# Determining the relationships between provider bias, experiences of ableism, and health outcomes for people with mobility disabilities

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $681,469

## Abstract

Project Title: Determining the relationships between provider bias, experiences of ableism, and health
outcomes for people with mobility disabilities
Project Abstract
Ableism, the act of discrimination and social prejudice based on presumed or actual impairment and/or
disability, is a pervasive and insidious force in clinical healthcare. Emerging literature points to multiple
factors that may contribute to ableism, however the mechanisms by which these factors impact the
health outcomes of people with disabilities have not been widely explored. Critical knowledge gaps exist
in understanding the relationships between lived experiences of ableism, biases of healthcare providers, and
both short- and long-term health outcomes. People with disabilities are a heterogeneous group with unique
experiences of ableism during healthcare encounters. As a first step towards investigating the mechanisms
through which ableism impacts health outcomes, we will focus on people with mobility disabilities
(PWMD), a disability group representing 1 in 7 adults. We will investigate ableism as a social determinant
of health in the context of rehabilitative care, evaluating its impact on self-perceived health status, depression,
anxiety, pain, participation, quality of life, and measures of healthcare utilization. Further, we will examine how
provider biases and practices impact patient outcomes, a necessary step to address ableism at a systems
level. This study will evaluate the relationships between self-perceived experiences of ableism, provider
biases, and health outcomes among PWMD.
 We will conduct a mixed-methods, observational study with a sequential explanatory design with 40
rehabilitation providers and over 400 PWMD across two study sites in Pittsburgh, PA, and Seattle, WA. We will
prospectively assess explicit and implicit disability biases of rehabilitation providers and then measure
perceived ableism and health outcomes of PWMD during episodes of rehabilitative care (Aim 1). We will
also evaluate the association between cumulative experiences of ableism and current self-reported health
outcomes among PWMD at a second data collection session using measures distinct from those related to the
episode of care (Aim 2a). Additionally, we will retrospectively analyze the electronic health records of our
cohort using cutting edge Natural Language Processing technology to detect patterns of potential bias
within provider documentation (Aim 2b). Finally, we will conduct qualitative semi-structured interviews
with PWMD to understand the lived experiences of ableism across contexts of rehabilitation and general
healthcare (Aim 3). Qualitative data will be used to contextualize quantitative results, map lived experiences to
health outcomes, and generate new theories about the role of ableism in provider-PWMD relationships. The
long-term goal of our work is to reduce disparities and maximize participation, health, and quality of life in
partnership with PWMD. This work wi...

## Key facts

- **NIH application ID:** 10992734
- **Project number:** 1R01HD116301-01
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Heather Ann Feldner
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $681,469
- **Award type:** 1
- **Project period:** 2024-09-01 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10992734

## Citation

> US National Institutes of Health, RePORTER application 10992734, Determining the relationships between provider bias, experiences of ableism, and health outcomes for people with mobility disabilities (1R01HD116301-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10992734. Licensed CC0.

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