1. Our Vision – Healthier Kansans living in safe and sustainable environments. Disability Surveillance Lori Haskett, BS; Jamie Simpson, MS Ed; Dan Dao, MPH; Jean P. Hall, PhD; Amanda Reichard, PhD; Noelle Kurth, MS Kansas Department of Health & Environment Office Injury & Disability Programs and University of Kansas Kansas BRFSS Stakeholder Meeting August 26, 2010

2. Our Vision – Healthier Kansans living in safe and sustainable environments. Proposal A collaborative effort between the Disability and Health Program at KDHE, and the Research and Training Center for Independent Living and the Center for Research on Learning at the University of Kansas. This would allow disability researchers and program managers to obtain greater understanding of disability issues among Kansas residents. Guide stakeholders to concentrate on interventions and strategies that could enhance the quality of life and reduce secondary conditions. Improved surveillance capacity required to develop public health responses. We propose questions that focus on sexual violence, smoking cessation, and functional limitations related to school or work

3. Our Vision – Healthier Kansans living in safe and sustainable environments. Rationale: Public Health Impact Approx. 54,000,000 Americans are living with a disability, which is almost 1 in every 5 persons – US Census Bureau (2010) 20% of the Kansas population or 422,108 persons have a self-reported disability - Kansas BRFSS (2007) “People with disability normally have poorer health and have greater medical vulnerability and a higher prevalence of secondary conditions than the general population” - Drainoni et al. (2006)

4. Our Vision – Healthier Kansans living in safe and sustainable environments. Rationale: Public Health Impact Cont’d. Sexual Violence: In North Carolina, women with disabilities were 4 times more likely to have experienced sexual violence than women without disabilities. (Martin et al 2006) Smoking Cessation: Smoking prevalence among people with disabilities is nearly 50 percent higher than among people without disabilities (29.9 percent vs. 19.8 percent), (CDC) Employment: 46% of working age adults with disabilities versus 84% of adults without disabilities were employed in the same time frame (US Census Bureau, 2010)

5. Our Vision – Healthier Kansans living in safe and sustainable environments. Rationale: Purpose These questions will: –Strengthen disability surveillance in Kansas –Provide deeper understanding of disparities relating to sexual violence, smoking cessation, and participation in work/school –Meet goals outlined in the “Kansas State Plan for Promoting the Health of People with Disabilities”

6. Our Vision – Healthier Kansans living in safe and sustainable environments. Rationale: Purpose Cont’d. These set of questions will also inform: –Researchers (etiology, causal factors, etc.) –Program Managers (program planning, implementation and evaluation) –Policy Makers (formulate policies to enhance health and quality of life for people with disability) –Other Stakeholders (Service Providers, Consumers, Persons with Disabilities, etc.)

7. Our Vision – Healthier Kansans living in safe and sustainable environments. Rationale: Public Health Importance Identify Healthy People 2010 Objectives relevant to proposed questions: 6.4 Social participation among adults with disabilities 6.5 Increase the proportion of adults with disabilities reporting sufficient emotional support. 6.6 Satisfaction with life among adults with disabilities 6.8 Employment parity 6.13 Surveillance and health promotion programs

8. Our Vision – Healthier Kansans living in safe and sustainable environments. Proposed Questions Sexual Violence (asked of all respondents) Now I’d like to ask you some questions about different types of physical and/or sexual violence or other unwanted sexual experiences. This information will allow us to better understand the problem of violence and unwanted sexual contact and may help others in the future. This is a sensitive topic. Some people may feel uncomfortable with these questions. At the end of this section, I will give you phone numbers for organizations that can provide information and referral for these issues. Please keep in mind that if you are not in a safe place you can ask me to skip any question you do not want to answer. 1. Are you in a safe place to answer these questions? 1 Yes 2 No [Go to closing statement]

9. Our Vision – Healthier Kansans living in safe and sustainable environments. Proposed Questions Now, I am going to ask you questions about unwanted sex. Unwanted sex includes things like putting anything into your vagina [If female], anus, or mouth or making you do these things to them after you said or showed that you didn’t want to. It includes times when you were unable to consent, for example, you were drunk or asleep, or you thought you would be hurt or punished if you refused. 2. Has anyone EVER had sex with you after you said or showed that you didn’t want them to or without your consent? 1 Yes 2 No 7 Don’t know / Not sure 9 Refused

10. Our Vision – Healthier Kansans living in safe and sustainable environments. Proposed Question 3. Has this happened in the past 12 months? 1 Yes 2 No 7 Don’t know/ Not sure 9 Refused

11. Our Vision – Healthier Kansans living in safe and sustainable environments. Proposed Questions Think about the time of the most recent incident involving a person who had sex with you –or- attempted to have sex with you after you said or showed that you didn’t want to or without your consent? What was that person’s relationship to you? Possible categories: Please ADD: 1 personal attendant/caregiver 2 Someone you were dating 3 Boyfriend/ Girlfriend 4 Stranger 5 Spouse or live-in partner 6 Relative 7 Don’t know/ Not sure 9 Refused

12. Our Vision – Healthier Kansans living in safe and sustainable environments. Proposed Question Closing Statement: We realize that this topic may bring up past experiences that some people may wish to talk about. If you or someone you know would like to talk to a trained counselor, please call 1-800-656- HOPE (4673). Would you like me to repeat this number?

13. Our Vision – Healthier Kansans living in safe and sustainable environments. (If they answered yes to “Do you currently smoke?”) Has you doctor advised you to quit smoking?

14. Our Vision – Healthier Kansans living in safe and sustainable environments. Asked only of those screening yes to disability: Does your impairment or health problem affect your ability to go to school or work? (From 2008, state-added disability module) Proposal

15. Our Vision – Healthier Kansans living in safe and sustainable environments. Relationship to Other Topics Health status Access to Quality Health Services Smoking cessation Anxiety and depression Emotional support and life satisfaction Social context

16. Our Vision – Healthier Kansans living in safe and sustainable environments. Alternate Data Sources Alternate data sources which currently ask similar questions: The National Health Interview Survey –Why are these alternate data sources inadequate? They don’t provide state and local level information that is critical for targeted intervention Reasons for choosing BRFSS as the means for data collection: –Sound methodology –Population based –Opportunity for cross assessment with other health indicators

17. Our Vision – Healthier Kansans living in safe and sustainable environments. Analytic Plan Cross assessment by: –Selected socio-demographic/socio-economic variables –Potential co-morbidity variables To assess trend analysis

18. Our Vision – Healthier Kansans living in safe and sustainable environments. Data Use Include: –Needs Assessment –To inform program planning for sexual violence –Presentations at conferences/meetings –To inform the needs of our partners

19. Our Vision – Healthier Kansans living in safe and sustainable environments. Contact Information Jamie Simpson Office of Injury & Disability Prevention Kansas Department of Health & Environment