HEALTH PROMOTION FOR WOMEN WITH PHYSICAL DISABILITIES

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DESCRIPTION (Adapted from Applicant's Description): The concept of wellness in the context of physical disability among women has only recently been introduced into the field of health promotion. The purpose of this project is to develop an intervention to enhance wellness among women with physical disabilities that is based on expanded theoretical models and measures of health promoting behaviors that accommodate some of the unique life circum-stances experienced by this population. Findings from the investigators' recently completed national survey indicate that segments of the population of women with physical disabilities are at higher risk for (1) certain acute and chronic conditions, (2) limited access to preventive health services, (3) negative social attitudes toward their potential for fitness and wellness, and (4) reduced motivational factors affecting health promotion behaviors, such as self-esteem, self-efficacy, and body image. Thus, there is a pressing need for the development of health promotion programming that is responsive to the needs of women with significant functional limitations and an accompanying research protocol to measure the effectiveness of such programming. The specific aims of this study are to: (1) Identify the psychological, physical, social, and environmental factors that contribute to health promoting behav-iors of women with physical disabilities. (2) Develop and test methods for measuring the health promoting behaviors of women with physical disabilities and their attitudes toward improving those behaviors. (3) Develop and pilot test an intervention to inform and motivate women with physical disabilities to take action to improve their psychological, social, and physical health. (4) Develop and pilot test a theory-driven, multi-component program to promote wellness among women with physical disabilities that targets increased self-efficacy related to health promoting behaviors. The proposed research will be grounded in the Transtheoretical Model which identifies five stages that characterize an individual's willingness to change a given behavior: (1) precontemplation, (2) contemplation, (3) preparation, (4) action, and (5) maintenance. To accomplish the aims of this study, the investigators will begin with qualitative focus groups and individual interviews to understand how women with physical disabilities define wellness and practice health promoting behaviors. In the next phase, they will use quantitative methodolo-gy to establish a baseline for the perceived health status, health promoting behaviors, and stage of change of a sample of 400 women with a range of physical disabilities and severity levels. They will then develop a motiva-tional intervention consisting of a newsletter, a wellness hot line, a fax-on-demand service, and a home page on the World Wide Web, to offer information and encourage action for women who may be in early stages of change or believe that their disability prevents them from engaging in health promoting activi-ties. In the final phase, the investigators wish to develop and test the feasibility of a wellness action group program that will focus on individual-ized goal setting, peer support, and enhanced self-efficacy for pursuing healthier living.