Title: Implications for Public Health: Research of Models and Theories of Disability
Funder: Department of Health (England)

Abstract: Nearly ten million people in England experience significant difficulty with day-to-day activities linked to disability. Many are living with other chronic conditions. The experience of disability is also strongly age-related. Further the impact of impairments has a marked social gradient. People with disabilities are disproportionately disadvantaged with respect to the social factors that contribute to health inequalities such as educational and employment opportunities poverty and poor housing and inequitable access to services. These environmental disadvantages are in turn disabling and create barriers to social inclusion. Public health research has largely overlooked the experience of disability having little to say on appropriate study designs and measures (including economic evaluation); or how to actively engage disabled people. Nor does it demonstrate much of an understanding of the different consequences of having lifelong acquired or fluctuating conditions; or how social disadvantage gender ethnicity sexual orientation and lifecourse mediate experience. Nonetheless we have some important platforms on which to build which offer alternative ways of defining and engaging with disability. Our project will scope models and theories of disability and by assessing whether and how existing intervention studies incorporate these approaches draw out recommendations for improving study designs and outcome measures. Analysis will focus on what works under what circumstances and with what consequences. To achieve this we propose a two-stage project. First we will undertake a scoping review and synthesis of research critiquing models and theories of disability. This review will summarise the range of models and theories; their place within disability studies and social movements of disabled people; and their potential contribution to public health research and policy. Second we will undertake a review of 60 purposively-selected public health interventions from the Cochrane (international) Library of intervention reviews. Thirty of the reviews (containing data on at least 160 studies) will be where people with disabilities are identified as a key target group and this will enable us to explore the potential for inclusive designs. Thirty will be more generic interventions which have potential relevance to adults and children with disabilities (and containing data on 160 studies). This will enable us to gain insights into the ability of mainstream research to capture the experience of disability and the possibilities of developing more universal and inclusive designs. Supplementary insights will be gained by sampling reviews identified in databases held by Campbell Collaboration and Joanna Briggs institute. Synthesis will assess the perspectives and methods employed when evaluating public health interventions. We will focus on mapping and offering a critical commentary on: the models and theories of disability underpinning the intervention; the terminology and categorisation of disability used or if no discussion a consideration of the potential relevance of the intervention to the experience of disabled people; whether a life course perspective is evident; methods of participant and public and involvement; and (inclusive) study designs and outcomes. The project will provide good practice guidelines sensitive to diverse experience of disability and grounded in an appreciation of current research practice.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE