JMIR Publications

ABSTRACT

Background:

Persons with physical disabilities (PWPD) are more subject to premature multimorbidity and adverse health events. A primary care approach that is tailored to this vulnerable population and accounts for social and functional risk factors could promote healthy aging and equitable health care.

Objective:

This project will evaluate the implementation of a health program designed for PWPD, and it will aim to use the results of such evaluation to generate the first best-practice protocol focused on primary care for PWPD.

Methods:

A pilot PWPD health program will be designed and implemented at a primary care clinic within the Michigan Medicine. The PWPD health program will be an integrated intervention involving a trained team of physicians, clinical social workers, and behavioral health specialists working in the same clinic. Participants from this clinic with identified physical disabilities, ages 18 and older, will be targeted by best practices advisories (BPAs) and family medicine clinicians and/or clinical social workers for potential enrollment. To create a quasi-experimental setting, a control site also within the UMHS has been selected, and suitable participants who will not be enrolled in the program will be identified for comparison purposes. A quantitative analysis to estimate the treatment effect will be conducted using a difference-in-differences (DD) approach. A qualitative analysis of patient interviews will also be completed. Outcomes of interest will include use of preventative services (e.g., hemoglobin A1c for diabetes screening) and number of emergency/hospital visits. Additionally, we will also measure anxiety and depression using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Screen (GAD) scores.

Results:

This study was funded in September 2018, data collection started in September 2021, and data collection is expected to be concluded in September 2023.

Conclusions:

This study is a mixed-methods evaluation of the effectiveness of an integrated health program designed for PWPD, based on a quasi-experimental comparison between an intervention and a control site. The intervention will be considered successful if it leads to improvements identified in health and behavioral outcomes. The findings will inform best practices in PWPD primary care, resulting in the first comprehensive protocol on the matter.