<\/a>Please note: Many individuals participate in multiple insurance programs.<\/p>\n <\/p>\n
At baseline, the CIL sample reported higher ratings of private insurance coverage and Medicaid and Medicare enrollment. Almost one-third of VR clients (29.7%) did not have any health insurance coverage versus 3.3% for the CIL sample. This difference should be considered when exploring potential reimbursement models for health promotion programming. For individuals receiving CIL services, reimbursement through health insurance programs may be a better solution than it would be for VR clients.<\/p>\n
The two groups reported similar rates of secondary health conditions at baseline<\/em>. Respondents indicated the degree of limitation from certain secondary conditions on a scale where 0 = no limitation, 1 = mild limitation (1-5 hours per week), 2 = moderate limitation (6-10 hours per week), and 3 = significant limitation (more than 11 hours per week). Aggregating the ratings for 29 secondary conditions (with a possible range of 0 to 87), the average score was 23.5 for the VR sample and 24.1 for the CIL sample. Group means were not statistically different. Additionally, nine of the ten most problematic secondary conditions at baseline appeared in both samples.<\/p>\nTable 2 reports on the top ten secondary conditions for the VR and CIL samples and compares the average severity ratings for each condition. With the exception of mobility issues, the VR sample reported higher limitation ratings for the top ten secondary conditions than the CIL sample. This speaks to the importance of health promotion programming within the VR system because the majority of these top ten conditions are responsive to health promotion interventions. Individuals in the CIL sample, on the other hand, reported a greater number of secondary conditions, on average, than that VR sample.<\/p>\n
<\/a>Table 2: Secondary Conditions\u00a0 Text Description of Table 2<\/a><\/p>\n
\n\n\nTop Ten Secondary Conditions<\/strong><\/th>\nVR Average Severity Rating<\/strong><\/th>\nCIL Average Severity Rating<\/strong><\/th>\n<\/tr>\n\n| \u00a0Fatigue<\/td>\n | 1.67<\/td>\n | 1.50<\/td>\n<\/tr>\n | \n| \u00a0Deconditioning<\/td>\n | 1.71<\/td>\n | 1.54<\/td>\n<\/tr>\n | \n| \u00a0Sleep Disturbance<\/td>\n | 1.67<\/td>\n | 1.21<\/td>\n<\/tr>\n | \n| \u00a0Joint Pain<\/td>\n | 1.64<\/td>\n | 1.32<\/td>\n<\/tr>\n | \n| \u00a0Chronic Pain<\/td>\n | 1.62<\/td>\n | 1.21<\/td>\n<\/tr>\n | \n| \u00a0Depression<\/td>\n | 1.28<\/td>\n | \u00a0.92<\/td>\n<\/tr>\n | \n| \u00a0Arthritis<\/td>\n | 1.32<\/td>\n | \u00a0.96<\/td>\n<\/tr>\n | \n| \u00a0Weight<\/td>\n | 1.24<\/td>\n | 1.13<\/td>\n<\/tr>\n | \n| \u00a0Anger<\/td>\n | \u00a0 .91<\/td>\n | \u00a0 .80<\/td>\n<\/tr>\n | \n| \u00a0Mobility<\/td>\n | \u00a0.96<\/td>\n | 1.22<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n Using t-test group comparisons, the VR and CIL respondents had similar scores on the Health Promoting Lifestyle Inventory scale at baseline. However, the VR sample reported less satisfaction with overall health (p = .02) and more days of limitation due to health issues. Table 3 compares the two samples on reported days of limitation. There were significant group differences at baseline in days of limitation due to physical health, pain, anxiety, and difficulty sleeping.<\/p>\n <\/a>Table 3: Days of Limitation\u00a0 Text Description of Table 3<\/a><\/p>\n \n\n\nDuring the past 30 days, for about how many days…<\/strong><\/th>\nVR<\/strong><\/th>\nCIL<\/strong><\/th>\nSig.<\/strong><\/th>\n<\/tr>\n\n| …was your physical health not good?<\/td>\n | 12.0<\/td>\n | \u00a0 9.83<\/td>\n | .02<\/td>\n<\/tr>\n | \n| …did poor physical or mental health health keep you from doing your usual activities, such as self-care, work or recreation?<\/td>\n | \u00a08.45<\/td>\n | \u00a0 7.63<\/td>\n | .35<\/td>\n<\/tr>\n | \n| …was your mental health not good?<\/td>\n | \u00a09.61<\/td>\n | \u00a0 8.49<\/td>\n | .22<\/td>\n<\/tr>\n | \n| …did pain make it hard for you to do your usual activities, such as self-care, work or recreation?<\/td>\n | 13.66<\/td>\n | \u00a0 9.36<\/td>\n | .00<\/td>\n<\/tr>\n | \n| …have you felt sad, blue or depressed?<\/td>\n | \u00a0 9.79<\/td>\n | \u00a0 8.24<\/td>\n | .08<\/td>\n<\/tr>\n | \n| …have you felt worried, tense or anxious?