AHRQ Highlights Urgent Need for Research to Improve Delivery of Preventive Services to People with Disabilities

Robert Otto Valdez, Ph.D., M.H.S.A.

Clinical preventive services are essential strategies for avoiding disease and promoting well-being for people of all ages. Accessing appropriate screening, counseling, early treatment, vaccines, and medications is vital to helping people live their healthiest possible lives.

Unfortunately, not everyone receives these services. This is particularly the case among people with disabilities, who have substantially less access to breast and cervical cancer screening; less screening for high cholesterol, high blood pressure, and tobacco/nicotine use; and less nutrition and exercise counseling. Only 5.3 percent of those living with disabilities received all appropriate preventive services in 2020, according to Healthy People 2030.

To eliminate these inequities, a substantial obstacle must be addressed: too little research is currently available on interventions to increase the delivery of preventive services or how clinicians, healthcare organizations, or systemic issues impact the delivery of clinical preventive services to disabled people.

To address this dearth of information, and in response to a mandate in the Consolidated Appropriations Act of 2023, AHRQ recently delivered to Congress "Research to Improve the Delivery of Clinical Preventive Services to People with Disabilities (PDF, 196 KB)." This agenda for new research, informed by an expert panel and a recently published AHRQ evidence review, recommends three guiding principles for exploring the barriers, facilitators, and interventions for delivering preventive services to people with disabilities.

First, projects must meaningfully engage disability communities throughout the research process. Second, they must build relationships and trust between researchers and people with disabilities. Third, variations among people with disabilities must be recognized.

These principles should be central to the federal government and other entities that seek to fund impactful and trusted research to support greater access to preventive care's health promotion and risk reduction benefits among disabled people.

Grounded in those principles, the report concluded new research on increasing access to and the use of preventive services should focus on:

• Healthcare systems, including the contexts in which communities and clinical teams deliver care and how systems may increase access and delivery of preventive clinical services
• Educating clinicians and healthcare organizations, including developing and assessing the impact of educational interventions
• Data and methods, including how to best collect data on disability status and experiences, as well as clinician knowledge and bias

The Report to Congress highlights the urgent need to move from talk to action when advancing clinical preventive services for people with disabilities, particularly by shortening the time between research and care delivery.

To underscore its commitment, AHRQ has released a Special Emphasis Notice to signal its strong interest in receiving health services research grant applications to improve healthcare for people with disabilities. This includes innovative proposals to reduce quality of care disparities, increase patient safety, improve healthcare access and effectiveness, and ultimately improve health outcomes for people with disabilities.

AHRQ has also joined the Promoting Health Through Prevention campaign, a recently launched effort to promote MyHealthfinder. This valuable tool helps Americans identify preventive services available for no out-of-pocket cost under the Affordable Care Act.

AHRQ is devoted to working with public and private partners to advance research and assist in actions that improve healthcare for everyone. Through continued collaboration with disability communities, we can pursue research and implement new evidence-based interventions that lead to better preventive care, including for those with disabilities.

Dr. Valdez is director of AHRQ.

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