Rethinking prevention for people with disabilities. Part I: A conceptual model for promoting health.

PURPOSE Health promotion and disease prevention activities tailored to people with disabilities are crucial to fulfilling the goals articulated in the Americans with Disabilities Act (ADA). We propose a conceptual model to facilitate design and evaluation of health promotion strategies across the life course of people with disabilities. Components of the model, described as planes of experience, integrate the individual’s total environment, the disabling process, opportunity and quality of life. Cost and outcomes re-search is recommended for the evaluation of prevention effectiveness. This model informs a U.S. disability policy that emphasizes environmental modification, prevention of secondary conditions and functional decline, promotion of independence and autonomy, and improvement in individual quality of life.