Partnering with People with Disabilities to Address Violence

People with developmental disabilities (DD) are among those most likely to experience interpersonal violence (IPV) and its adverse consequences. People with DD experience typical forms of IPV, as well as disability-specific IPV, such as destruction of medical equipment or communication devices and medication manipulation (Powers, et al., 2008). IPV by personal care assistants and service providers is a unique problem as well (Sobsey and Doe, 1991). Most research on IPV and disability has focused on women with disabilities, who are more likely than women without disabilities to experience physical and sexual IPV, increased severity of IPV, multiple forms of IPV, and longer duration of IPV (Nosek, et al., 2001). Although not as well-studied, IPV against men with disabilities is a serious problem. Powers, et al.’s (2008) survey of 342 community-living men with disabilities, including 195 men with DD, found that 65% reported lifetime physical abuse while 24% reported lifetime sexual abuse.

Findings show that IPV negatively impacts the abilities of people with disabilities to work, live independently, and maintain their health. However, only a few studies have investigated the specific associations of disability, health and interpersonal IPV.  For example, Hughes, et al. (2001) linked abuse, social support, vitality, mobility, pain, and unemployment with depression in women with disabilities.  In a 2003 study of 415 women with disabilities, Hughes and colleagues linked high levels of perceived stress with abuse, greater pain, and less social support. 
Purpose and Specific Aims: The proposed project will use a Community Based Participatory Research (CBPR) approach and rigorous methods to advance understanding of the associations between disability, health, and IPV in adults with DD. We will accomplish our purpose via the following specific aims: 1) To demonstrate and evaluate ways that people with DD can be included at all levels in violence research (design, implementation, analysis and interpretation, and dissemination); 2) To develop, adapt and pilot test assessment measures, recruitment procedures, consent materials, and study protocols that can be safely and validly used with adults with DD; 3) To identify the physical and mental health outcomes of IPV against people with DD; 4) To assess the extent to which disability characteristics, secondary conditions, and contextual factors increase risk for IPV; 5) To assess the association between IPV and decrement of disability and development of secondary conditions. 

We will conduct three interrelated studies over the three years. The centerpiece is an in-person IPV and Health Survey Study of 400 women and men with DD (200 men, 200 women, 200 rural, 200 urban), conducted during Years 2 and 3, to investigate a) associations of disability characteristics, secondary conditions and contextual factors on risk for IPV; b) physical and mental health outcomes of IPV; and c) impact of IPV on disabilities and secondary conditions. We will conduct the Measurement Adaptation Study in Year 1 to prepare measures needed for the Survey Study, which have not been adapted or validated for use by people with intellectual and other developmental disabilities. In Years 1 through 3, we will conduct the CBPR Disability and IPV Evaluation Study to examine the processes and outcomes of involving individuals with DD in IPV research. 

The proposed studies will be conducted with adults with developmental disabilities, including intellectual disabilities, occurring prior to age 22 and causing problems with multiple major life activities. We will recruit through self-advocacy groups, centers for independent living, disability-specific support groups, and diverse community programs, such as domestic violence programs, and homeless-serving organizations. Our CBPR organizational partners and Community Advisory Board (CAB) will guide recruitment activities. We will use descriptive statistics for each participant characteristic variables and scales and use GLMM with categorical and continuous predictors to investigate factors predicting risk of IPV, health, decrement of disability and secondary conditions. Factor analysis, latent class analysis, and Cronbach's alpha will be used to evaluate the psychometric properties of adapted measures.