"It All Goes Back to the Services": A Rural/Urban Comparison of Barriers and Facilitators to Disability Services
Methods: Twenty in-depth interviews (N=11 urban; N=9 rural) were conducted with organizational representatives who provide disability services. Two researchers coded the data until 100% consensus was reached. Convergence and divergence across rural and urban perspectives were examined. Major themes were identified and illustrative quotes selected.
Results: Multiple barriers cutting across both communities (e.g., lack of health insurance, high out of pocket expenses) emerged. Access to public transportation and a range of services were major barriers in rural communities but not urban. Key services (e.g., dentists) are absent in rural areas or have long waiting lists. Socio-economic status is the determining factor in overcoming barriers to service provision, with many low income families in rural areas lack resources (e.g., transportation) to overcome barriers. Several facilitators of services emerged (e.g., training parents to deliver services on their own).
Conclusion: Whereas there are range of services available in urban communities, low income, rural families of children with disabilities face unique barriers, particularly when their child transitions out of the school system. Service providers reported extensive efforts to work with parents to overcome barriers; however, community-based strategies (e.g., opportunities for community engagement) are recommended to overcome service barriers in rural communities.
Learning Areas:Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Public health or related education
Public health or related research
Describe barriers and facilitators to services for youth with disabilities and their families. Identify rural/urban differences in barriers and facilitators to services for youth with disabilities and their families. Identify strategies for overcoming barriers to services for youth with disabilities and their families in rural communities.
Keyword(s): Children With Special Needs, Community Health Assessment
Qualified on the content I am responsible for because: I have considerable expertise in qualitative research and analysis, which I used in this study to investigate barriers and facilitators to disability services.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.