National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Center on Disability at the Public Health Institute, Oakland, California.
Am J Prev Med. 2017 Dec;53(6):898-903. doi: 10.1016/j.amepre.2017.06.025. Epub 2017 Aug 30.
Approximately 40 million people in the U.S. identify as having a serious disability, and people with disabilities experience many health disparities compared with the general population. The Guide to Community Preventive Services (The Community Guide) identifies evidence-based programs and policies recommended by the Community Preventive Services Task Force (Task Force) to promote health and prevent disease. The Community Guide was assessed to answer the questions: are Community Guide public health intervention recommendations applicable to people with disabilities, and are adaptations required?
An assessment of 91 recommendations from The Community Guide was conducted for 15 health topics by qualitative analysis involving three data approaches: an integrative literature review (years 1980-2011), key informant interviews, and focus group discussion during 2011.
Twenty-six recommended interventions would not need any adaptation to be of benefit to people with disabilities. Forty-one recommended interventions could benefit from adaptations in communication and technology; 33 could benefit from training adaptations; 31 from physical accessibility adaptations; and 16 could benefit from other adaptations, such as written policy changes and creation of peer support networks. Thirty-eight recommended interventions could benefit from one or more adaptations to enhance disability inclusion.
As public health and healthcare systems implement Task Force recommendations, identifying and addressing barriers to full participation for people with disabilities is important so that interventions reach the entire population. With appropriate adaptations, implementation of recommendations from The Community Guide could be successfully expanded to address the needs of people with disabilities.
美国约有 4000 万人被认定为有严重残疾，与一般人群相比，残疾人经历着许多健康差距。社区预防服务指南（社区指南）确定了社区预防服务工作队（工作队）推荐的循证计划和政策，以促进健康和预防疾病。社区指南的评估旨在回答以下问题：社区预防服务工作队的公共卫生干预建议是否适用于残疾人，是否需要进行调整？
对社区指南中的 91 项建议进行了评估，涉及 15 个健康主题，采用三种数据方法进行定性分析：综合文献综述（1980 年至 2011 年）、关键知情人访谈以及 2011 年期间的焦点小组讨论。
26 项建议的干预措施不需要任何调整即可使残疾人受益。41 项建议的干预措施可以通过沟通和技术方面的调整受益；33 项可以通过培训调整受益；31 项可以通过物理可达性调整受益；16 项可以通过其他调整受益，例如书面政策变更和创建同伴支持网络。38 项建议的干预措施可以通过一种或多种调整来增强残疾包容性而受益。
随着公共卫生和医疗保健系统实施工作队的建议，确定和解决残疾人充分参与的障碍非常重要，以便干预措施能够覆盖整个人口。通过适当的调整，社区指南建议的实施可以成功扩展，以满足残疾人的需求。
