and individual contacts, professional meetings, & news release

Individually administered by working group members and graduate students

Caregivers reported health information and service needs of young consumers and those with severe communication disorders

7

Review of AssessmentReview of Assessment

• Family and other Caregivers (n=277)• Individuals with Disabilities (n=113)• Health Professions Students (n=570)

• Clinical Service Providers (n=145)– 32% primary care MDs; 19% PT, OT, SLP– 61% female– 89% white; 8% black– Mean 15.5 yrs. providing services to pts. with disabilities– 56% report treating >50 patients with disabilities annually

8

ResultsResults

• 99% looked for information about health/medical topics from any source

• 1st preference to obtain information about health/medical topics– 61% most often chose the Internet– 12% chose a medical library or a reference text– 9% selected a peer-reviewed journal

• 55% said most recent searched for health information was for someone else

9

Service Providers Selected ResultsService Providers Selected Results

10

0%

20%

40%

60%

80%

It took a lot of effort to get the information you

needed

You felt frustrated during your search for the information

You were concerned about the

quality of the information

The information you found was

hard to understand

% S

tro

ng

ly A

gre

eo

r So

mew

hat

Ag

ree

Items and Groups

Level of Agreement With Statements About Information Searches

Consumers

Caregivers

Students

Providers

11

Level of Confidence in Obtaining Health Care Information

0%

20%

40%

60%

80%

Completelyconfident

Veryconfident

Somewhatconfident

A littleconfident

Notconfident at

all

Responses by Group

Per

cent

age

of

Res

pond

ents Consumers

Caregivers

Students

Providers

12

0%

20%

40%

60%

80%

100%

% a

Lo

t o

r S

om

e T

rust

Med

library

Colleagues Gov t

agency

Journal Prof org Nonprofit Internet Pharm

info/w eb

Group and Source

Level of Trust in Accuracy of Information Source- Students and Providers - Students

Providers

13

0% 20% 40% 60% 80% 100%

Percentage a Lot or Some Trust

Radio TV

Tel info ref

Religious

Magaz new s

Soc contact

Gov agency

Internet

Broch pamph

Nonprofit

Book libr

Serv prov id

Gro

up

an

d S

ou

rce

Level of Trust in Accuracy of Information Source- Consumers and Caregivers -

Caregivers

Consumers

Anticipated or encountered obstacles when treating individuals with disabilities (n = 62)

Responses: • funding and insurance issues (n=15)

• communication with patient or caregiver (n=14)

• patient following treatment recommendations (n=12)

14

Obstacles or ChallengesObstacles or Challenges

161 responses

1)Accessing resources and coordinating health services (n=45)

2)Gen. training on disabilities, evaluating patients & accommodations for individual needs (n=42)

3)Communication among provider, patient, family (n=29)

15

Priority Training NeedsPriority Training Needs

Using Data to Address NeedsUsing Data to Address NeedsDeveloped (6) YouTube training modules featuring

clinicians, consumers, medical librarian, radio announcer:

1. Preparing Patients with Disabilities for a Successful Office Visit2. Disability Etiquette3. Practice Accommodations for Patients with Disabilities4. Staying Healthy between Doctor Visits5. Using the Internet to Learn about Your Health6. Preparing to Visit Your Healthcare Provider

Field testing and disseminationAssisting faculty of professional schools to use during

preservice education

16

• Overly ambitious timeline from funders to achieve multiple goals

• Limited generalizability - majority of student respondents were enrolled in health professions degree programs at UAB

• Content validity only• Few online Spanish language webpages for

health information

17

Study LimitationsStudy Limitations

18

Healthy Me Healthy U© PartnershipsHealthy Me Healthy U© Partnerships