Foundations of Rehabilitation Science Test 3

Why is youth obesity a primary concern in the U.S.?

It affects both youth with and without disabilities and contributes to long-term health complications.

What are key factors influencing youth obesity?

Gender, age, race, socioeconomic status (SES), and BMI.

How is SES linked to obesity?

Lower-income populations may lack access to healthier food, which is often more expensive

What did Basset et al. (2015) project regarding obesity trends?

Every U.S. adult could be overweight or obese by 2040.

What are the main determinants of children’s health?

Social, environmental, and behavioral factors beyond the health care system (AAP, 2010).

Which population is identified as at-risk by AAP (2010)?

Children with disabilities.

How has physical activity changed in youth without disabilities (Basset)?

Decreased in tech societies, commuting, PE, and outdoor play; sports: increased for females, stable for males.

What are obesity risk factors in youth with disabilities (Rimmer)?

Lower physical activity, nutrition issues, limited awareness, and low social participation.

How does obesity affect people with disabilities?

It's a leading secondary condition and leads to higher health care costs.

How much higher are obesity rates in adults with disabilities?

58% higher compared to those without disabilities.

What are annual disability-related healthcare costs in WI and MN?

$7.8 billion/year.

What is the average per-person expenditure?

$12,104 (WI), $11,559 (MN).

Which age group in WI has the highest obesity percentage?

Adults 65+ years old (37.8%).

What is the economic impact of obesity in people with disabilities?

Higher medical care needs, limited mobility, and delayed treatment increase costs.

Which healthcare service shows the highest obesity-related expense?

Prescription drugs (3x higher for people with disabilities).

Which payer group has the highest additional obesity expenditures?

Medicare, followed by private insurance and Medicaid.

What challenges contribute to obesity in people with disabilities?

Poor diet options, medication effects, physical limitations, pain, energy deficits, and inaccessible environments.

What is the leading cause of death in the U.S.?

Heart disease for both men and women.

What is the most common type of heart disease?

Coronary artery disease.

What are medical conditions that increase CVD risk?

High blood pressure, high cholesterol, and diabetes.

What behaviors increase CVD risk?

Unhealthy diet, physical inactivity, obesity, excessive alcohol, tobacco use.

What is the leading cause of death among adults with disabilities?

Heart disease.

How do movement disabilities affect mortality?

Higher mortality from all causes.

Define "Aging with disability."

Aging into old age with a disability acquired earlier in life.

Define "Aging into disability."

Acquiring disabilities later in life as part of aging.

What increases CVD risk in people with disabilities?

Behavioral health risks, secondary conditions, lack of preventive services, and lower quality of care.

What is physical activity (PA)?

Body movement increasing energy expenditure above resting levels.

Give examples of leisure-time PA.

Walking, dancing, gardening, hiking, swimming.

What percent of Americans don’t have a regular exercise routine?

~80%.

What is sedentary behavior?

Waking behavior with ≤1.5 METs in a sitting or lying posture.Includes activities like watching TV, sitting at a desk, or reading.

What are sedentary behavior patterns?

How sedentary time is accumulated (duration, timing, frequency).

Define "Prolonger."

A person who extends the duration of sedentary behavior, often leading to increased health risks. Someone who sits for long, uninterrupted periods.

Define "Breaker."

A person who interrupts sedentary behavior with activity breaks, reducing the overall time spent in a sedentary posture. (Someone who interrupts sedentary time frequently.)

What is health promotion?

Enabling people to improve and control their health.

What are ecological models of health behavior?

Focus on the interaction between people and their environments.

What theories influence health promotion?

Transtheoretical model, social cognitive theory, ecological models.

Name four types of health promotion programs.

Training programs, informational campaigns, environmental changes, financial support.

What are major health promotion concerns?

Individual variation, responders vs non-responders.

Who provides health promotion info?

Academic, government, NGO, professional organizations.

How is health promotion info presented?

Research summaries, fact sheets, opinion pieces, websites, etc.

What are CDC (2019) recommendations for providers?

Ask about PA, discuss barriers, recommend options, refer to resources.

What are the five steps for inclusion?

Define policy, educate staff, remove barriers, engage disability community, evaluate progress.

What is the goal of integrated service teams?

