Publications by authors named "Jacob A Bentley"

18 Publications

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The role of social connectedness in buffering the effects of discrimination on post-trauma cognitions in forcibly displaced Muslims.

Psychol Trauma 2022 Jan 16;14(1):47-54. Epub 2021 Sep 16.

Department of Psychology - Center for Anxiety and Traumatic Stress, University of Washington.

Introduction: Among trauma-exposed, forcibly displaced Muslims, very little is known about how social connectedness, or perceived interpersonal connection and belonging, may alter the relationship between discrimination and negative posttraumatic cognitions. Discrimination may aggravate trauma psychopathology (Helms et al., 2010); however, social connectedness may buffer its negative effects (Juang & Alvarez, 2010).

Objective: We examined whether higher religious and racial/ethnic discrimination would be associated with stronger negative posttraumatic cognitions and whether stronger social connectedness may adaptively buffer this relationship.

Method: Trauma exposed individuals (N = 99) who identified as Muslim and as a refugee, asylum seeker, or internally displaced person participated in the study. Measures of discrimination, social connection, and posttraumatic cognitions were completed.

Results: Higher discrimination was moderately associated with stronger negative trauma-related cognitions (r = .40, p < .001) and with lower social connectedness (r = -.32, p = .001). Social connectedness moderated the relationship between discrimination and posttraumatic cognitions, such that at lower levels of social connectedness there was a stronger relationship between discrimination and posttraumatic cognitions (-2SD: b = .32, -1SD: b = .23, M: b = .14), this was not present at higher levels of social connectedness.

Conclusions: Connectedness to one's minority group may be an important protective factor by modulating the effects of discrimination on posttrauma adjustment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0001070DOI Listing
January 2022

Implicit associations related to physical disability among nursing students.

Disabil Health J 2021 10 8;14(4):101150. Epub 2021 Jun 8.

Seattle Pacific University, USA. Electronic address:

Background: Negative beliefs about disability are associated with poorer outcomes for individuals with disabilities; understanding disability-related attitudes is critical for clinical care. Recently, interest in attitudes toward people with disabilities has increased; however, most studies focus on explicit attitudes. In contrast, the Disability Attitude Implicit Association Test (DA-IAT) is designed to evaluate respondents' underlying automatic preferences regarding physical ability.

Objective: The aim of this pilot study was to expand the literature on health professionals' implicit disability attitudes by analyzing the DA-IAT in a sample of nursing students.

Methods: A cross-sectional design was utilized with a sample of nursing students (n = 95; 88.7% female). Respondents completed the DA-IAT online before responding to some basic demographic questions.

Results: Participants associated able-bodied status with positive descriptors more quickly than disability related stimuli.

Conclusions: Most participants in this sample of nursing students (87%) mentally associated able-bodiedness with desirable traits in a more efficient manner than disability. Future research should focus on developing models to better understand the relationship between automatic processing, disability-related attitudes, and how this relationship informs clinician behavior.
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http://dx.doi.org/10.1016/j.dhjo.2021.101150DOI Listing
October 2021

Reaching the Unreached: Bridging Islam and Science to Treat the Mental Wounds of War.

Front Psychiatry 2021 2;12:599293. Epub 2021 Jun 2.

Ma'alin Haruon Masjid, Hargeisa, Somalia.

Radical new paradigms are needed to equip non-professionals and leverage community faith-based infrastructure to address the individual and communal wounds of war- and conflict-related trauma. Muslims in war-torn regions like Somalia experience high rates of trauma and posttraumatic stress; yet, lack of providers, potential stigma, and lack of integration with one's faith are substantial barriers to care. In this pre-post feasibility clinical trial (NCT03761732), mosque leaders implemented a brief, group- and mosque-based intervention, , targeting trauma-related psychopathology and community reconciliation for trauma survivors ( = 26) in Somaliland, Somalia. Leaders were trained in a brief 2-day training, with supervision provided remotely via WhatsApp. This six-session intervention combines empirically-supported trauma-focused psychotherapy and Islamic principles, focusing on wisdom from the lives of the Prophets and turning to Allah in dua about trauma. There were large, clinically meaningful effects for PTSD ( = 1.91), depression ( = 2.00), somatic symptoms ( = 2.73), and well-being ( = 1.77). Qualitative data from group members highlighted how well the program was aligned with their Islamic faith, built community, and need to expand the program. These results highlight the feasibility of this non-expert, easily up-scalable mental health approach in war-torn Muslim regions and refugee communities. This program has the potential to provide a low-cost, self-sustaining, Islam-based intervention addressing the psychological wounds of war consistent with the IOM's call to develop novel approaches to address unmet clinical needs. NCT03761732.
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http://dx.doi.org/10.3389/fpsyt.2021.599293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208506PMC
June 2021

