Search Results (27)

Digital technologies are revolutionizing health systems worldwide. People with higher digital health literacy are better equipped to access reliable health information, utilize telehealth services, and effectively manage their health through applications. However, a notable digital divide exists for people with intellectual disabilities, and the digitization of healthcare can limit their health opportunities. This scoping review examines the current evidence on digital health literacy among people with intellectual disabilities, emphasizing specific challenges and the need for tailored adaptations. Eleven articles from ten databases were included in the review. Although digital health literacy is becoming increasingly important, it is rarely discussed for people with intellectual disabilities. The term “digital health literacy” is not used, with the exception of one article. However, the focus is mostly on applicability and often at the functional level. The findings underscore that people with intellectual disabilities are underrepresented in research studies and interventions related to digital health literacy. Additionally, the results indicate the lack of a theoretical population-specific framework that focuses on competencies and life experiences. Participation in the digital world is a human right (UN CRPD). Addressing the digital gap is crucial, as improving digital health literacy can lead to better health outcomes, equitable access to health services, and reduced health disparities among people with intellectual disabilities. Based on the results, research directions for developing a population-specific framework for this highly vulnerable group are discussed. Full article

This article examines the accessibility of public space for individuals with disabilities in the Netherlands, as well as the relevant legal frameworks intended to promote accessibility. It discusses the Convention on the Rights of Persons with Disabilities (UN CRPD) and efforts to implement its provisions at the local level. The article first provides an overview of Dutch legislation and regulations concerning accessibility in public spaces. It then presents an analysis of the experiences of individuals with disabilities in navigating streets and pavements in two Dutch cities, Utrecht and Almere. The central question is to what extent equal participation in public space has been realised. The findings indicate that national legislation remains inadequate in addressing the accessibility of streets and pavements. Despite the constitutional amendment in January 2023, which prohibits discrimination on the grounds of disability, substantive equality is largely dependent on the individual policies and bylaws of the 342 municipalities. The involvement of individuals with disabilities in shaping the inclusive use of public space is therefore crucial at the local level. This article highlights local initiatives that have successfully drawn the attention of municipal policymakers and civil servants to the importance of accessible streets. Full article

Health equity is an important aspect of wellbeing and is impacted by many social determinants. The UN Convention on the Rights of Persons with Disabilities (CRPD) is a testament to the lack of health equity and the many health inequity issues based on social determinants experienced by disabled people. The health equity/health inequity situation of disabled people is even worse if their identities intersect with those of other marginalized groups. Many societal developments and discussions including discussions around the different sustainability pillars can influence the health equity/health inequity of disabled people. The general aim of this study was to better understand the academic engagement with the health equity and health inequity of disabled people beyond access to healthcare. To fulfill our aim, we performed a scoping review of academic abstracts using a hit count manifest coding and content analysis approach to abstracts obtained from SCOPUS, the 70 databases of EBSCO-HOST, Web of Science, and PubMed. Health equity and health inequity abstracts rarely cover disabled people as a group, less with many specific groups of disabled people, and even less or not at all with the intersectionality of disabled people belonging to other marginalized groups. Many social determinants that can influence the health equity and health inequity of disabled people were not present. Ability-based concepts beyond the term ableism, intersectionality-based concepts, and non-health based occupational concepts were not present in the abstracts. Our qualitative content analysis of the 162 abstracts containing health equity and disability terms and 177 containing health inequity and disability terms found 65 relevant abstracts that covered problems with health equity disabled people face, 17 abstracts covered factors of health inequity, and 21 abstracts covered actions needed to deal with health inequity. Our findings suggest a need as well as many opportunities for academic fields and academic, policy, and community discussions to close the gaps in the coverage of health equity and health inequity of disabled people. Full article

This article documents and explores the history of the e-scooter ban in Toronto, Ontario, Canada as a pathway to examining broader issues concerning the eradication of accessibility barriers in public spaces for pedestrians with disabilities and respectful uses of consultation to develop disability-inclusive regulations. The use of e-scooters poses a particular dilemma to accessibility for persons with disabilities. On the one hand, the concept of disability contemplates attitudinal and environmental barriers, as noted, for example, in the Preamble of the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD). Attitudinal and environmental barriers have traditionally stemmed from interests that are inherently opposed to the collective interests of disabled persons. Examples include attitudes that project stigma against persons with disabilities or a focus on seeking to preserve historical features of the built environment for their aesthetics, without consideration for their accessibility or functionality for disabled persons. They have also generally originated in periods of historical marginalization or exclusion of persons with disabilities. By contrast, e-scooter debates and connected debates regarding the regulation of micromobility vehicles, contain at least one dimension that could very well be shared with persons with disabilities—that is, the preservation of the environment. E-scooters are also a phenomenon of contemporary disability exclusion: policies concerning environmental sustainability, including those promoting e-scooters, are being developed contemporaneously with growing international and national legal recognition of disability rights. These factors render arguments over appropriate regulation of the use of public spaces more complex as, within those arguments, one sees two competing positive policy directions that need to be addressed: the rights of pedestrians with disabilities and environmental sustainability. This article concludes with theoretical and practical suggestions for strengthening regulatory policymaking to address these and other complex intersectional issues of accessibility policy design. Full article