<\/td>\n | 12.97<\/td>\n | \u00a0 9.90<\/td>\n | .00<\/td>\n<\/tr>\n | \n| …have you felt that you did not get enough rest or sleep?<\/td>\n | 16.07<\/td>\n | 11.58<\/td>\n | .00<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n Next Steps<\/span><\/strong><\/p>\nOver the next two years, RTC: Rural will collect longitudinal data from the VR sample at 6-month intervals. Follow-up data collection includes questions about the participant’s progression through VR services, including employment, training, and educational outcomes. These data will be used to create a regression model to determine the probability of successful employment placement, based on presenting secondary conditions and lifestyle behaviors.<\/p>\n Findings that link secondary health conditions, health promoting lifestyle behaviors, and employment outcomes (i.e. lower rates of secondary conditions and higher rates of health promoting behaviors are associated with better employment outcomes), build a case for VR support of health promotion services. CIL consumers experienced significant decreases in the incidence and prevalence of secondary conditions, significant improvements in health promoting lifestyle behaviors, and significant
\ndecreases in medical costs after participation in the eight-week Living Well with a Disability<\/em> health promotion program (Ravesloot, Seekins, & White, 2005). If these types of health changes contribute to successful employment outcomes, it will make sense for VR to fund health promotion activities.<\/p>\nNext steps include modifications to, and pilot testing of, the Living Well with a Disability<\/em> health promotion curriculum in a VR setting.<\/p>\nReferences<\/span><\/strong><\/p>\nAldana, S.G. (2001). Financial impact of health promotion programs: A comprehensive review of the literature. American Journal of Health Promotion<\/em>, 15, 296-320.<\/p>\nHarris Interactive, Inc. (2004). N.O.D.\/Harris 2004 survey of Americans with disabilities (Study No. 20835). New York: Author.<\/p>\n Pelletier, K. (2001). A review and analysis of the clinical- and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1998-2000 update. American Journal of Health Promotion<\/em>, 16, 107-116.<\/p>\nRavesloot, C., Seekins, T., & White, G. (2005). Living Well with a Disability<\/em> health promotion intervention: Improved health status for consumers and lower costs for health care policymakers. Rehabilitation Psychology<\/em>, 50, 239-245.<\/p>\nFor more information, contact:<\/strong><\/span><\/p>\nCatherine Ipsen, M.A.
\nMontana Disability and Health Program
\nThe University of Montana Rural Institute
\n52 Corbin Hall, Missoula, MT 59812-7056
\n888-268-2743 toll-free;
\n406-243-5467 Voice;
\n406-243-4200 TTY
\n406-243-2349 (fax)
\nhttp:\/\/rtc.ruralinstitute.umt.edu<\/a>
\nhttps:\/\/mtdh.ruralinstitute.umt.edu<\/a><\/p>\nThis research was supported by grant H133B030501 from the National Institute on Disability and Rehabilitation Research. Opinions expressed are the author’s and are not necessarily those of the funding agency. This factsheet was prepared by Catherine Ipsen RTC: Rural 2005. It is also available in standard, Braille, large print, and text formats.<\/p>\n","protected":false},"excerpt":{"rendered":" Rural Disability and Rehabilitation Research Progress Report #31 Working Well with a Disability: Project Update November 2005 People with disabilities have significantly lower employment rates than people without disabilities (Harris Interactive, Inc., 2004). One possible contributor to this disparity is that primary disabling conditions place people at greater risk for secondary health conditions, which […]<\/p>\n","protected":false},"author":10,"featured_media":0,"parent":149,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-5267","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=\/wp\/v2\/pages\/5267","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5267"}],"version-history":[{"count":0,"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=\/wp\/v2\/pages\/5267\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=\/wp\/v2\/pages\/149"}],"wp:attachment":[{"href":"https:\/\/mtdh.ruralinstitute.umt.edu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5267"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}} | | | | | | | | |