Islamic Trauma Healing: Integrating Faith and Empirically Supported Principles in a Community-Based Program.

Cogn Behav Pract 2021 Mar 20;28(2):167-192. Epub 2020 Nov 20.

University of Washington.

Access to adequate, much less state-of-the-art, mental health care is a global problem. Natural disasters, civil war, and terrorist conflict have forcibly displaced millions of Muslims and have resulted in a remarkable level of individual and communitywide trauma exposure. As a result, many are at risk for posttraumatic stress and other trauma-related disorders. Many religiously oriented Muslims traditionally rely on Islamic principles and teachings, as well as their community, to cope with and address trauma-related distress. Islamic Trauma Healing is a six-session, lay-led group intervention developed within a Somali Muslim community that integrates evidence-based trauma-focused cognitive-behavioral therapy principles with cultural and religious practices aimed to enhance uptake and create an easily up-scalable intervention for a wide range of trauma. In sessions, narratives of prophets who have undergone trauma (e.g., Prophet Ayyub, faith during hard times) present Islamic principles and facilitate cognitive shifts. Group members spend individual time turning to Allah in dua (i.e., informal prayer), focused on exposure to trauma memories. Program themes arc across suffering to healing to growth following trauma. This paper describes the core theoretical principles and methods in the Islamic Trauma Healing program. We also describe leader perspectives and the program's train-the-trainer model, in which lay leaders are trained to further disseminate the program and allow Islamic Trauma Healing to be owned and sustained by the Muslim community.
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http://dx.doi.org/10.1016/j.cbpra.2020.10.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136181PMC
March 2021

Differences in Posttraumatic and Psychosocial Outcomes Among Refugees, Asylum Seekers, and Internally Displaced Persons.

J Nerv Ment Dis 2021 01;209(1):28-34

School of Psychology, Family, and Community, Seattle Pacific University.

Refugees, asylum seekers, and internally displaced persons differ in their experiences, potentially affecting posttraumatic outcomes such as posttraumatic stress disorder (PTSD) symptoms, posttraumatic cognitions, and posttraumatic growth (PTG), as well as psychosocial outcomes such as social connection, discrimination, and well-being. We explored these differences in a sample of N = 112 Muslim displaced persons. Results from planned contrasts indicated that refugees reported more PTSD symptoms (t[46.63] = 3.04, p = 0.004, d = 0.77) and more PTG (t[94] = 2.71, p = 0.008, d = 0.61) than asylum seekers. Higher posttraumatic cognitions predicted less social connections across displacement immigration category. The strength of this relationship was more pronounced for asylum seekers than refugees (b = -0.43, p = 0.014). Refugees may focus more on direct threats from others, resulting in more PTSD symptoms, whereas asylum seekers' uncertainty may pose a greater threat, exacerbating posttraumatic beliefs that drive social disconnection.
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http://dx.doi.org/10.1097/NMD.0000000000001248DOI Listing
January 2021

COVID-19: Understanding and mitigating trauma in ICU survivors.

Psychol Trauma 2020 Aug 25;12(S1):S100-S104. Epub 2020 Jun 25.

Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine.

The spread of coronavirus disease 2019 (COVID-19) has placed many individuals in need of critical care, with a high proportion of hospitalized patients being admitted to intensive care units (ICU) to treat acute outcomes of COVID-19 (e.g., respiratory failure via mechanical ventilation). The ICU is known to be a setting where individuals are at a high risk of experiencing significant psychological difficulties, and patients with COVID-19 are particularly susceptible to such experiences, which can impact their recovery process (e.g., postintensive care syndrome). This article seeks to highlight the intersection between critical care related to trauma and COVID-19 and point providers toward opportunities for anticipating and managing secondary effects in effort to promote psychological adaptation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000884DOI Listing
August 2020

Healthcare coverage and utilization among caregivers in the United States: Findings from the 2015 Behavioral Risk Factor Surveillance System.

