Perceptions of Health and Disability
Among Service Providers in Alabama
Brian F. Geiger, Stephen L. Firsing III
& Gary Edwards
University of Alabama at Birmingham
United Cerebral Palsy of Greater Birmingham
American Association for Health Education, Research Coordinating Board
Indianapolis, IN
March 18, 2010
Funded by the Alabama Council on Developmental Disabilities &
the National Network of Libraries of Medicine
Background to the Project
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
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, Healthy People 2010
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Background 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
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HealthyMe 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
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Project 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 languages
Summarized results and prioritized content of
training modules
Developed scripts for modules and solicited
peer review
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Review of Assessment
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
Number of Survey Items by Item Type
Item Category
Demographics
Consumers/
Caregivers
Service Providers/
Students
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
6
Review 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
Results
• 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
Service Providers Selected Results
• 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
% Strongly Agree
or Somewhat Agree
Level of Agreement With Statements
About Information Searches
80%
Consumers
60%
Caregivers
40%
Students
20%
Providers
0%
It took a lot of
You felt
You were The information
effort to get the frustrated during concerned you found was
information you your search for about the
hard to
needed
the information quality of the understand
information
Items and Groups
10
Level of Confidence in Obtaining
Health Care Information
Percentage of
Respondents
80%
60%
Consumers
Caregivers
40%
Students
20%
Providers
0%
Completely
Very
confident confident
Somewhat
confident
A little
Not
confident confident at
all
Responses by Group
11
% a Lot or Some Trust
Level of Trust in Accuracy of Information Source
Students
- Students and Providers 100%
Providers
80%
60%
40%
20%
0%
Med
library
Colleagues
Gov t
Journal
Prof org
Nonprofit
agency
Internet
Pharm
info/w eb
Group and Source
12
Level of Trust in Accuracy of Information Source
- Consumers and Caregivers Serv prov id
Book libr
Group and Source
Nonprofit
Broch pamph
Internet
Gov agency
Caregivers
Consumers
Soc contact
Magaz new s
Religious
Tel info ref
Radio TV
0%
20%
40%
60%
80%
100%
Percentage a Lot or Some Trust
13
Obstacles or Challenges
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
Priority Training Needs
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
Using Data to Address Needs
Developed (6) YouTube training modules featuring
clinicians, consumers, medical librarian, radio
announcer:
1.
2.
3.
4.
5.
6.
Preparing Patients with Disabilities for a Successful Office Visit
Disability Etiquette
Practice Accommodations for Patients with Disabilities
Staying Healthy between Doctor Visits
Using the Internet to Learn about Your Health
Preparing to Visit Your Healthcare Provider
Field testing and dissemination
Assisting faculty of professional schools to use during
preservice education
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Study Limitations
• 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
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Healthy Me Healthy U© Partnerships
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