Worldwide, 200 million children experience disability, with the vast majority living in low- and middle-income countries. The United Nations Convention on the Rights of the Child (CRC) places great importance on the rights of all children for the opportunities for survival, growth, health, and development. A subsequent document, the UN Convention on the Rights of Persons with Disabilities (CRPD), identifies children with disabilities as rights bearers who should be considered in all policies and programming worldwide. Nigeria, in 1991 and 2010, ratified the CRC and the CRPD, respectively. Nonetheless, knowledge of the extent to which their disability and child-directed policies considers these two key conventions, in ensuring that children and children with disabilities have access to care within their right remains limited. This study examined the extent to which Nigeria’s current disability and childhood policies have integrated the two child and disability related conventions from the UN. Using a structured search of databases and Nigerian federal and state government websites, we conducted a policy review to identify their disability and child-related disability policies. We also included the CRC and CRPD reports submitted by the Nigerian government to the United Nations Office of the High Commissioner for Human Rights (OHCHR) (2008 and 2010 cyclical year). A thematic analysis, based on the CRC and CRPD report, identified the following six themes: participation, support systems, awareness raising, factors associated with adherence to the CRC, laws and rights, and services. The review showed that the available Nigerian disability policies were federal, with some state policies which aligned with the CRC and CRPD. Also identified was the lack of disability policies specific to children and their families. We concluded that, to ensure proper inclusion of the rights of all children, including those with disabilities, in Nigeria there is a need for a more optimal uptake of recommendations of the CRC and CRPD as laid out by the UN. Full article

The right to live in the community is fundamental and is directly related to the possibility of independent living for persons with disabilities, a central principle of the UN Convention on the Rights of Persons with Disabilities (CRPD), ratified by Bulgaria in 2012. The opposite of these principles is living in an institution, and being compelled to reside in a space where one does not have the ability or one is not allowed to exercise control over one’s life and day-to-day decisions. Through oral history and anthropological reconstructive analysis, with a special focus on the cultural contexts and social meanings of personal experience, we explore how families of children with disabilities are simultaneously victims of the local disabling legacies, environments and practices, and key agents that effectuate and perpetuate institutional culture. We highlight the dynamics and interactions of the traumatic images on the legacy of state socialism, the actual barriers during the transition period, the coping strategies chosen by families and, ultimately, the grim effects with regard to the affirmation and implementation of the idea of independent living for people with disabilities in Bulgaria. Full article

Since the UN Convention on the Rights of Persons with Disabilities (CRPD) was created, segregation of persons with disabilities is no longer allowed. Separate schools, sheltered workshops, and isolated social care homes impede inclusion and must be banned. Sport is a remarkable exception to this general principle. The CRPD explicitly states that persons with disabilities should have the opportunity to organize, develop, and participate in disability-specific sporting activities. This contribution—focusing on the Paralympics and Special Olympics—examines why the CRPD allows and encourages disability-specific sporting competitions, despite (or perhaps due to) its radical choice for inclusion. Beyond that, this contribution asks the obvious follow-up question: if disability-specific competitions are allowed, how can the criteria for participation be determined in a manner consistent with the CRPD? The CRPD opposes a medical approach to disability, yet that approach is often used in selection criteria. Although this contribution primarily focuses on sports, the impact is wider: it raises questions on inclusion and how to assess disability. Full article

Children with disabilities were especially vulnerable during the COVID-19 pandemic, and policies designed to mitigate its effects were limited in addressing their needs. We analyzed Canadian policies related to children with disabilities and their families during the COVID-19 pandemic to identify the extent to which these policies aligned with the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) and responded to their mental health needs by conducting a systematic collection of Canadian provincial/territorial policies produced during the pandemic, building a categorization dictionary based on the UN CRPD, using text mining, and thematic analysis to identify policies’ alignment with the UN CRPD and mental health supports. Mental health was addressed as a factor of importance in many policy documents, but specific interventions to promote or treat mental health were scarce. Most public health policies and recommendations are related to educational settings, demonstrating how public health for children with disabilities relies on education and community that may be out of the healthcare system and unavailable during extended periods of the pandemic. Policies often acknowledged the challenges faced by children with disabilities and their families but offered few mitigation strategies with limited considerations for human rights protection. Full article