Rehabil Psychol 2020 Feb 23;65(1):63-71. Epub 2020 Jan 23.

Department of Clinical Psychology.

Purpose/objective: Caregivers are vital to our health care system and its sustainability, yet extensive literature has recognized caregivers' vulnerabilities for experiencing financial, physical, and emotional difficulties-compromising the sustainability of their services. The risks associated with being a caregiver are not well-defined and warrant further exploration to guide national health initiatives underway. This brief report sought to identify risks that may be associated with the wide-ranging secondary effects of being a caregiver. Specifically, health care coverage and utilization were compared between caregivers and noncaregivers in a large national sample.

Method: A cross-sectional study design was used with data from the 2015 Behavioral Risk Factor Surveillance System. Risk ratio analyses were conducted to assess how many times more likely unpaid adult caregivers were for experiencing specific risks related to health care access, relative to noncaregivers.

Results: Caregivers ( = 24,034; 64.5% female; 69.6% preretirement age) were more at risk for lacking health care coverage and underutilizing needed health care service due to cost, when compared to noncaregivers ( = 84,412; 57.3% female; 61.8% preretirement age). Caregivers were also at an increased risk for lifetime diagnosis of a depressive disorder and activity limitations due to a health challenge.

Conclusions: Our findings highlight the need for the development of low-cost and accessible clinical services available to caregivers. Rehabilitation psychology can offer unique and instrumental contributions for addressing this growing population's health care needs by informing disability-focused public health agendas and incorporating caregivers into rehabilitation programs for care recipients. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/rep0000307DOI Listing
February 2020

Prevalence and factors associated with utilization of rehabilitation services among people with physical disabilities in Kampala, Uganda. A descriptive cross sectional study.

BMC Public Health 2019 Dec 27;19(1):1742. Epub 2019 Dec 27.

Department of Global Health, Milken Institute School of Public Health, the George Washington University, Washington, DC, USA.

Background: Worldwide, fifteen percent (15%) of the world's population or one (1) billion people live with some form of disability. In Uganda, 12.4% of the Uganda's population lives with some form of disability and Kawempe division accounts for (22.6%) of all persons with disabilities living in Kampala district. Rehabilitation services are provided within Kawempe division at Mulago hospital physiotherapy department and Katalemwa rehabilitation center in Kampala district, Uganda at a free and a subsidized cost to help to improve the function, independence, and quality of life of persons with physical disabilities. However, many people with physical disabilities do not utilize the services and the reasons are not clear.

Methods: The study design was a descriptive cross-sectional study employing quantitative methods of data collection. A total of 318 participants were included in the study. Simple random sampling was used to select the study participants. Ethical issues were maintained at all levels during data collection and dissemination of results.

Results: The study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Kampala, Uganda. Factors that were significantly associated with utilization of rehabilitation services among people with physical disabilities at multivariable logistic regression analysis included; age (AOR: 0.30; 95% CI: 0.12-0.74), socioeconomic status (AOR: 2.13; 95% CI: 1.03-4.41), education level (AOR: 4.3; 95% CI: 1.34-13.91) and awareness of the participants about the rehabilitation services (AOR: 5.1; 95% CI: 2.74-9.54) at p value ≤0.05.

Conclusion: The study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Uganda. Factors that were significantly associated with utilization of rehabilitation services included; age, socioeconomic status, education level and awareness of the participants about the services. Therefore, the government and other relevant stake holders should increase sensitization and awareness of rehabilitation services, their benefits and facilities providing such services to people with physical disabilities, healthcare professionals and the general public.
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http://dx.doi.org/10.1186/s12889-019-8076-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935194PMC
December 2019

Postgraduate training for trauma prevention, injury surveillance and research, Uganda.

