TY - JOUR
T1 - Association of state-level and individual-level factors with choice making of individuals with intellectual and developmental disabilities
AU - Houseworth, James
AU - Stancliffe, Roger J.
AU - Tichá, Renáta
N1 - Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/12
Y1 - 2018/12
N2 - Background: State-level factors have not been examined in research on choice, despite findings of between-state differences. Aims: To examine both individual and state-level factors associated with choice. Methods and procedures: We used multilevel modeling to explore two choice scales, support-related and everyday choice, based on the National Core Indicators (NCI) data from 2013-14. Outcomes and Results: At the individual level, milder ID, greater mobility, fewer problem behaviors, answering questions independently, communicating verbally, and living in a non-agency setting, particularly independent settings, were associated with more choice for both scales. State-level factors overall explained variance for both scales, but were more strongly associated with support-related choice. A higher proportion of people with IDD living independently within the state predicted more support-related choice. High cost of living within a state predicted less everyday choice. Higher proportion of people living with family and lower proportion being served within a state predicted more everyday choice. Conclusions and implications: These findings suggest further study of choice in relation to policies that: (1) increase independent living for individuals with IDD, and (2) assist individuals/families living in high cost states. State differences on important QOL outcomes are likely to be associated with economic and system-based factorsbeyond individual differences.
AB - Background: State-level factors have not been examined in research on choice, despite findings of between-state differences. Aims: To examine both individual and state-level factors associated with choice. Methods and procedures: We used multilevel modeling to explore two choice scales, support-related and everyday choice, based on the National Core Indicators (NCI) data from 2013-14. Outcomes and Results: At the individual level, milder ID, greater mobility, fewer problem behaviors, answering questions independently, communicating verbally, and living in a non-agency setting, particularly independent settings, were associated with more choice for both scales. State-level factors overall explained variance for both scales, but were more strongly associated with support-related choice. A higher proportion of people with IDD living independently within the state predicted more support-related choice. High cost of living within a state predicted less everyday choice. Higher proportion of people living with family and lower proportion being served within a state predicted more everyday choice. Conclusions and implications: These findings suggest further study of choice in relation to policies that: (1) increase independent living for individuals with IDD, and (2) assist individuals/families living in high cost states. State differences on important QOL outcomes are likely to be associated with economic and system-based factorsbeyond individual differences.
KW - Choice
KW - Community living
KW - Cost of living
KW - Intellectual disability
KW - Residence type
KW - State factors
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U2 - 10.1016/j.ridd.2018.08.008
DO - 10.1016/j.ridd.2018.08.008
M3 - Article
C2 - 30144747
AN - SCOPUS:85051827934
SN - 0891-4222
VL - 83
SP - 77
EP - 90
JO - Research in Developmental Disabilities
JF - Research in Developmental Disabilities
ER -