Barriers and strategies affecting the utilisation of primary preventive services for people with physical disabilities: a qualitative inquiry

Authors

  • Thilo Kroll PhD,

    1. National Rehabilitation Hospital, Center for Health & Disability Research, Research Division, 102 Irving Street, NW, Washington, DC 20010-2949, USA,
    2. University of Dundee, School of Nursing & Midwifery, Alliance Self Care Research, Scotland, UK,
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  • Gwyn C. Jones PhD,

    1. National Rehabilitation Hospital, Center for Health & Disability Research, Research Division, 102 Irving Street, NW, Washington, DC 20010-2949, USA,
    2. Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
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  • Matthew Kehn BA,

    1. National Rehabilitation Hospital, Center for Health & Disability Research, Research Division, 102 Irving Street, NW, Washington, DC 20010-2949, USA,
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  • Melinda T. Neri BA

    1. National Rehabilitation Hospital, Center for Health & Disability Research, Research Division, 102 Irving Street, NW, Washington, DC 20010-2949, USA,
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Matthew Kehn National Rehabilitation Hospital Center for Health & Disability ResearchResearch Division, 102 Irving Street, NW, Washington DC 20010-2949USAE-mail: matthew.e.kehn@medstar.net

Abstract

Individuals with physical disabilities are less likely to utilise primary preventive healthcare services than the general population. At the same time they are at greater risk for secondary conditions and as likely as the general population to engage in health risk behaviours. This qualitative exploratory study had two principal objectives: (1) to investigate access barriers to obtaining preventive healthcare services for adults with physical disabilities and (2) to identify strategies to increase access to these services. We conducted five focus group interviews with adults (median age: 46) with various physically disabling conditions. Most participants were male Caucasians residing in Virginia, USA. Study participants reported a variety of barriers that prevented them from receiving the primary preventive services commonly recommended by the US Preventive Services Task Force. We used a health services framework to distinguish structural–environmental (to include inaccessible facilities and examination equipment) or process barriers (to include a lack of disability-related provider knowledge, respect, and skilled assistance during office visits). Participants suggested a range of strategies to address these barriers including disability-specific continuing education for providers, the development of accessible prevention-focused information portals for people with physical disabilities, and consumer self-education, and assertiveness in requesting recommended services. Study findings point to the need for a more responsive healthcare system to effectively meet the primary prevention needs of people with physical disabilities. The authors propose the development of a consumer- and provider-focused resource and information kit that reflects the strategies that were suggested by study participants.

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