Bull World Health Organ 2018 Jun 12;96(6):423-427. Epub 2018 Apr 12.

Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E-8132, Baltimore, Maryland, 21205, United States of America (USA).

Problem: The burden of trauma and injuries in Uganda is substantial and growing. Two important gaps that need addressing are the shortage of trained people and a lack of national data on noncommunicable diseases and their risk factors in Uganda.

Approach: We developed and implemented a new track within an existing master of public health programme, aimed at developing graduate-level capacity and promoting research on key national priorities for trauma and injuries. We also offered training opportunities to a wider audience and set up a high-level national injury forum to foster national dialogue on addressing the burden of trauma, injuries and disability.

Local Setting: The Chronic Consequences of Trauma, Injuries and Disability in Uganda programme was implemented in 2012 at Makerere University School of Public Health in Kampala, Uganda, in conjunction with Johns Hopkins Bloomberg School of Public Health in Baltimore, United States of America.

Relevant Changes: Over the years 2012 to 2017 we supported four cohorts of master's students, with a total of 14 students (9 females and 5 males; mean age 30 years). Over 1300 individuals participated in workshops and seminars of the short-term training component of the programme. The forum hosted three research symposia and two national injury forums.

Lessons Learnt: Institutional support and collaborative engagement is important for developing and implementing successful capacity development programmes. Integration of training components within existing academic structures is key to sustainability. Appropriate mentorship for highly motivated and talented students is valuable for guiding students through the programme.
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http://dx.doi.org/10.2471/BLT.17.200949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996215PMC
June 2018

Caregiving for Uganda's elders with disability: Using cross-sectional surveillance data to identify healthcare service gaps in low- and middle-income settings.

Disabil Health J 2018 07 31;11(3):456-460. Epub 2017 Dec 31.

Department of Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.

Background: Disability is highly prevalent in low-and-middle-income countries (LMICs), but there is a relative dearth of disability and caregiving research from LMICs.

Objective: To examine type and severity of disability experienced by individuals 60 years and older, caregivers and type of caregiving assistance, and the interrelationships between sociodemographic factors involved in Uganda.

Methods: Data was collected from two Eastern Ugandan districts using the WHO Disability Assessment Schedule 2.0. Data on availability of caregiver was analyzed for 816 participants with disability. Group comparisons and regression analyses examined differences based on caregiver availability.

Results: Approximately 66% of individuals with disability had a caregiver. The mean age of those with a caregiver (74.7 ± 8.9 years) was statistically significantly (p = .0004) higher than that of individuals without caregiver (72.4 ± 8.2 years). Significant differences based on caregiver availability were found relative to sex (p = .009), age (p≤.001), education level (p≤.001), occupation (p≤.001) and head of household status (p≤.001). The most frequent types of disability were related to vision (78.4%) and ambulation (71.7%). Caregiving most often fell to family members. Logistic regression results showed that individuals over the age of 80 years were 2.51 times more likely to have a caregiver compared to those 60-69 years (p≤.001). Those in the highest wealth quintile were 1.77 times more likely to have a caregiver.

Conclusions: Findings demonstrate gaps in caring for aging individuals with disabilities in LMICs and highlight the importance of understanding caregiver access in generating effective healthy aging initiatives and long-term care systems.
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http://dx.doi.org/10.1016/j.dhjo.2017.12.011DOI Listing
July 2018

The physical postures of yoga practices may protect against depressive symptoms, even as life stressors increase: a moderation analysis.

Psychol Health Med 2018 Aug 8;23(7):870-879. Epub 2018 Jan 8.

a Department of Clinical Psychology , Seattle Pacific University , Seattle , WA , USA.

