A Scoping Review of the Evidence on Disability Accommodations Targeting Equitable Communication Access in Health Care.

Purpose: The Americans with Disabilities Act (ADA) of 1990 protects the civil rights of people with disabilities, including their right to effective communication and equitable health care access through accommodations. The ADA website lists examples of accommodations (e.g.

Challenges of managing pediatric polypharmacy in a pediatric complex care program: A qualitative pilot study.

Background: Pediatric polypharmacy is often necessary for symptom and disease management in children with medical complexity (CMC) but can result in medication-related problems. Little is known about how pediatric care teams coordinate efforts to manage polypharmacy. This limits the pragmatic design of interventions to comprehensively manage pediatric polypharmacy.

How healthcare organizations provide disability accommodations to promote equitable care: A qualitative study.

Background: Federal laws require healthcare organizations (HCOs) to provide patients' disability accommodations when requested. However, patients' accommodations needs are often unmet, contributing to inequities in healthcare access and outcomes. Little is known about the systems and processes HCOs use to provide accommodations in varied settings.

Frequency of depression and anxiety symptoms among adults with childhood- versus adult-onset disability.

Background: Individuals with disabilities experience high rates of depression and anxiety. Potential differences between those with childhood- versus adult-onset disability have not been adequately explored.

Objective: To examine the relationship between age of disability onset and frequency of reported depression and anxiety symptoms.

How Women and Men with Parkinson's Disease Approach Decision-Making for Deep Brain Stimulation Surgery.

Background: Women make up only 23% to 30% of recipients for deep brain stimulation (DBS) surgery for Parkinson's disease (PD), a discrepancy that is not accounted for by differences in disease incidence. One of the many factors that may contribute to this gap includes gender differences in decision-making.

Objective: The aim was to explore how women and men approach the decision for DBS in terms of informational needs, weighing risks and benefits, and decision-making.

The criticality of reasonable accommodations: A scoping review revealing gaps in care for patients with blindness and low vision.

Background: Health and healthcare disparities for surgical patients with blindness and low vision (pBLV) stem from inaccessible healthcare systems that lack universal design principles or, at a minimum, reasonable accommodations (RA).

Objectives: We aimed to identify barriers to developing and implementing RAs in the surgical setting and provide a review of best practices for providing RAs.

Methods: We conducted a search of PubMed for evidence of reasonable accommodations, or lack thereof, in the surgical setting.

Can you know before you go? Information about disability accommodations on US hospital websites.

Background: People with disability (PWD) face challenges accessing healthcare. Websites are a public-facing resource that can help PWD determine if a hospital can accommodate their needs, yet few studies have described whether hospital websites contain adequate accommodation information.

Objective: To characterize the extent to which information about disability accommodations is available on US hospital websites.

Identifying Decisional Needs for Adult Tracheostomy and Prolonged Mechanical Ventilation Decision Making to Inform Shared Decision-Making Interventions.

Background: Decision making for adult tracheostomy and prolonged mechanical ventilation is emotionally complex. Expectations of surrogate decision makers and physicians rarely align. Little is known about what surrogates need to make goal-concordant decisions.

How Health Care Organizations Are Implementing Disability Accommodations for Effective Communication: A Qualitative Study.

Background: Prior studies have documented that, despite federal mandates, clinicians infrequently provide accommodations that enable equitable health care engagement for patients with communication disabilities. To date, there has been a paucity of empirical research describing the organizational approach to implementing these accommodations. The authors asked US health care organizations how they were delivering these accommodations in the context of clinical care, what communication accommodations they provided, and what disability populations they addressed.

Disparities in Smoking and Heavy Drinking Behaviors by Disability Status and Age of Disability Onset: Secondary Analysis of National Health Interview Survey Data.

Objectives: People with childhood-onset disabilities are living into adulthood, and the prevalence of smoking and illicit drug use among adults with disabilities is high. We evaluated the relationship between disability status and age of disability onset, current cigarette smoking status, and heavy alcohol drinking.

Methods: We conducted a secondary data analysis of the National Health Interview Survey (NHIS), a US survey on illness and disability.

Drivers of Decision-Making for Adult Tracheostomy for Prolonged Mechanical Ventilation: A Qualitative Study.

Background: Decision-making about tracheostomy and prolonged mechanical ventilation (PMV) is emotionally complex. Expectations of surrogate decision-makers and physicians rarely align. Little is known about what surrogates need to make goal-concordant decisions.

Preferred Communication Strategies for People with Communication Disabilities in Health Care Encounters: a Qualitative Study.

