Research  Agenda

Building safe, accessible environments is foundational to our progress towards health equity.

With an aging population there will be a greater proportion of adults with acquired visual impairment, hearing loss, osteoarthritis, dementia, and other chronic health conditions. In addition, with medical advances promoting early survivorship and improved disease control, there is a growing population of individuals aging with a disability. This dual phenomena of global aging coupled with increased longevity for individuals with disabilities creates new opportunities for societies striving to meet the needs of populations aging into disability and those aging with disabilities acquired earlier in the life course.

​Grounded in disability and health frameworks, my research investigates the impact of environments on the health of people with disabilities. My interdisciplinary training bridges the fields of social epidemiology, kinesiology, gerontology, and disability studies to conduct innovative research addressing population health and health equity. I am passionate about identifying and modifying environmental exposures to facilitate physical activity, mobility, and participation. As a result, my work provides evidence-based recommendations to translate research findings into practice and policy. My overarching research goal is to create accessible and inclusive healthy communities.

Mission

Integrate multiple data sources to study how environments affect mobility among people with disabilities to inform policies that increase participation and inclusion within society.

Vision

Equitable environmental development can optimize societal inclusion and individual participation among people with disabilities.

Current Studies

Investigating the role of public transit on health behaviors among older adults with disabilities.
Many older adults and people with disabilities experience difficulty traveling outside their homes, making limited transportation a structural barrier to health. With millions of older adults who don't drive, we know that other transportation options are important. We want to find out how public transit affects older adults' physical activity and social participation, especially for those with disabilities. This project has three main goals:

1. Examine if self-reported public transit use is associated with physical activity and social participation among older adults with and without disabilities,
2. Determine if the accessibility of public transit systems is associated with physical activity and social participation behaviors among older adults,
3. Test the hypotheses that public transit use partially mediates the link between public transit features and (a) physical activity and/or (b) social participation among older adults.

We are collecting data on public transit accessibility and combining it with a study on older adults' health. We are using this data to see how disability, public transit features, and using public transit all work together to shape older adults' physical activity and social participation. We hope our research will show if access to public transit is related to physical activity and social participation in older adults with disabilities. We believe this could help reduce health differences among this group. Ultimately, we aim to translate our findings to help guide plans for public transit systems that include older adults with disabilities.
Funding: National Institute on Aging, K99AG081563 (PI: Twardzik)

Previous Studies

Outdoor Environmental Facilitators and Barriers of Stroke Survivors’ Mobility and Functional Status.
Stroke is a major cause of disability in the U.S., affecting about 6.6 million Americans over 20. With more people surviving strokes and returning home, we want to find out what helps them function better, especially when it comes to moving around. In our project, we examine preexisting data and use wearable sensors and interviews to find out which outdoor features matter most for stroke survivors' mobility and functioning in the first 18 months after their stroke. This project has three main goals:

1. Examine the moderating effect of environmental features found on participants' residential blocks on the relationship between stroke severity and 18-month trajectory of functional status post stroke
2. Identify environmental features that moderate the relationship between stroke severity and mobility adaption (i.e. slower gait speed) in real-time using wearable sensors (i.e. mobile inertial measurement units)
3. Identify the most salient environmental features for functional status and mobility as reported by stroke survivors using qualitative interviews.

We believe our findings will help guide plans and policies to make the outdoors more accessible for stroke survivors. We hope this can improve their independence, reduce reliance on caregivers, delay nursing home moves, and prevent other health problems. Through our work, we aim to make a positive difference in the lives of stroke survivors and their families.
Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development, F31HD098870 (PI: Twardzik)

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