Yoga contains sub-components related to its physical postures (asana), breathing methods (pranayama), and meditation (dhyana). To test the hypothesis that specific yoga practices are associated with reduced psychological distress, 186 adults completed questionnaires assessing life stressors, symptom severity, and experience with each of these aspects of yoga. Each yoga sub-component was found to be negatively correlated with psychological distress indices. However, differing patterns of relationship to psychological distress symptoms were found for each yoga sub-component. Experience with asana was negatively correlated with global psychological distress (r = -.21, p < .01), and symptoms of anxiety (r = -.18, p = .01) and depression (r = -.17, p = .02). These relationships remained statistically significant after accounting for variance attributable to Social Readjustment Rating Scale scores (GSI: r = -.19, p = .01; BSI Anxiety: r = -.16, p = .04; BSI Depression: r = -.14, p = .05). By contrast, the correlations between other yoga sub-components and symptom subscales became non-significant after accounting for exposure to life stressors. Moreover, stressful life events moderated the predictive relationship between amount of asana experience and depressive symptoms. Asana was not related to depressive symptoms at low levels of life stressors, but became associated at mean (t[182] = -2.73, p < .01) and high levels (t[182] = -3.56, p < .001). Findings suggest asana may possess depressive symptom reduction benefits, particularly as life stressors increase. Additional research is needed to differentiate whether asana has an effect on psychological distress, and to better understand potential psychophysiological mechanisms of action.
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http://dx.doi.org/10.1080/13548506.2017.1420206DOI Listing
August 2018

Disability Characteristics of Community-Based Rehabilitation Participants in Kayunga District, Uganda.

Ann Glob Health 2017 May - Aug;83(3-4):478-488

Johns Hopkins University, Baltimore, MD; Seattle Pacific University, Seattle, WA.

Background: Approximately 80% of individuals with disability reside in low- and middle-income countries where community-based rehabilitation (CBR) has been used as a strategy to improve disability. However, data relating to disability severity among CBR beneficiaries in low-income countries like Uganda remain scarce, particularly at the community or district level.

Objectives: To describe severity of disability and associated factors for persons with physical disabilities receiving CBR services in the Kayunga district of Uganda.

Methods: A cross-sectional sample of 293 adults with physical disabilities receiving a CBR service in the Kayunga district was recruited. Disability severity was measured using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS2.0), and analyzed as a binary outcome (low: 0-9, high: 10-48). Inferential statistics using odds ratios were used to determine factors associated with impairment severity.

Findings: The mean WHODAS 2.0 score of persons with physical disabilities was 12.7 (standard deviation = 8.3). More than half (52.90%) of people with physical disabilities reported a high level of functional impairment. Increased disability severity was significantly associated with limited access to assistive devices (adjusted odds ratio [AOR] = 4.55, 95% confidence interval [CI]: 1.87-14.08, P < .001), and increased use of medical health care (AOR = 5.55, 95% CI: 1.84-16.79, P = .002).

Conclusion: These findings suggest a high level of moderate to severe functional impairments in persons with physical disabilities receiving CBR in Kayunga district. These data provide support for efforts to enhance CBR's ability to liaise with local health care, education, and community resources to promote access to needed services and ultimately improve the functional status of persons with disabilities in low-resource settings.
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http://dx.doi.org/10.1016/j.aogh.2017.10.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728444PMC
August 2018

Characteristics of individuals seeking activity-based restorative therapy following spinal cord injury: A focus on hope.

NeuroRehabilitation 2017 ;41(1):237-240

Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: There is a lack of evidence regarding the psychosocial characteristics of individuals with spinal cord injury (SCI) undergoing activity-based restorative therapy (ABRT) treatment.

Objectives: This study seeks to describe the hopefulness of a sample of ABRT participants and describe the relationship between hopefulness and level of rehabilitation engagement.

Methods: A prospective cross-sectional cohort study was conducted using a convenience sample of 73 individuals with SCI (mean time since injury = 66.6 months) seeking out-patient, post-acute rehabilitation at a metropolitan ABRT center. Outcome measures included a demographic survey, The Hope Scale, the Patient Health Questionare-9 and the Hopkins Rehabilitation Engagement Rating Scale.

Results: The ABRT group reported higher levels of hope (M = 54.78, SD = 7.13) than have been reported in a sample of individuals with SCI seeking traditional rehabilitation in the acute (M = 24.58, SD = 4.06) setting. Rehabilitation engagement was not related to hopefulness in the ABRT group.

