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Barrington M, Fisher KR, Harris-Roxas B, Spooner C, Trollor JN, Weise J. Access to healthcare for people with intellectual disability: a scoping review. Scand J Public Health 2025:14034948251317243. [PMID: 39939836 DOI: 10.1177/14034948251317243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2025]
Abstract
AIMS People with intellectual disability experience stark health inequalities, often because of poor access to mainstream healthcare. This scoping review aimed to identify factors that influence access to healthcare for people with intellectual disability using Levesque and colleagues' comprehensive framework of healthcare access. METHOD This review followed Joanna Briggs Institute guidelines. Articles were identified and retrieved from CINAHL, PsycINFO, PubMed and EMBASE. Two reviewers completed abstract and full-text screening, addressing any conflicts at each stage. Data was extracted and coded deductively, according to the supply (healthcare provider) and demand (healthcare seeker) dimensions of Levesque and colleagues' framework. RESULTS Following search and screening, 66 references were included for review. Barriers to healthcare were more frequently identified in the literature compared to facilitators, with most information relating to supply-side dimensions. Barriers were related to inaccessible health information, low health literacy, stigma and discrimination by healthcare providers, and lack of organisational support, training and resourcing in both healthcare and support sectors. Facilitators often involved specialist workforces, strong interpersonal skills among healthcare providers, and advocacy from supporters. Importantly, findings indicated that both sociohistorical processes and support networks are necessary to understanding access experiences for people with intellectual disability. CONCLUSIONS Greater efforts are required internationally to ensure the health rights of people with intellectual disability, to eliminate discrimination, and provide the support and resources necessary for all stakeholders to facilitate healthcare access. Models of healthcare access for people with intellectual disability should consider both the role of supporters and the sociohistorical context within which healthcare access occurs.
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Affiliation(s)
- Maryann Barrington
- National Centre of Excellence in Intellectual Disability Health, UNSW Sydney, NSW, Australia
| | - Karen R Fisher
- Social Policy Research Centre, UNSW Sydney, NSW, Australia
| | - Ben Harris-Roxas
- School of Population Health, UNSW Sydney, Australia
- School of Public Health, University of Technology Sydney, Australia
| | - Catherine Spooner
- Centre for Primary Health Care & Equity, UNSW Sydney, NSW, Australia
| | - Julian N Trollor
- National Centre of Excellence in Intellectual Disability Health, UNSW Sydney, NSW, Australia
| | - Janelle Weise
- National Centre of Excellence in Intellectual Disability Health, UNSW Sydney, NSW, Australia
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Doherty AJ, Benedetto V, Harris C, Ridley J, O'Donoghue A, James-Jenkinson L, Fidler D, Clegg A. Preventing falls at home among people with intellectual disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:702-724. [PMID: 37076958 DOI: 10.1111/jar.13104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/10/2023] [Accepted: 03/31/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Falls are common among people with intellectual disabilities. Many falls happen within the home. Our scoping review aimed to identify evidence for falls-risk factors and falls-prevention interventions for this population. METHOD We conducted a multi-database search to identify any type of published study that explored falls-risk factors or falls-prevention interventions for people with intellectual disabilities. Following a process of (i) title & abstract and (ii) full-text screening, data was extracted from the included studies and described narratively. RESULTS Forty-one studies were included. Risks are multifactorial. There was limited evidence of medical, behavioural/psychological, or environmental interventions to address modifiable risk factors, and no evidence of the interventions' cost-effectiveness. CONCLUSIONS Clinically and cost effective, acceptable and accessible falls-prevention pathways should be available for people with intellectual disabilities who are at risk of falls from an earlier age than the general population.
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Affiliation(s)
- Alison J Doherty
- Institute for Global Health and Wellbeing, University of Central Lancashire, Preston, UK
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, Health Technology Assessment (HTA) Unit, Applied Health Research hub, University of Central Lancashire, Preston, UK
- Methodological Innovation, Development, Adaptation and Support (MIDAS) Theme, National Institute for Health and Care Research Applied Research Collaboration North West Coast (NIHR ARC NWC), based at the University of Central Lancashire, Preston, UK
| | - Valerio Benedetto
- Institute for Global Health and Wellbeing, University of Central Lancashire, Preston, UK
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, Health Technology Assessment (HTA) Unit, Applied Health Research hub, University of Central Lancashire, Preston, UK
- Methodological Innovation, Development, Adaptation and Support (MIDAS) Theme, National Institute for Health and Care Research Applied Research Collaboration North West Coast (NIHR ARC NWC), based at the University of Central Lancashire, Preston, UK
| | - Catherine Harris
- Institute for Global Health and Wellbeing, University of Central Lancashire, Preston, UK
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, Health Technology Assessment (HTA) Unit, Applied Health Research hub, University of Central Lancashire, Preston, UK
- Methodological Innovation, Development, Adaptation and Support (MIDAS) Theme, National Institute for Health and Care Research Applied Research Collaboration North West Coast (NIHR ARC NWC), based at the University of Central Lancashire, Preston, UK
| | - Julie Ridley
- Institute for Global Health and Wellbeing, University of Central Lancashire, Preston, UK
- Centre for Citizenship and Community, University of Central Lancashire, Preston, UK
| | | | | | - Dave Fidler
- Pathways Associates (Community Interest Company), Accrington, UK
| | - Andrew Clegg
- Institute for Global Health and Wellbeing, University of Central Lancashire, Preston, UK
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, Health Technology Assessment (HTA) Unit, Applied Health Research hub, University of Central Lancashire, Preston, UK
- Methodological Innovation, Development, Adaptation and Support (MIDAS) Theme, National Institute for Health and Care Research Applied Research Collaboration North West Coast (NIHR ARC NWC), based at the University of Central Lancashire, Preston, UK
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Gómez LE, Navas P, Verdugo MÁ, Tassé MJ. Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability. World J Psychiatry 2021; 11:1039-1052. [PMID: 34888172 PMCID: PMC8613764 DOI: 10.5498/wjp.v11.i11.1039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/17/2021] [Accepted: 10/18/2021] [Indexed: 02/06/2023] Open
Abstract
This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability (ID) at all stages of their life. We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population, along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems. We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID. The review is structured around the three generations of therapies: Applied behavior analysis (e.g., positive behavior support), cognitive behavioral therapies (e.g., mindfulness-based cognitive therapy), and contextual therapies (e.g., dialectical behavior therapy). We conclude with some recommendations for professional practice in the fields of ID and psychiatry.
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Affiliation(s)
- Laura E Gómez
- Department of Psychology, University of Oviedo, Oviedo 33011, Asturias, Spain
| | - Patricia Navas
- Department of Personality, Evaluation and Psychological Treatments, Institute on Community Integration, University of Salamanca, Salamanca 37005, Salamanca, Spain
| | - Miguel Ángel Verdugo
- Department of Personality, Evaluation and Psychological Treatments, Institute on Community Integration, University of Salamanca, Salamanca 37005, Salamanca, Spain
| | - Marc J Tassé
- Department of Psychology and Psychiatry, The Ohio State University Nisonger Center-UCEDD, Columbus, OH 43210-1257, United States
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