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) establishes that people with disabilities shall enjoy their human rights on an equal basis with others. Those rights include the right to legal capacity and to protection against discrimination, including intersectional and multiple forms of discrimination on the basis of disability and gender. In an effort to support the realisation of the CRPD, the United Nations team in Serbia undertook a project to address the implementation of these rights under the UN Partnership on the Rights of Persons with Disabilities (UNPRPD) programme. Namely, by bringing together stakeholders from the UN, government and civil society, the UNPRPD project in Serbia sought to create structural changes to uphold the rights of people with disabilities. With a view of understanding the process of change within, rather than the outcomes of, this UPRPD project, twenty-eight semi-structured interviews were conducted using the Most Significant Change Technique (MSCT) with key stakeholders involved in such a project. The interviews were analysed using Interpretive Phenomenological Analysis (IPA) to preserve the unique and diverse perspectives of participants who had differing roles across the project. The analysis allowed us to identify a number of facets of the process that facilitate structural change: coalition-building events; strengthening stakeholder capacity and relationships; the participation of persons with disabilities; and innovation in terms of what made the project significant, novel and in itself a change. All these facets are discussed in this article, with the purpose of supporting global efforts in alignment with the CRPD. On the whole, this article aims to support a better understanding of disability-inclusive development projects in line with the CRPD and to give evidence on how countries may begin to tackle the structural exclusion of persons with disabilities in society. Full article

In the last fifteen years, changes have been taking place in education systems at the international and national levels that aim to achieve, in the near future, the objectives set by the UN International Convention on the Rights of Persons with Disabilities (hereafter CRPD). Spain is no stranger to these objectives, as recognized in the new Organic Law for the Modification of the Law on the Organization of Education. This situation makes it necessary to know the perceptions that professionals in training (about to graduate) from faculties of education have about the legal content established by articles 4.1.i and 24 of the CRPD on inclusive education. In order to ascertain these perceptions, the EPACO-DI-1 instrument was used in a quantitative and confirmatory study by means of a multivariate factor analysis (CFA), applying the parallel estimation method of ordinary least squares (OLS) and principal axes with polychoric correlation and promax oblique rotation. This study involved 552 fourth-year students between the ages of 21 and over 45 from the specializations offered by the Faculty of Education of the University of Murcia. The obtained results are consistent and show the validity of the EPACODI-1 scale for determining the perceptions of professionals in training on inclusive education. Full article

In this paper we aim to make a valuable contribution to the surprisingly limited body of research on access to justice for disabled women who have been subjected to violence. Using an interdisciplinary sociolegal approach, this paper carries out an empirical qualitative study of one Icelandic court case and draws on this to provide a critical analysis of access to justice issues for disabled women who have been subjected to gender-based violence. Much about this case suggests that it is a positive example of justice being accessed, and we identify a number of features of the case as particularly significant in this regard. We reflect on how these positive aspects of the case can inform initiatives to enhance access to justice for disabled women and highlight ways in which Icelandic justice processes could more firmly embed the international human rights standards set out in the UN Convention on the Rights of Persons with Disabilities. Full article

Understanding the complexity of informed consent processes is critically important to the success of research that requires participants to test, develop, or inform research data and results. This is particularly evident in research involving persons experiencing neurodegenerative diseases (e.g., Alzheimer’s disease, dementia) that impair cognitive functioning, who according to national law are considered to have a diminished capacity, or to lack the capacity, to consent to research participation. Those who would potentially benefit most from applied research participation may be excluded from participating and shaping data and outcomes. This article offers insights into challenges faced by the Smart and Healthy Ageing through People Engaging in Supportive Systems (SHAPES) Project in obtaining the consent of older persons, including older persons with disabilities. The promotion of continuing health, active ageing, and independent living is central to SHAPES, requiring project partners to reflect on traditional informed consent approaches to encourage the full, cognisant participation of older persons with disabilities. We examine how this issue may be addressed, with reference to the inclusive approach of SHAPES. In respecting the inalienable legal capacity of all legal persons, SHAPES uses the UN Convention on the Rights of Persons with Disabilities (CRPD) and the human rights model of disability as part of the theoretical framework. A novel, inclusive, representative informed consent framework was designed and is detailed herein. This framework provides significant opportunity to advance the inclusion of persons with disabilities or those experiencing neurodegenerative diseases in innovative research and is readily transferable to other research studies. The SHAPES approach is a substantial contribution to research on informed consent, demonstrating the utility of the human rights model of disability in facilitating the full research participation of target populations. Full article