Conclusions: The ABRT group demonstrated high levels of hopefulness. The difference in hopefulness noted between this group and previous studies could be due to the time elapsed since injury, the presence of choice in the rehabilitation process, or the possibility that individuals who chose to participate in ABRT may have inherently different hopefulness characteristics than the broader SCI population.
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http://dx.doi.org/10.3233/NRE-171476DOI Listing
March 2018

Globalizing rehabilitation psychology: Application of foundational principles to global health and rehabilitation challenges.

Rehabil Psychol 2016 Feb;61(1):65-73

Centre for Global Health and School of Psychology, Trinity College.

Purpose/objective: This article reviewed foundational principles in rehabilitation psychology and explored their application to global health imperatives as outlined in the World Report on Disability (World Health Organization & World Bank, 2011).

Research Method/design: Historical theories and perspectives are used to assist with conceptual formulation as applied to emerging international rehabilitation psychology topics.

Results: According to the World Report on Disability (World Health Organization & World Bank, 2011), there are approximately 1 billion individuals living with some form of disability globally. An estimated 80% of persons with disabilities live in low- to middle-income countries (WHO, 2006). The primary messages and recommendations of the World Report on Disability have been previously summarized as it relates to potential opportunities for contribution within the field of rehabilitation psychology (MacLachlan & Mannan, 2014). Yet, undeniable barriers remain to realizing the full potential for contributions in low- to middle-income country settings.

Conclusions/implications: A vision for engaging in international capacity building and public health efforts is needed within the field of rehabilitation psychology. Foundational rehabilitation psychology principles have application to the service of individuals with disabilities in areas of the world facing complex socioeconomic and sociopolitical challenges. Foundational principles of person-environment interaction, importance of social context, and need for involvement of persons with disabilities can provide guidance to the field as it relates to global health and rehabilitation efforts. The authors illustrate the application of rehabilitation psychology foundational principles through case examples and description of ongoing work, and link foundational principles to discreet domains of intervention going forward.
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http://dx.doi.org/10.1037/rep0000068DOI Listing
February 2016

Characterizing disability at the Iganga-Mayuge Demographic Surveillance System (IM-DSS), Uganda.

Disabil Rehabil 2016 12;38(13):1291-9. Epub 2015 Oct 12.

a International Injury Research Unit, Health Systems Program, Department of International Health , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA .

Purpose: There is a need to better measure disability as an outcome to understand the magnitude of the problem and its impact on health and socio-economic status. The aim of this study was to characterize the physical disabilities present at the Iganga-Mayuge Demographic Surveillance Site (IM-DSS) in Uganda.

Methods: WHODAS 2.0 was used to examine the consequences of disability on activity limitations and participation in society. One thousand five hundred and fourteen individuals over the age of 18 at the IM-DSS with previously identified physical disabilities were included. Total and domain scores were calculated, and regression analyses examined differences by age, sex, education, occupation and SES.

Results: The mean total score was 40.72. Domain 2 - getting around, had the highest mean score (57.21), followed by household activities (55.18). Domains 5.2 (work/school activities) and 6 (participation in society) also had relatively high mean scores - 47.71 and 49.44, respectively.

Conclusion: This study serves as an indication of what the major limitations are among individuals in rural Uganda with physical disabilities. In general, individuals with disabilities had the most trouble on getting around, life activities and participation in society. This can guide public health planners and policy-makers on priorities to ameliorate the impact of disabilities in this population.

Implications For Rehabilitation: This study found that in general, individuals with disabilities had the most trouble on getting around, life activities and participation in society. This can guide public health planners and policy-makers on rehabilitation priorities to ameliorate the impact of disabilities in this population. Efforts can be made to develop and implement rehabilitation programs that cater to the needs of vulnerable populations including females and older individuals. Programs that focus on education and employment for physically disabled individuals ought to be given priority. These could include legislative changes, and modification of the physical environment, among others.
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http://dx.doi.org/10.3109/09638288.2015.1079928DOI Listing
December 2016

A new screening instrument for disability in low-income and middle-income settings: application at the Iganga-Mayuge Demographic Surveillance System (IM-DSS), Uganda.

BMJ Open 2014 Dec 19;4(12):e005795. Epub 2014 Dec 19.

International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.

