Alana Officer - Academia.edu (original) (raw)

Papers by Alana Officer

Health and Quality of Life Outcomes, 2016

Background: The World Health Organization (WHO) was tasked with developing health system guidelin... more Background: The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. Methods: We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Results: Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). Conclusion: The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their acceptability. The majority of stakeholders found 'Task shifting' as neither feasible nor acceptable.

Journal of Intellectual Disability Research, 2014

ObjectivesThe prevalence of intellectual disabilities (ID) has been estimated at 10.4/1000 worldw... more ObjectivesThe prevalence of intellectual disabilities (ID) has been estimated at 10.4/1000 worldwide with higher rates among children and adolescents in lower income countries. The objective of this paper is to address research priorities for development disabilities, notably ID and autism, at the global level and to propose the more rational use of scarce funds in addressing this under‐investigated area.MethodsAn expert group was identified and invited to systematically list and score research questions. They applied the priority setting methodology of the Child Health and Nutrition Research Initiative (CHNRI) to generate research questions and to evaluate them using a set of five criteria: answerability, feasibility, applicability and impact, support within the context and equity.FindingsThe results of this process clearly indicated that the important priorities for future research related to the need for effective and efficient approaches to early intervention, empowerment of fam...

Bulletin of the World Health Organization, 2009

World Health Organization eBooks, 2011

General health care "My doctor is great. He is my friend and not just my doctor. He used to be my... more General health care "My doctor is great. He is my friend and not just my doctor. He used to be my father's doctor too. When I want to see the doctor he always has time for me. He always talks to me about this, about that, before he says, "What is wrong?" I used to be on 60 mg of blood pressure medicine for my high blood pressure. But then my doctor told me that I had to get more life to help my pressure. He did not want me to twiddle my thumbs and watch soap operas seven days a week. He wanted me to move around and be active. It was a good idea. So I went and got some volunteer work. Now I have friends and I always talk to people. And I only need 20 mg of medicine!" Jean-Claude "You can not have a baby", those were the words of the first gynecologist I visited few months after I got married. I was so confused. Why wouldn't I be able to have a baby? I am physically disabled, but I have no medical reason not to. I faced a lot of challenges either because of bad attitude of nurses or doctors questioning my eligibility to be a mother or the inaccessible medical facilities, whether it is the entrances, bathrooms, examinations beds etc. I am now a mother of a 5 year old boy which is one of the best things that ever happened to me, but I keep thinking why did it end up to be a luxury thing while it is a right? Why was I only able to do it when I had the money to go to a better medical care system?" Rania "Even though during my appointments to the medical centre, doctors haven't discussed health promotion with me and they don't even have a scale to measure my body weight, I still try to engage in activities that would enhance my health and wellbeing. It's not easy as most fitness facilities and equipment are not accessible. I'm yet to find dietary advice for people with spinal cord injury or identify a dentist near my place of residence with accessible facility and equipment." Robert 3 General health care 57 Health can be defined as "a state of physical, mental, and social well-being and not merely the absence of disease or infirmity" (1). Good health is a prerequisite for participation in a wide range of activities including education and employment. Article 25 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) reinforces the right of persons with disabilities to attain the highest standard of health care, without discrimination (2). A wide range of factors determine health status, including individual factors, living and working conditions, general socioeconomic, cultural and environmental conditions, and access to health care services (3, 4). This Report shows that many people with disabilities experience worse socioeconomic outcomes than people without disabilities: they experience higher rates of poverty, lower employment rates, and have less education. They also have unequal access to health care services and therefore have unmet health care needs compared with the general population (5-8). This chapter focuses on how health systems can address the health inequalities experienced by people with disabilities. It provides a broad overview of their health status, explores the main barriers to using health care, and suggests ways to overcome them. Understanding the health of people with disabilities This section provides a general overview of the health status of people with disabilities by looking at the different types of health conditions they may experience and several factors that may contribute to the health disparities for this population (see Box 3.1). Increasing evidence suggests that, as a group, people with disabilities experience poorer levels of health than the general population (18). They are often described as having a narrower or thinner margin of health (9, 17). Primary health conditions Disability is associated with a diverse range of primary health conditions: some may result in poor health and high health care needs; others do not ■ Adults with chronic conditions such as multiple sclerosis, cystic fibrosis, severe arthritis, or schizophrenia may have complex and continuing health care needs related to their primary health condition or associated impairments (20). Risk of developing secondary conditions Depression is a common secondary condition in people with disabilities (21-23). Pain has been Box 3.1. Terminology Primary health condition A primary health condition is the possible starting point for impairment, an activity limitation, or participation restriction (9). Examples of primary health conditions include depression, arthritis, chronic obstructive pulmonary disease, ischaemic heart disease, cerebral palsy, bipolar disorder, glaucoma, cerebrovascular disease, and Down syndrome. A primary health condition can lead to a wide range of impairments, including mobility, sensory, mental, and communication impairments. Secondary conditions A secondary condition is an additional condition that presupposes the existence of a primary condition. It is distinguished from other health conditions by the lapse in time from the acquisition of the primary condition to the occurrence of the secondary condition (10). Examples include pressure ulcers, urinary tract infections, and depression. Secondary conditions can reduce functioning, lower the quality of life, increase health care costs, and lead to premature mortality (11). Many such conditions are preventable and can be anticipated from primary health conditions (12, 13). Co-morbid conditions A co-morbid condition is an additional condition independent of and unrelated to the primary condition (14). The detection and treatment of co-morbid conditions are often not well managed for people with disabilities and can later have an adverse affect on their health (12): for example, people with intellectual impairments and mental health problems commonly experience "diagnostic overshadowing" (15). Examples of co-morbid conditions include cancer or hypertension for a person with an intellectual impairment. General health care needs People with disabilities require health services for general health care needs like the rest of the population. General health needs include health promotion, preventive care (immunization, general health screening), treatment of acute and chronic illness, and appropriate referral for more specialized needs where required. These needs should all be meet through primary health care in addition to secondary and tertiary as relevant. Access to primary health care is particularly important for those who experience a thinner or narrower margin of health to achieve their highest attainable standard of health and functioning (16). Specialist health care needs Some people with disabilities may have a greater need for specialist health care than the general population. Specialist health care needs may be associated with primary, secondary, and co-morbid health conditions. Some people with disabilities may have multiple health conditions, and some health conditions may involve multiple body functions and structures. Assessment and treatment in these instances can be quite complex and therefore may necessitate the knowledge and skills of specialists (17).

