e2 Abstracts / Disability and Health Journal 3 (2010) e1ee9

Comparison of health characteristics between working and

nonworking adults with physical disabilities: Implications for health

promotion

Gwyn C. Jones, PhD, Centers for Disease Control and Prevention

Introduction/Purpose: Investigate differences in health characteristicsamong working and nonworking adults with physical disabilities.Method/Approach: We combined data from the 2000-2007 NationalHealth Interview Survey to investigate health-related differences betweenworking and nonworking adults aged 18 to 64 years with a lower-extremity mobility limitation, hearing impairment, or visual impairment.We examined the measures of physical health, depressive symptoms, sixchronic conditions, and four health behaviors for each disability group,controlling for demographics in the logistic models.Results/Findings: With the exceptions of mild depressive symptoms andalcohol use, nonworking adults in all disability groups were significantlymore likely (p ! .01) to have poorer health, all chronic conditions, and toengage in adverse health behaviors. Compared with working adults,nonworking visually impaired adults were most likely to report fair/poorhealth (50.1% vs. 13.8%), to have diabetes (19.7% vs. 7.8%), and to besmokers (35.1% vs. 30.2%). Hearing-impaired workers were the mostlikely to use alcohol (72.8% vs. 52.0%). Nonworking adults with mobilitylimitations were most likely to be physically inactive (54.3% vs. 35.4%).After adjusting for demographics, the odds of having fair/poor health,chronic conditions, and engaging in most adverse health behaviorsdecreased sharply for workers in each disability group.Conclusions/Recommendations: Our findings showed strong differencesin health status, depressive symptoms, chronic conditions, and healthbehaviors between working and nonworking adults for all physicaldisability groups. Health promotion efforts for nonworking adults withdisabilities to treat chronic diseases and improve health behavior practicesmay increase their ability to gain employment and remain in the workforce.

Transtheoretical model applied to receipt of clinical preventive

service by women with mobility impairments

Jana J. Peterson, Oregon Health and Science University

Rie Suzuki, University of Michigan-Flint

Emily S. Walsh, Oregon Health and Science University

Gloria L. Krahn, National Center on Birth Defects and Developmental

Disabilities, Centers for Disease Control and Prevention

Introduction: Women with mobility impairments are less likely than arewomen in the general population to receive regular mammograms,Papanicolou tests, and clinician weight checks. General populationstudies have consistently demonstrated theoretical relationships betweenTranstheoretical Model (TTM) constructs and receipt of clinicalpreventive services. The purpose of this study was to investigate whetherthese theoretical relationships were consistent among women withmobility impairments.Method/Approach: The sample consists of 144 women with mobilityimpairments aged 35 to 64 years in Oregon, recruited via Oregon’sMedicaid provider, a durable medical equipment vendor, and postedflyers. Women not current with recommended guidelines formammography, Papanicolou tests, and/or clinician weight checks wereeligible for the study. A one-way independent ANOVA and post-hocTukey’s pairwise comparisons were conducted to test mean differences inself-efficacy, perceived benefits of screenings, and perceived susceptibilityto disease by TTM stage for receipt of each clinical preventive service.Results/Findings: ANOVA results revealed significant differences in self-efficacy by TTM stage groups for mammography, Papanicolou tests, andweight checks, and post-hoc results indicated an increasing trend inmeans with increasing stage. Similarly, ANOVA revealed significantdifferences in perceived benefits by TTM stage groups for weight checks,with an increasing trend in means with increasing stage in post-hoc results.Conclusion/Recommendations: The findings offer evidence for severaltheoretical relationships between TTM constructs for clinical preventiveservice receipt among women with mobility impairments. Interventions

that increase self-efficacy and utilize other TTM constructs may increasethe rate of service receipt among women with mobility impairments.

Social participation among adults with disabilities: The role of the

urban environment.

Philippa Clarke, Els Nieuwenhuijsen, Jennifer Ailshire, University of

Michigan, Ann Arbor, MI 48104

Introduction: Health and social participation are shaped by complexinteractions between individuals and the diverse environments in whichthey are situated. Yet, research on the role of the environment in thedisablement process has been scarce.Method/Approach: Using data from the Chicago Community Adult HealthStudy (2002), we examined the role of the built physical and socialenvironment on social participation (interpersonal interactions andrelationships) among adults age 45+ (N 5 1195) according to their levelof difficulty walking several blocks (no difficulty vs. some or a lot ofdifficulty). The International Classification of Functioning, Disability,and Health (ICF) was used to identify and map the key variables foranalysis. Built environment characteristics were assessed using systematicsocial observation to independently rate indicators of crime, socialdisorder, physical decay, and neighborhood security in the blocksurrounding each respondent’s residence in Chicago.Results/Findings: Using linear regression (controlling for age, gender,race/ethnicity, marital status, education, income, health conditions, andcognition), we found that adults with mobility difficulty (ICF d450) weresignificantly less likely to interact with friends, neighbors or relatives(ICF d9205) than were adults who reported no difficulty walking (p !.01). However, living in a safe neighborhood in Chicago (characterized bythe presence of neighborhood crime watch signs and security warningsigns [ICF e545]) facilitated social participation among those withwalking difficulty (p ! .01). In these safe neighborhoods, there was nodifference in the frequency of social interaction between those with andwithout walking difficulties. Neighborhood safety had no effect on thefrequency of social participation among adults who could walkindependently.Conclusions/Recommendations: These results highlight thecharacteristics of urban environments that can facilitate participationamong those with mobility limitations.

The contribution of cognitive difficulties to disability in persons

with multiple sclerosis

Alexa Stuifbergen, PhD, RN, FAAN, The University of Texas at Austin

School of Nursing, Austin, TX

Introduction: The effects of multiple sclerosis (MS) on cognition, thoughtto occur in 50% to 75% of persons with MS, have gained increasingrecognition as one of the major disabling symptoms of the disease. Whilenumerous studies have addressed the emotional and physical impact ofMS, little attention has been given to the relationship of cognitivelimitations to social and role functioning in persons with MS. Thepurpose of this study was to explore the relationships among functionallimitations, neuropsychological competence in daily activities and socialand role-related functioning.Method/Approach: Participants completed a questionnaire battery as partof an ongoing longitudinal study of quality of life among persons with MS.The battery included measures of illness and sociodemographic variables,functional limitations (physical and cognitive), depressive symptoms andthe SF-36 subscales of social, role-emotional, and role-physical functioning.Results/Findings: The sample (N 5 417) ranged in age from 30 to 90 years(mean, 58.5 years) and had been diagnosed for a mean of 21.8 years. Themajority are white/non-Hispanic (87%) and married (69%) and hadcompleted high school (83%). Using stepwise multiple regressiondepressive symptoms, functional limitations and cognitive difficultiespredicted social functioning scores (R2 5 0.42). Forty-six percent of thevariance in emotional role functioning was explained by depressive