title: Obstacles to preventive care for individuals with disability: Implications for nurse practitioners.
abstract: OBJECTIVE
  Individuals with disabilities have been identified as a population with a significantly lower usage of preventive services. Nurse practitioners (NPs) provide a key access point in the healthcare delivery system for preventive services for vulnerable populations such as those with disabilities. It is essential to understand existing barriers that prohibit access to effective preventive care for this vulnerable population.
  
  
  METHODS
  Systematic search and review of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Google Scholar, and government reports and World Health Organizations reports. Twenty-six articles were included in the review.
  
  
  CONCLUSIONS
  This literature review confirmed previous notions that people with disabilities are receiving much fewer preventive services than the general population. The studies reviewed identified four major barriers that contributed to the lack of preventive care. These barriers included physical environment and system, transportation, provider knowledge and attitude, and financial. Recognition of the obstacles that this subpopulation faces in accessing preventive care services is the first step to effectively remedying this problem.
  
  
  CONCLUSIONS
  Preventive services have been identified as one of the cornerstones to improving health and quality of life. By understanding the circumstances that restrict those with disabilities from accessing preventive services, NPs can provide meaningful and effective solutions.
authors.affiliation: Henry Ford Health System, Detroit, Michigan.|College of Nursing, Wayne State University, Detroit, Michigan.
authors.forename: Anna
authors.initials: A
authors.lastname: Marrocco
authors.affiliation: College of Nursing, Wayne State University, Detroit, Michigan.
authors.forename: Helene J
authors.initials: HJ
authors.lastname: Krouse
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D006233:Persons with Disabilities / Q000523:psychology*; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D054625:Healthcare Disparities / Q000191:economics / Q000639:trends; D006801:Humans; D009722:Nurse Practitioners / Q000639:trends*; D011315:Preventive Medicine / Q000379:methods*; D035862:Vulnerable Populations / Q000523:psychology
keywords: Disability; access to health care; healthcare delivery; preventive therapy; primary health care; vulnerable populations