title: Secondary analysis of a scoping review of health promotion interventions for persons with disabilities: Do health promotion interventions for people with mobility impairments address secondary condition reduction and increased community participation?
abstract: BACKGROUND
  Secondary conditions can have very serious outcomes for people with physical disabilities. Such consequences can range from immobility due to pressure sores to withdrawal and isolation due to depression, decreasing participation in the community.
  
  
  OBJECTIVE
  To further investigate these assumptions, we conducted a review of the literature on health promotion interventions that include physical activity for adults with disabilities to determine whether they have a positive effect on the reduction of secondary conditions and increased community participation.
  
  
  METHODS
  We conducted a secondary analysis of the results of a scoping review of health promotion programs containing physical activity for people with mobility impairments (N = 5). This secondary analysis examined the relationship between health promotion containing physical activity and prevention of secondary conditions among people with various physical disabilities. We further examined evidence and effects of independent variables on the outcome of increased community participation for study participants.
  
  
  RESULTS
  The outcomes from this investigation are varied, with 2 studies providing evidence of reducing secondary conditions while another shared anecdotal statements referencing a decrease in secondary conditions. Of the remaining 2 studies in this paper, 1 showed no intervention effect on reducing secondary conditions while the remaining study reported an increase in secondary conditions. Regarding increased participation in the community, 2 of 5 studies directly reported on these outcomes, while increased community participation was referenced in another 2 articles, but without any data presented. The final study did not report on any post intervention in the community.
  
  
  CONCLUSIONS
  This review demonstrates that research on health promotion interventions containing physical activity lack description about whether such interventions help reduce or prevent secondary conditions. Additionally, the review shows that further work is needed in terms of sustaining health programs effects beyond the initial proximal activity gains, with attention given toward more distal outcomes of increased participant participation in the community.
authors.affiliation: Department of Applied Behavioral Science and Research, Training Center on Independent Living, University of Kansas, Lawrence, 66045, USA. glen@ku.edu
authors.forename: Glen W
authors.initials: GW
authors.lastname: White
authors.forename: Chiaki
authors.initials: C
authors.lastname: Gonda
authors.forename: Jana J
authors.initials: JJ
authors.lastname: Peterson
authors.forename: Charles E
authors.initials: CE
authors.lastname: Drum
mesh_terms: D000203:Activities of Daily Living; D003863:Depression; D006233:Persons with Disabilities / Q000534:rehabilitation*; D015444:Exercise; D006293:Health Promotion; D006801:Humans; D051346:Mobility Limitation; D003668:Pressure Ulcer; D058992:Social Participation; D016896:Treatment Outcome