BMC Geriatrics

Background The World Health Organization (WHO) encourages healthy ageing strategies to help devel... more Background The World Health Organization (WHO) encourages healthy ageing strategies to help develop and maintain older people’s functional abilities in five domains: their ability to meet basic needs; learn, grow, and make decisions; be mobile; build and maintain relationships, and contribute to society. This scoping review reports the available evidence-based interventions that have been undertaken with people ≥ 50 years of age in rural and remote areas and the outcomes of those interventions relevant to enhancing functional ability. Methods The scoping review was undertaken following the JBI methodology. A literature search was carried out to identify published intervention studies for enhancing functional ability in older people living in rural and remote settings. The databases searched included CINAHL, Scopus, ProQuest Central, PubMed, EBSCOHost, APA PsycInfo, Carin.info, and the European Network for Rural Development Projects and Practice database. Gray literature sources incl...

Oxford Textbook of Geriatric Medicine

This chapter explores the role of age-friendly environments in supporting healthy ageing. Environ... more This chapter explores the role of age-friendly environments in supporting healthy ageing. Environments are important determinants of the trajectories of intrinsic capacity and functional ability over a person’s life course and into older age. Several domains of functional ability are particularly important in later life. We explore the importance of environments in enhancing three domains of functional ability: the ability to meet basic needs, to be mobile, and to build and maintain relationships. The chapter concludes with implications of an environmental approach to Healthy Ageing for geriatric medicine. These are new perspectives on holistic views of older persons in their environment, on making health services more age-friendly and on working collaboratively to achieve better outcomes.

Australasian Journal on Ageing

ObjectivesIn 2007, the World Health Organization published a guide on age‐friendly cities. Howeve... more ObjectivesIn 2007, the World Health Organization published a guide on age‐friendly cities. However, little is known about interventions that have been implemented to promote age‐friendly communities in rural and remote areas. This paper presents the findings from a scoping review undertaken to locate available evidence of interventions, strategies, and programs that have been implemented in rural and remote areas to create age‐friendly communities.MethodsThis scoping review used the Joanna Briggs Institute (JBI) methodology.ResultsA total of 219 articles were included in this review. No intervention studies were referred to as ‘age‐friendly’. However, there were interventions (mostly healthcare‐related) that have been implemented in rural and remote areas with older people as participants. There were also non‐evaluated community programs that were published in the grey literature. This review identified the common health interventions in older people and the indirect relevance to th...

Prevalence and risk of violence against adults with

BMJ Open, 2021

ObjectivesTo analyse the empirical support of the functional ability concept in the healthy agein... more ObjectivesTo analyse the empirical support of the functional ability concept in the healthy ageing framework developed by the WHO in a sample of the Philippine older population. According to this framework, environmental factors may enhance or hinder functional ability, which is the person’s ability to do what they value, broadly represented by subjective well-being. Moreover, this network of relationships may be moderated by personal characteristics such as gender.DesignCross-sectional observational study.SettingPhilippines, general population.ParticipantsRespondents of the 2016 National Disability Prevalence Survey/Model Functioning Survey aged 50+ (N=2825).Primary and secondary outcome measuresLatent (unobserved) measures of functional ability, environmental factors (physical environmental factors and social network and support) and subjective well-being (positive affect, negative affect and evaluative well-being) were obtained from different items from the survey questionnaire u...

