The SCI Exercise Self-Efficacy Scale (ESES): development and psychometric properties

<p>Abstract</p> <p>Background</p> <p>Rising prevalence of secondary conditions among persons with spinal cord injury (SCI) has focused recent attention to potential health promotion programs designed to reduce such adverse health conditions. A healthy lifestyle for people with SCI, including and specifically, the adoption of a vigorous exercise routine, has been shown to produce an array of health benefits, prompting many providers to recommend the implementation of such activity to those with SCI. Successfully adopting such an exercise regimen however, requires confidence in one's ability to engage in exercise or exercise self-efficacy. Exercise self-efficacy has not been assessed adequately for people with SCI due to a lack of validated and reliable scales, despite self efficacy's status as one of the most widely researched concepts and despite its broad application in health promotion studies. Exercise self efficacy supporting interventions for people with SCI are only meaningful if appropriate measurement tools exist. The objective of our study was to develop a psychometrically sound exercise self-efficacy self-report measure for people with SCI.</p> <p>Methods</p> <p>Based on literature reviews, expert comments and cognitive testing, 10 items were included and made up the 4-point Likert SCI Exercise Self-Efficacy Scale (ESES) in its current form. The ESES was administered as part of the first wave of a nationwide survey (n = 368) on exercise behavior and was also tested separately for validity in four groups of individuals with SCI. Reliability and validity testing was performed using SPSS 12.0.</p> <p>Results</p> <p>Cronbach's alpha was .9269 for the ESES. High internal consistency was confirmed in split-half (EQ Length Spearman Brown = .8836). Construct validity was determined using principal component factor analysis by correlating the aggregated ESES items with the Generalised Self Efficacy Scale (GSE). We found that all items loaded on one factor only and that there was a statistically significant correlation between Exercise Self-Efficacy Scale (ESES) and Generalised Self Efficacy Scale (GSE) (Spearman RHO = .316; p < .05; n = 53, 2-sided).</p> <p>Conclusion</p> <p>Preliminary findings indicate that the ESES is a reliable instrument with high internal consistency and scale integrity. Content validity both in terms of face and construct validity is satisfactory.</p

Repealing or Replacing the ACAs Provisions: How Would Adults with Disabilities Fare?

Key Findings:Proposed reforms to the ACA would likely mean that fewer people with disabilities would have coverage at all. For those who did, a smaller number would have the comprehensive coverage necessary to meet their health care needs, and their coverage would cost more. However, neither current economic models nor evidence from studies on the effect of the ACA conclusively predict what consequences health reforms would have on the employment status of individuals with disabilities.In this brief, we focus on the effects the proposed policy changes could have on individuals with disabilities and individuals with chronic conditions that could become disabling. We begin by discussing the likely effects on coverage and access to care, and review the potential effects the coverage changes would have on employment

Health and housing among low-income adults with physical disabilities

The purpose of this study was to understand the impact of living environment on the health and access to health care of low-income working-age adults with physical disabilities. We conducted focus groups of participants with physical disabilities in the District of Columbia living in each of three housing situations (a homeless shelter, a nursing home, and an inaccessible house or apartment). Twenty-eight people participated in the focus groups. Most were male (79%) and African American (93%). Participants from a homeless shelter expressed concerns about accessibility and sanitation at the shelter. Nursing home participants expressed a need for privacy and autonomy that would foster consumer-directed care. Participants living in inaccessible apartments or houses worried about their ability to maintain daily living and social activities. Participants perceived barrier-free housing conditions to be a prerequisite for independent living and for ensuring their basic health and well-bein