Implementation of the United Nations Convention on the rights of persons with disabilities (UN CRPD) requires countries to harmonise their legislative frameworks with it. This paper investigates the national legislative frameworks of four Asian countries to see the extent to which they provide support services in accordance with Article 19 of the UN CRPD. The UN CRPD requires persons with disabilities to have access to and choice and control over support services. To analyse the policy alignment with the UN CRPD, an analytical framework based on the Capability Approach (CA) was developed. The results show that most countries address support services, including assistive devices, only from the perspective of a social security measure for persons with disabilities living in poverty, failing to uphold the rights of those not meeting those eligibility criteria. However, while support services are inseparably linked to social security, they also are a right for persons with disabilities. Therefore, a paradigm shift is required in the approach of support services and the distributive systems of countries, from one that addresses persons with disabilities as those requiring care considered a burden, to one that considers them rights holders with equal opportunities, for which, support services are a pre-requisite. Full article

According to the UN-CRPD, cities must develop action plans about universal accessibility (UA). Operationalization of these plans is complex, and little is known about what municipal employees know about UA. Aim: The aim is to document implementation determinants of UA within a municipal organization in Quebec, Canada. Methods: An observational cross-sectional study was performed. Employees answered a survey based on the TDF and the DIBQ. Facilitators, barriers, and factors influencing the determinants were identified. Results: A total of 43% of the employees completed the survey. The implementation of UA measures is more facilitated by their beliefs about the impact on citizens, while the external context hinders the proper implementation. It is also influenced by six factors: (1) professional role, (2) capacity, (3) resources, (4) willingness, (5) characteristics, and (6) feedback. Discussion: Results suggest that understanding the consequences, sufficient resources, abilities, and willingness can influence implementation of UA. Conclusion: These findings have informed the objectives of the next action plan of the municipal organization and could guide the development of solutions. Full article

The state of the ‘social’ that individuals, social groups and societies experience are a focus of international conventions, declarations and goal setting documents. Many indicators of the ‘social’ and measures of well-being that contain sets of indicators of the ‘social’ exist to ascertain the state of the ‘social’ of individuals, social groups, and societies. Marginalized groups are well known to have problems with the ‘social’ they experience. Equity, Diversity, and Inclusion (EDI) and similar phrases are used in policy discussions to deal with ‘social problems’ within research, education, and general workplace environments encountered by women, Indigenous peoples, visible/racialized minorities, disabled people, and LGBTQ2S+. The prevention of the worthening of the ‘social’ is one focus of science and technology governance and ethics discussions. Many health professions are also concerned about the ‘social’ such as the well-being of their clients and their roles as stated by many of their associations include being advocates and change agents. The objective of the study was to ascertain how the ‘social’ is engaged with in conjunction with the following international documents (“Convention on the Rights of Persons with Disabilities”, “Convention on the Rights of the Child”, “Convention on the Elimination of All Forms of Discrimination against Women”, “Declaration on the Rights of Indigenous Peoples”, “Universal Declaration of Human Rights”, “International Convention on the Elimination of All Forms of Racial Discrimination”, “UN Framework Convention on Climate Change”, “transforming our world: the 2030 agenda for sustainable development” and “UN flagship report on disability and development Realizing the Sustainable Development Goals by, for and with persons with disabilities”; from now on called “the documents”). A scoping review using the academic databases SCOPUS, Web of Science, databases accessible under Compendex, and the databases accessible under EBSCO-HOST, coupled with a manifest hit-count coding approach was uses to answer five research questions: (1) Which terms, phrases, and measures of the ‘social’ are present in the literature searched (2) Which of the social issues flagged in the Convention on the Rights of Persons with Disabilities (CRPD) are present in the academic abstracts mentioning the other eight documents? (3) Which EDI frameworks, phrases and social groups covered under EDI are present in the literature covered. (4) Which technologies, science and technology governance terms and ethics fields are present in the literature covered? (5) Which health professions are mentioned in the literature covered? The results reveal vast gaps and opportunities to engage with the ‘social’ in relation to “the documents” covered for all five questions. Full article