R-6, Community Engagement Evaluation Project

Overview
Fifty years of legislation has fueled the move to get people with disabilities out of institutions and into their communities. However, people with disabilities still aren’t participating in their communities as much as they could be. That’s because they run into roadblocks in many parts of their life.

The first step in getting rid of these roadblocks is to measure how much these barriers get in the way. The second step is to create and test ways to get rid of the barriers.

The Community Engagement Initiative is a way to identify roadblocks, specifically those in housing, transportation, education, employment, healthcare, education, and accessing public areas. It does this through collaboration between local government and local disability groups.

This collaboration is done by having community members who have disabilities gather to identify participation barriers and resources in the community. Next, these community members meet with local government officials, business leaders, and others to figure out ways to get rid of the barriers, use resources, and provide support.

To date, this proposed solution has been tested in six communities and put into action in seven more Oregon communities. For a more detailed literature review, click here.

Anticipated Benefits
In the beginning, this study may change healthcare providers’ attitudes and address community barriers at the sites. As it continues, people with disabilities may perceive their environments as being more welcoming. Local healthcare facilities also may be more receptive to people with disabilities. If the Community Engagement Initiative proves itself to be an effective way to make measurable improvements in health care access for people with disabilities, then it can be used in other communities.

Hypotheses

• People with disabilities who participate in the process will indicate improved receptivity within local healthcare environments following intervention.
• Healthcare infrastructure representatives who participate in the process will show an increase in positive attitudes toward disability rights following intervention.
• Communities that participate in the process will demonstrate measurable improvements in access to healthcare for people with disabilities between baseline and post-intervention assessments.

Study Design
The Community Engagement Imitative method will be used in Kansas, Missouri, and Oregon at three sites in each state for matched comparison use. For a more detailed description, click here.

Study Progress
Analysis was done on the inter-rater reliability of the Outpatient Health Care Usability Profile, and it was validated.


“If the study is successful, we will consider expanding the project to determine its success via replication by other communities and with a greater number of topics” Charles Drum, Ph.D., J.D.

"But one of the good things about this community engagement work is that it breaks down barriers -- both between people who are in infrastructure positions who ought to know about disability and don’t and people in the disability community." Charles Drum, Ph.D., J.D.

Read more from Charles Drum, Ph.D., J.D., interview.
Listen to Drum excerpt.

More Information
Community barriers
Besides physical inaccessiblity, other roadblocks such as stigma and other social  and political restrictions may keep people from disabilities to living their life to the fullest.

Community participation
Process in which members are active in the decision making and policy development of their community.

Deinstitutionalizion
Both a policy and a practice, this movement that began in the 1960s has reduced the number of people living in state-operated institutions and increased the number of people needing support to live in their communities.

Health care access
Other, broader views of secondary condition definitions include environmental factors such as access to health services and structural barriers located within the environment that affect the health status of people with disabilities. Counter to this view is that environmental barriers actually represent issues of limited participation, not secondary conditions.

For additional information, view
Healthfinder
Health and Wellness Consortium
 
For more information, contact Danielle Bailey, M.P.H., baileyd@ohsu.edu; Martha Hodgesmith, marthah@ku.edu; or the Research and Training Center on Measurement and Interdependence in Community Living at the RTC/IL, 4089 Dole, 1000 Sunnyside Avenue, Lawrence, KS 66045, 785.864.4095 (voice), 785.864.0706 TTY, RTCIL@ku.edu
National Institute of Disability Rehabilitation Research grant H133B060018