Background: People with communication disabilities (CDs), which includes disabilities in speech, language, voice and/or hearing, experience health and healthcare disparities. A barrier to accessing high-quality, equitable care is the lack of effective communication between patients and their providers.

Objective: In designing a patient-prompted tool to facilitate communication, we analyzed qualitative feedback on communication strategies and the experience of people with CDs, caregivers, and providers in healthcare encounters.

Documentation of Disability Status and Accommodation Needs in the Electronic Health Record: A Qualitative Study of Health Care Organizations' Current Practices.

Background: This qualitative study aimed to understand how early adopting health care organizations (HCOs) implement the documentation of patients' disability status and accommodation needs in the electronic health record (EHR).

Methods: The authors conducted qualitative interviews with HCOs that had active or past initiatives to implement systematic collection of disability status in the EHR. The interviews elicited participants' current experiences, desired features of a standard EHR build, and challenges and successes.

Parental experience and understanding of parent-provider discussions of treatment for infants with ureteropelvic junction obstruction.

Objective: The purpose of the current study was to understand what families identify as necessary information to guide decision-making in the treatment of their child with UPJO.

Methods: We conducted semi-structured interviews with parents of children with UPJO using phenomenological methodology. Data were systematically analyzed according to principles of thematic analysis, using a team-based inductive approach.

A coordinated approach for managing polypharmacy among children with medical complexity: rationale and design of the Pediatric Medication Therapy Management (pMTM) randomized controlled trial.

Background: Children with medical complexity (CMC) often rely upon the use of multiple medications to sustain quality of life and control substantial symptom burden. Pediatric polypharmacy (≥ 5 concurrent medications) is prevalent and increases the risk of medication-related problems (MRPs). Although MRPs are associated with pediatric morbidity and healthcare utilization, polypharmacy is infrequently assessed during routine clinical care for CMC.

Publication Trends of Qualitative Research in Dermatology: A Scoping Review.

Importance: Qualitative studies serve as a tool for dermatologists and researchers in dermatology to engage with and understand perspectives of populations with different cultures and backgrounds.

Objective: To assess (1) current approaches to qualitative dermatologic research and (2) the publication trends of these studies with the aim to inform researchers regarding qualitative research and its significance and applicability in the field of dermatology.

Evidence Review: A scoping review was conducted in which PubMed and CINAHL Plus were searched using dermatology AND qualitative, dermatology, and 7 qualitative methods terms.

Implementation strategies to address the determinants of adoption, implementation, and maintenance of a clinical decision support tool for emergency department buprenorphine initiation: a qualitative study.

Background: Untreated opioid use disorder (OUD) is a significant public health problem. Buprenorphine is an evidence-based treatment for OUD that can be initiated in and prescribed from emergency departments (EDs) and office settings. Adoption of buprenorphine initiation among ED clinicians is low.

Qualitative exploration of public health vending machines in young adults who misuse opioids: A promising strategy to increase naloxone access in a high risk underserved population.

Background: Take home naloxone (THN) programs have been shown to effectively reverse opioid overdose events with limited adverse events, yet often miss young adults who use opioids. To identify opportunities for naloxone expansion, we conducted interviews with young adults who had used opioids. We explored young adults' experience with current THN programs, and perspectives on ideal THN programs and emerging naloxone public health vending machine (PHVM) programs shown to increase access to sterile syringes in young adults.

Have Almost Fifty Years Of Disability Civil Rights Laws Achieved Equitable Care?

For almost fifty years, federal civil rights laws such as Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) of 1990 and the ADA Amendments Act of 2008, and Section 1557 and other provisions of the 2010 Patient Protection and Affordable Care Act have prohibited discrimination against Americans with disabilities, including in health care. Despite these laws, disabled Americans continue to experience disparities in health and health care, from preventive care to home and community-based services. In its 2022 the National Council on Disability highlighted some of these disparities and recommended remedies.

Trust and activation in defining patient-clinician interactions for chronic disease management.

Objective: Patient-clinician relationship quality and patient activation can both improve patient health outcomes, but prior work has primarily examined these factors independently. We examine how these two factors shape patient behavior in the setting of ambulatory heart failure care, where serial intensification of multiple medications is central to chronic care delivery.

Methods: We used content analysis to analyze 22 in-depth patient interviews and 32 audio-recorded clinic visits collected for the EPIC-HF Trial.

Research to Advance Health and Health Care Equity for People With Communication Disabilities: An Overview of Research Symposium Papers.

Presentation Video: https://doi.org/10.23641/asha.