Objective: The measurement of disability in low-income countries is recognised as a major deficiency in health information systems, especially in Africa. The Iganga and Mayuge Demographic Surveillance System (IM-DSS) in Uganda provides a special opportunity to develop population-based data to inform national health policies and evaluate innovations in assessing the burden of disability in Uganda. In this study, we apply a new instrument to screen for physical disabilities at the IM-DSS. The study utilised a modified version of the short set of questions proposed by the Washington Group on Disability Statistics. The instrument was applied at the household level and information was collected on all individuals over the age of 5, who were residents of the IM-DSS.

Setting: The study was based at the IM-DSS, which covers the parts of Iganga and Mayuge districts in Eastern Uganda.

Participants: 57,247 individuals were included in the survey, with 51% of the study population being women.

Primary Outcomes: Activity limitations

Results: The overall prevalence of physical disability at the IM-DSS was 9.4%, with vision being the most common type of difficulty reported in this population, and communication being least prevalent. Disability was less likely to be observed among males than their female counterparts (OR 0.75; 95% CI 0.71 to 0.81; p<0.001). Statistically significant associations were found between disability and increasing age, as well as disability and decreasing household wealth status.

Conclusions: This study shows that the modified short set of questions can be readily applied in a DSS setting to obtain estimates on the prevalence and types of disability at the population level. This instrument could be adapted for use to screen for disability in other LMIC settings, providing estimates that are comparable across different global regions and populations.
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http://dx.doi.org/10.1136/bmjopen-2014-005795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275668PMC
December 2014

Cardiovascular responses to a laboratory stressor in women: Assessing the role of body awareness.

Body Mov Dance Psychother 2012 Feb 28;7(1):55-70. Epub 2011 Nov 28.

Women's Health Lab, School of Psychology, Family, and Community, Seattle Pacific University, Seattle, WA, USA.

Body awareness (BA) is characterised by a general tendency towards awareness and recognition of normal, non-emotive bodily processes and physical sensations. BA considers one's sensitivity towards and belief in how well they can sense, predict, and describe their bodily functions and sensations. This study investigated the role of BA in haemodynamic and anxiety responses to a laboratory stressor. Women ( = 40) completed assessments of BA and state/trait anxiety. Women with low BA displayed higher blood pressure (BP) and heart rate (HR) reactivity in response to the stressor than women with high BA. Delayed HR recovery poststressor was observed in women with low BA. BA was a significant predictor of haemodynamic reactivity over and above trait anxiety. BA effects on state anxiety were not observed. Thus, greater BA is associated with less haemodynamic stress reactivity in women lending further support for the development of BA interventions aimed at stress reduction.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5033505PMC
http://dx.doi.org/10.1080/17432979.2011.617522DOI Listing
February 2012

The indirect effect of somatic complaints on report of posttraumatic psychological symptomatology among Somali refugees.

J Trauma Stress 2011 Aug 13;24(4):479-82. Epub 2011 Jul 13.

Department of Clinical Psychology, Seattle Pacific University, Seattle,WA 98119, USA.

Somali refugees are a growing population of displaced persons at risk for considerable traumatic exposure and its subsequent psychological symptomatology. Two hypotheses were proposed to evaluate the relationships between somatic complaints and posttraumatic psychological symptoms in a community-based sample of 74 adult Somali participants. As hypothesized, traumatic exposure predicted increased symptoms of posttraumatic stress disorder (PTSD; r = .64, p < .01), depression (r = .31, p < .01), and anxiety (r = .38, p < .01) in the basal model. In evaluation of the second hypothesis, somatic complaints were found to have a statistically significant indirect effect on the predictive relationship between traumatic life events and mood disturbance, accounting for 9% of the variance in depression and 14% of the variance in anxiety. However, somatic complaints failed to have an indirect effect on the relationship between traumatic exposure and symptoms of PTSD. Post hoc analyses revealed that, consistent with research conducted with nonrefugee populations, PTSD had a statistically significant indirect effect that accounted for 13% of the variance in the relationship between trauma and somatic complaints. These findings provide preliminary data regarding the influence of somatic complaints on the self-reported psychological symptoms of internationally displaced Somali refugees.
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http://dx.doi.org/10.1002/jts.20651DOI Listing
August 2011
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