title: Multidimensional health risk appraisal among adults aging with acquired disabilities.
abstract: BACKGROUND
  The increasing older adult population includes people with disabilities facing added challenges of aging. The Affordable Care Act Section 4103 calls for an annual health risk appraisal (HRA) to be administered with older adults. HRAs show promise when used with older adults, yet little is known about their use with adults aging with acquired disabilities.
  
  
  OBJECTIVE
  1) Explore psychometrics of the multidimensional Stay Well and Healthy! Health Risk Appraisal tool (SWH-HRA) among persons aging with disabilities acquired in early or mid-life, and 2) Assess SWH-HRA application to characterize disability subgroup differences.
  
  
  METHODS
  Psychometric analysis conducted on SWH-HRA interview data collected with 93 participants with an acquired disability of at least five years or more post-onset. ANOVA and Chi-square to explore differences in risks by subgroups identified by etiology (traumatic brain injury, stroke, spinal cord injury, and movement disorders).
  
  
  RESULTS
  A high prevalence of health risks was noted. Risks were associated with health, participation and quality of life outcomes. With the exception of independence in basic activities of daily living and incontinence, few statistically significant differences were noted among disability subgroups. Patterns of risk clusters and prevalence within disability subgroup were consistent with findings in the literature.
  
  
  CONCLUSIONS
  The SWH-HRA provides a valid and comprehensive health risk assessment. When used in annual wellness visits among persons with disabilities, it has the potential to inform the partnership between health providers and individuals with disabilities as they collaborate to promote healthy aging.
authors.affiliation: Department of Nursing, College of Health and Human Services, University of New Hampshire, 4 Library Way, Hewitt Hall 279, Durham, NH 03824-3563, USA. Joan.Hahn@unh.edu
authors.forename: Joan Earle
authors.initials: JE
authors.lastname: Hahn
authors.forename: Harriet Udin
authors.initials: HU
authors.lastname: Aronow
authors.forename: Emily R
authors.initials: ER
authors.lastname: Rosario
authors.forename: Nancy
authors.initials: N
authors.lastname: Guenther
mesh_terms: D000203:Activities of Daily Living; D000375:Aging; D000704:Analysis of Variance; D001930:Brain Injuries; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D006233:Persons with Disabilities; D005260:Female; D006262:Health; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis; D010300:Parkinson Disease; D011594:Psychometrics; D011788:Quality of Life; D018570:Risk Assessment / Q000592:standards; D013119:Spinal Cord Injuries; D020521:Stroke; D014549:Urinary Incontinence