Which public health interventions hold promise for promoting health among people with disabilities and preventing secondary conditions?

According to data reported in the Healthy People 2010 plan, compared with people without disabilities, people with disabilities are generally less physically activity, and have higher rates of obesity, depression, and other conditions that occur secondary or in addition to the primary disability. Clearly, people with disabilities can benefit from public health interventions to increase routine health and wellness examinations and screenings, as well as other improvements in lifestyle, including physical fitness.

	Data from Healthy People 2010 and other research demonstrate considerably less leisure or physical activity among people with disabilities. HP2010 disparities fact sheet.
	The U.S. Surgeon General reports that regular physical activity is an important part of healthy lifestyles, especially for people with life-long disabilities who are at particularly high risk for developing secondary conditions such as heart disease and diabetes http://www.cdc.gov/nccdphp/sgr/sgr.htm
	In March of 1999, the President's Council on Physical Fitness released a report on fitness among people with disabilities  http://www.fitness.gov/activity/activity2/digest_mar1999/digest_mar1999.html

The Disability and Health Team at Center for Disease Control and Prevention (CDC)  supports several efforts to develop, test, and implement health promotion interventions across the lifespan of people with disabilities. These efforts reach beyond short-term rehabilitation interventions to address healthy lifestyles.

Living Well With a Disability Researchers at the University of Montana’s Rural Institute on Disabilities, in conjunction with collaborators at the University of Kansas and people with disabilities throughout the country at various centers for independent living, recently completed the development of the Living Well With a Disability curriculum. This theory-based, 10-week, behavior-modification curriculum has demonstrated promise in promoting the health of people with disabilities. It includes setting goals, seeking information, solving problems through strategies, developing healthy reactions to frustration and stress, overcoming depression, engaging in and maintaining exercise habits, and enhancing nutritional intake. Participants engage in therapeutic interventions delivered at centers for independent living by trained peer educators.  

To date, investigators have demonstrated a 37% overall reduction in the prevalence of reported secondary conditions among participants, and a 45% reduction in the number of physician visits during the 6 months following the intervention.  In addition, the cost-effectiveness analysis for this intervention indicated that the cost of the intervention would be recouped within 2 months among participants who frequently use medical services, and within 6 months among participants who less frequently use medical services. Investigators are currently examining other places to deliver the curriculum including, the Internet, the YMCA, vocational rehabilitation facilities, storefront physical fitness facilities featuring adaptive aerobic exercise machines, and hospitals. This intervention is copyrighted and more information about the curriculum can be viewed at: http://ruralinstitute.umt.edu/rtcrural/health/NewDirectionsReRpt.htm or  http://ruralinstitute.umt.edu/rtcrural/health/SecondaryCondition.htm

Links - Health Promotion Interventions for People With Disabilities.

Exercise for People with Disabilities: Getting Started on Your Fitness Plan (2000). This collaborative publication provides a wealth of information and tools for getting involved in fitness activities. It is produced by the Research and Training Center on Independent Living, University of Kansas. Copies may be obtained by calling 785 864-4095 or visiting their website at http://www.rtcil.org.

Promoting the Health of People With Disabilities: Protocols for Preventive Interventions (1996). This document was published by the Center for Disability Policy and Research at the University of Washington. For a copy of this brief manuscript, contact Dr. Donald Patrick at 206/685-7252.

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