Mobility

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Mobility

• Barbara M. Altman
• Disability Statistics Consultant

2
Part I Discussion of Response Patterns
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Mobility Questions

• Washington Group Question
• Do you have difficulty walking or climbing
  steps?
  
• No, No difficulty
• Yes, Some difficulty
• Yes, A lot of difficulty
• Cannot do at all
• Extended Questions - Aids
• Do you use any kind of equipment, such as a
  wheelchair, walker, or cane to help you get
  around? /Yes/No

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Extended Questions

• Problem Walking
• Do you have difficulty going outside of your
  home?
  
• Cant do at all
• A lot of difficulty
• Some difficulty
• No difficulty
• Do you have difficulty walking a long distance
  such as a kilometer (or a mile)?
  
• No difficulty
• Some difficulty
• A lot of difficulty
• Cant do at all

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More Extended Questions

• Problems Step, Stand, Sit, Stoop, Walk short
  distance
  
• By yourself and not using aids, do you have any
  difficulty.
  
• Walking for a quarter of a mile (about 2-3
  blocks)?
  
• Walking up ten steps without resting?
• Standing or being on your feet for about two
  hours?
  
• Sitting for about two hours?
• Stooping, crouching or kneeling?
• Answers
• Yes
• No

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Non Problematic Patterns
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Problematic Patterns
8
Other/Borderline Patterns
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Country Examples

• Examples from three countries who did cognitive
  testing
  
• Lesotho
• India
• South Africa

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Part II Combined Test Results
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Special Aspects of Non Problem Patterns

• D No disability on WG question, but indication
  of a split between answering about going outside
  or having a problem walking distances. Can this
  be a cultural orientation problem?
• Viet Nam have 10 with D pattern, most are related
  to going outside
  
• Gambia has 7 with D pattern, most are related to
  some or a lot of difficulty walking long
  distances
  

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Special Aspects of Non Problem Patterns

• E No indication of disability on WG question,
  but indicators of problem with walking steps,
  standing, sitting, stooping or walking ¼ mile.
  
• Responses predominantly indicate that person has
  difficulty standing for 2 hours. Since WG
  question asks about walking or climbing steps
  connection is not really direct.
• Argentina had 6 respondents with this pattern,
  two who mentioned difficulty climbing steps. Is
  this a possible problem with translation of or,
  an problem with an interviewer or inattention.

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Special Aspects of Non Problem Patterns

• F Indication of a disability on the WG question
  associated with positive responses to the walking
  steps, standing, sitting, stooping or walking ¼
  mile questions.
• In this instance the positive response is to the
  indicator of difficulty walking stairs which
  would be consistent with the WG question.
  

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Special Aspects of Non Problem Patterns

• G In this instance the pattern is a positive
  response to the WG question and a positive
  response on the problem walking distances or
  getting outside the home.
• This has a smaller number and the pattern seems
  to be more associated with walking long
  distances.
  
• Compared with D pattern which occurs more
  frequently we seem to be more likely not to
  capture on the WG question. Cultural orientations
  may play a role?

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Reconciling Contradictory Patterns

• D WG Question No Walking Yes
  G WG Question Yes Walking Yes
  
• D pattern represented in 47 responses
  G pattern represented in 15 responses
  
• D pattern more common, need to examine the
  characteristics of the two patterns to assess if
  this is related to age (G may reflect older
  group).
• Also need to examine difference in these two
  responses by countries since in some places
  walking long distances is more commonplace.

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Problematic Patterns

• H WG question positive, no other positive
  responses to extended questions.
  
• Pattern only found in 20 respondents, 7
  countries.
  
• Raises question of other limitations such as
  vision problems or self help. Need to look at
  those relationships.
  
• Cross limitation should also be examined for some
  other patterns we cant explain
  

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Problematic Patterns continued

• I Most commonly occurring problem pattern (48).
  No to WG question, but yes to functioning
  questions.
  
• No immediate explanation that explains the
  pattern, however, most of the patterns reflect
  just some difficulty (lowest level) in walking
  long distances and problems with sitting,
  stooping or standing, not directly related to
  walking.
• Only 5 have a more serious pattern

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Problematic Patterns continued

• J No to WG question, yes in all the other areas.
  Only 10 responses in this pattern, 6 of these in
  Mexico, 8 in SA.
  
• Would seem that a positive answer to using an aid
  would be directly related to a positive answer on
  WG question.
  
• May demonstrate a form of cultural sensitivity or
  stigma.
  
• K Yes to WG question, yes to Aid. I dont find
  that a problem pattern (3).

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Borderline Patterns

• M and N Yes on WG seems to be supported by yes
  on Aids questions and in one of the other
  functioning sections (22).
  
• L, O and P No on WG question but all with yes
  on use of an Aid and one other area (16). Almost
  all of these patterns found in Argentina,
  Paraguay, Mexico and India. May be another
  indication of the effect of stigma.

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Discussion of Problematic Responses

• Only approximately 10 of responses are
  problematic. We dont know how this translates
  into a random sample situation. Need field test
  results.
• Also need further analysis to see if there is an
  age, gender or overlapping effects (other
  limitation statuses). Some evidence might
  indicate the effects of stigmatizing status.
• Need to examine response rates when burden is not
  a problem.
  
• I interpret these results as very encouraging and
  would expect that we wont change this element at
  all.