• Studies on barriers and/or facilitators to the receipt of clinical preventive services among people with disabilities are lacking for most preventive services and most types of disability.
• Most studies pertained to receipt of breast and/or cervical cancer screening.
• For breast and cervical cancer screening, studies reported most categories of barriers/facilitators and included all types of disability; for other preventive services, fewer studies reported fewer categories of barriers/facilitators and fewer types of disability.
• Evidence on interventions to improve receipt of preventive services among people with disabilities is especially limited, with most studies also related to breast and/or cervical cancer screening.
• Limited evidence from three trials found various educational and health advocacy interventions to be associated with increased rates of breast and cervical cancer screening among people with physical disabilities, cognitive/intellectual/ developmental disabilities, and serious mental illness.
• Evidence on interventions to improve receipt of other preventive services is more limited, with no clear effect of interventions for any preventive service.

Objectives. (1) Summarize reported barriers and facilitators to the receipt of clinical preventive services among people with disabilities; (2) evaluate the literature on the effectiveness of interventions to improve receipt of preventive services among people with disabilities.

Data sources. Electronic databases (Ovid®, MEDLINE®, PsycINFO®, Embase®, the Cochrane Central Register of Controlled Trials, and EBSCO CINAHL Plus) from 1990 through April 23, 2024.

Review methods. Following the Agency for Healthcare Research and Quality Methods Guide, the methods and protocol were determined a priori. We used independent dual review to determine inclusion of studies related to 20 preventive services with Grade A or Grade B recommendations by the U.S. Preventive Services Task Force. We assessed general quality (studies of barriers/facilitators) or risk of bias (effectiveness studies) using study design-specific criteria. Barriers/facilitators were classified into seven general categories (environment-level, person-level, provider-level, healthcare system-level, accessibility of healthcare facility, accessible communication, and policy-level). Barriers/facilitators and interventions were described and presented for each preventive service according to general types of disability (physical, cognitive/intellectual/developmental, sensory, serious psychiatric/mental illness). Due to high methodological/clinical heterogeneity of studies and limited available data, we did not assign strength of evidence ratings or conduct meta-analyses.

Results. Of 11,472 references, we included 68 studies—54 on barriers/facilitators and 16 on the effectiveness of interventions, with 2 studies included for both barriers/facilitators and interventions. Evidence was lacking for most preventive services and generally limited to one or two types of disability for any given preventive service. Studies on barriers/facilitators pertained to 10 preventive services; studies on the effectiveness of interventions pertained to 8 preventive services. Most evidence was for two preventive services—breast cancer screening and cervical cancer screening. For breast and cervical cancer screening, studies reported on most categories of barriers/facilitators and included all types of disability; for other preventive services, fewer studies reported fewer categories of barriers/facilitators and fewer types of disability. Limited evidence from three trials found various educational and health advocacy interventions to be associated with increased rates of breast and cervical cancer screening among women with physical disabilities, cognitive/intellectual/developmental disabilities, and serious mental illness.

Conclusions. We found limited evidence on barriers and facilitators to receipt of most preventive services among people with disabilities, and especially limited evidence on interventions to improve receipt of those services. Most studies were related to breast and cervical cancer screening. The lack of studies for most preventive services and types of disability underscores the need for research to address substantial gaps in the evidence.

Buckley DI, Nygren P, Blackie K, Dana T, Hsu F, Holmes R, Horner-Johnson W, Nicolaidis C, Chou R. Healthcare Delivery of Clinical Preventive Services for People With Disabilities. Comparative Effectiveness Review No. 275. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 75Q80120D00006.) AHRQ Publication No. 24-EHC032. Rockville, MD: Agency for Healthcare Research and Quality; September 2024. Posted final reports are located on the Effective Healthcare Program search page.