Provide one-stop healthcare for people with disabilities.

Who are key healthcare stakeholders?

Professionals, policymakers, purchasers, regulators, managers, consumers.

What are the six healthcare improvement aims?

Safety, effectiveness, patient-centered, timely, efficient, equitable.

What makes care patient-centered?

Respecting individual needs and values in all clinical decisions.

What are barriers doctors face in recommending PA?

Lack of time, uncertainty about impact, safety, patient interest, and referral options.

Benefits of PA for patients?

Improves mental/physical health, daily functioning, stress coping, disease prevention.

Why do few doctors prescribe exercise?

Low confidence, time constraints, lack of reimbursement.

What should PTs do to support health promotion?

Screen for PA, support capability, address environment and opportunities.

What are the three healthcare continuation needs for PWD?

PTs with health promotion training, rehab professionals in community fitness, funding support.

What does IDEA focus on? Key legislation

Educational experiences for students with disabilities.

What do Section 504 and ADA enforce?

Equal rights and access for individuals with disabilities.

How does legislation affect clinical populations?

It ensures access and support across the lifespan and in the community.

What areas do disability-related policies in the U.S. address?

Education, employment, health, voting, transportation, telecommunications, housing, and more.

What role do pediatric health care providers play in relation to disability and legislation?

They act as advocates promoting the well-being of all children in both educational and healthcare settings.

Define “legislation” in the context of disability law.

The preparation and enactment of laws at local, state, and national levels.

Define “litigation” in the context of disability rights.

The use of the judicial process (e.g., lawsuits) to create new laws or enforce existing laws, often used to benefit individuals with disabilities.

What does IDEA stand for and who does it cover?

Individuals with Disabilities Education Act; covers individuals ages 0–21.

What are key elements of IDEA?

Due process, equal opportunity in nonacademic activities, mandated identification/evaluation, and shared decision-making with parents/students.

What is the purpose of special education services under IDEA?

Specially designed instruction, free of cost, to meet the unique needs of children with disabilities in various settings.

What are “Related Services” under IDEA?

Supportive services required to assist a child with a disability to benefit from special education.

What is an IEP and who is it for?

Individualized Education Program; required for students with disabilities aged 3–21 under IDEA.

What is an IFSP and who is it for?

Individualized Family Service Plan; required for infants and toddlers with disabilities (ages 0–2) for early intervention.

What is the goal of early intervention services under IDEA?

Enhance development and minimize potential delays in identified areas.

Who participates in determining eligibility for early intervention services?

Multidisciplinary team, parents, service coordinator, professionals, advocates, and others interested in the child’s well-being.

What does Section 504 of the Rehabilitation Act (1973) ensure?

Prohibits discrimination based on disability in programs receiving federal funding.

What does Section 504 require of athletic events and physical education in public schools?

Equal access for students with disabilities; athletic events must be accessible to all, including those in wheelchairs.

Do all school facilities need to be accessible under Section 504?

No; not all facilities must be accessible as long as the programs themselves are accessible.However, schools must make reasonable accommodations to ensure students with disabilities can participate in programs.

When was the Americans with Disabilities Act passed, and what did it build upon?

Passed in 1990; it extended the Rehabilitation Act's nondiscrimination protections to all programs regardless of funding source.

Who is protected under the ADA?

Individuals with a physical or mental condition that substantially limits one or more major life activities.

Name at least five major life activities listed under the ADA.

Walking, seeing, hearing, speaking, breathing, learning, working, and caring for oneself.

What does Title I of the ADA cover?

Employment—prohibits discrimination against qualified individuals with disabilities.

What does Title II of the ADA cover?

Public Services & Transportation—prohibits exclusion from benefits/services.

What does Title III of the ADA cover?

Public Accommodations—ensures access to privately operated businesses.

What does Title IV of the ADA address?

Telecommunications access for people with hearing or speech disabilities.

What does Title V of the ADA include?

Miscellaneous provisions related to enforcement and legal interpretation.

What are some roles of healthcare providers in relation to disability legislation?

• Identifying children in need of services

• Sharing info with schools

• Participating in school meetings

• Using educational info in treatment

• Working in schools or health clinics

• Improving school systems administratively