International Journal of Environmental Research and Public Health, 2020

Evidence shows that ageism negatively impacts the health of older adults. However, estimates of i... more Evidence shows that ageism negatively impacts the health of older adults. However, estimates of its prevalence are lacking. This study aimed to estimate the global prevalence of ageism towards older adults and to explore possible explanatory factors. Data were included from 57 countries that took part in Wave 6 of the World Values Survey. Multilevel Latent Class Analysis was performed to identify distinct classes of individuals and countries. Individuals were classified as having high, moderate or low ageist attitudes; and countries as being highly, moderately or minimally ageist, by aggregating individual responses. Individual-level (age, sex, education and wealth) and contextual-level factors (healthy life expectancy, population health status and proportion of the population aged over 60 years) were examined as potential explanatory factors in multinomial logistic regression. From the 83,034 participants included, 44%, 32% and 24% were classified as having low, moderate and high a...

Bulletin of the World Health Organization, 2017

Bulletin of the World Health Organization, 2018

A life-course approach to health encompasses strategies across individuals' lives that optimi... more A life-course approach to health encompasses strategies across individuals' lives that optimize their functional ability (taking into account the interdependence of individual, social, environmental, temporal and intergenerational factors), thereby enabling well-being and the realization of rights. The approach is a perfect fit with efforts to achieve universal health coverage and meet the sustainable development goals (SDGs). Properly applied, a life-course approach can increase the effectiveness of the former and help realize the vision of the latter, especially in ensuring health and well-being for all at all ages. Its implementation requires a shared understanding by individuals and societies of how health is shaped by multiple factors throughout life and across generations. Most studies have focused on noncommunicable disease and ageing populations in high-income countries and on epidemiological, theoretical and clinical issues. The aim of this article is to show how the li...

Innovation in Aging, 2017

Bulletin of the World Health Organization, 2016

The Gerontologist, 2016

The designations employed and the presentation of the material in this publication do not imply t... more The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. Preface vii Acknowledgements ix 1. Adding health to years Healthy Ageing Trajectories of Healthy Ageing A public-health framework for Healthy Ageing Key issues for public-health action Dealing with diversity Reducing inequity Enabling choice Ageing in place Contents 3. Health in older age Demographic and epidemiological changes Population ageing Why are populations ageing? Are the added years in older age being experienced in good health? Health characteristics in older age Underlying changes Health conditions in older age Other complex health issues in older age Intrinsic capacity and functional ability Intrinsic capacity across the life course Patterns of functioning in countries at different levels of socioeconomic development Significant loss of functional ability, and care dependence Key behaviours that influence Healthy Ageing Physical activity Nutrition Key environmental risks Emergency situations Elder abuse 4. Health systems Introduction Rising demand, barriers to use, poorly aligned services Demand for health services Barriers to use Systems designed for different problems Economic impact of population ageing on health systems Responses The goal: optimize trajectories of intrinsic capacity Adapt interventions to individuals and their levels of capacity Implement older-person-centred and integrated care Align health systems Conclusion 5. Long-term-care systems Financing long-term care: it always has a cost Care provision: outdated and fragmented Responding to the challenge of long-term care Moving towards an integrated system: a revolutionary agenda General principles of an integrated system of long-term care Enabling ageing in the right place Building workforce capacity and supporting caregivers Promoting integrated care through case management and broader collaboration Ensuring sustainable and equitable financing Changing mindsets about long-term care: a political and social challenge Conclusion 6. Towards an age-friendly world Preface viii World report on ageing and health functional ability has the highest importance. The greatest costs to society are not the expenditures made to foster this functional ability, but the benefits that might be missed if we fail to make the appropriate adaptations and investments. The recommended societal approach to population ageing, which includes the goal of building an age-friendly world, requires a transformation of health systems away from disease-based curative models and towards the provision of integrated care that is centred on the needs of older people. The report's recommendations are anchored in the evidence, comprehensive, and forward-looking, yet eminently practical. Throughout, examples of experiences from different countries are used to illustrate how specific problems can be addressed through innovation solutions. Topics explored range from strategies to deliver comprehensive and person-centred services to older populations, to policies that enable older people to live in comfort and safety, to ways to correct the problems and injustices inherent in current systems for long-term care. In my view, the World report on ageing and health has the potential to transform the way policy-makers and service-providers perceive population ageingand plan to make the most of it.

International journal of environmental research and public health, Jan 22, 2015

We greatly appreciate and wish to thank Madans, Mont and Loeb for the issues they raise in their ... more We greatly appreciate and wish to thank Madans, Mont and Loeb for the issues they raise in their Comment [1] on our paper "Measuring Disability: Using the WHO Model Disability Survey to Address the Impact of Screeners on Disability Rates" [2]. [...].

International Journal of Public Health, 2015

Objective Our objective was to quantify disability prevalence among older adults of low-and middl... more Objective Our objective was to quantify disability prevalence among older adults of low-and middle-income countries, and measure socio-demographic distribution of disability. Methods World Health Survey data included 53,447 adults aged 50 or older from 43 low-and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Results Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Conclusions Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.