Collaborative Rehabilitation Research on Diversity in CRPs

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Collaborative Rehabilitation Research on
Diversity in CRPs

• Joan Reed, MA, CRC
• Linda Holloway, Ph.D., CRC, LCDC
• Paul Leung, Ph.D., CRC
• 5th Annual NCRE Conference
• February 17-20, 2005 Tucson, AZ

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Background

• This presentation highlights the results of
  research completed by the Rehabilitation Research
  Initiative (RRI), a collaborative partnership
  between two rehabilitation education programs in
  Texas, the University of Texas-Pan American
  (UTPA) and the University of North Texas (UNT).

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RRI Capacity Building for CRPs

• Goal
• Increase the capacity of CRPs to serve
  individuals with disabilities from diverse racial
  and ethnic backgrounds.
• Objectives
• Identify barriers by conducting research.
• Identify new and innovative solutions.
• Disseminate results to a national audience.

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Rationale

• This presentation addresses
• Community-based programs and diversity issues in
  the context of the VR-CRP relationship.
• An important area of emerging rehabilitation
  research and pre-service education diversity in
  community rehabilitation programs (CRPs).

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Presentation Topics

• Socioeconomic and Demographic Trends Impacting
  Diversity in CRPs,
• Diversity in the Context of the VR-CRP
  Relationship,
• Inclusion of Diversity and CRP Issues in the
  Pre-service Rehabilitation Educational
  Curriculum,
• Results of Research from the RRI project.

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Socioeconomic and Demographic Trends Impacting
Diversity in CRPs
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Increasing Numbers of Diverse Populations

• Data from U.S. Census
• Table 1.a Projected population by race and
  Hispanic origin (2000 to 2050)
• Table 1.b Projected population change (2000 to
  2050)

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Table 1a. Projected Population of the United
States, by Race and Hispanic Origin 2000 to
2050 (In thousands except as indicated. As of
July 1. Resident population.) (Leading dots
indicate sub-parts.) Population or percent and
race or Hispanic origin
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Table 1b. Projected Population Change in the
United States, by Race and Hispanic Origin 2000
to 2050 (In thousands except as indicated. As of
July 1. Resident population.) (Leading dots
indicate sub-parts.) Numerical or percent change
and race or Hispanic origin
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Increasing Numbers of People with Disabilities
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VR-CRP Relationship

• VR counselors become more dependent on CRPs when
  resources are scarce
• Increased number of VR consumers with more
  significant disabilities requires more
  collaboration with CRPs
• Political climate of privatization and faith
  based organizations encourages VR to work with
  CRPs

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Diversity in the Context of the VR-CRP
Relationship
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Increasing VR Diversity Includes CRPs

• Efforts to increase diversity of the VR system
  includes CRPs

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Employees in CRPsRegions I (n80)

• 80 Caucasian
• 8 African American
• 1 Hispanic
• 1 American Indian
• 10 Not reporting

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Employees in CRPsRegions VI (n87)

• 46 Caucasian
• 25 African American
• 18 Hispanic
• 3 American Indian
• 2.3 Asian
• 2.3 Other
• 3.4 Not reporting

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Data on Diversity in CRPs

• Data on CRPs in the U.S. is scarce.
• Best sources for CRP data
• University of Wisconsin-Stout, Research and
  Training Center.
• 10 Regional CRP-RCEPs

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Relevance to Rehabilitation Education

• Pre-service rehabilitation educators must
  understand diversity issues in the context of the
  VR-CRP relationship and include it as part of the
  educational curriculum.

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Inclusion of Diversity and CRP Issues in the
Pre-Service Rehabilitation Curriculum
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Diversity Issues in the Pre-service
Rehabilitation Curriculum

• Requires knowledge based upon research,
• The use of new and different methodologies, and
• Dissemination of results and resources.

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Requires Knowledge Based Upon Research

• Knowledge gained from RRIs research and
  capacity-building efforts
• Focus Groups
• Consumers, CRP Staff, VR Personnel
• Telephone Interviews
• CRP Staff
• Web-based survey
• VR Counselors

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Knowledge Gained from RRIs Research

• The focus of RRIs research is on the
  participation of consumers from diverse racial
  and ethnic backgrounds in CRPs.
• Identification of Barriers
• Recommendation of Strategies

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The Use of New and Different Methodologies

• Incorporation of Electronic Formats
• Research methodologies
• Web-based surveys
• Web accessibility impacts data collection.
• Need to deal with different levels of web
  accessibility (i.e., Section 508, Bobby, W3C) in
  order to reach the target population and collect
  meaningful data.

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Dissemination of Results and Resources

• Electronic formats
• RRI Web Site
• Diversity Training ToolKit
• Online Diversity Training for CRPs
• Personal, face-to-face formats
• Train the Trainer workshops
• Presentations and local, regional, and national
  conferences and meetings.

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Results of Research from the RRI Project
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Focus Groups

• Data from three focus groups was used to identify
  key barriers to minority participation in CRPs.
• Consumers
• CRP Staff
• VR Personnel

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Barriers Identified by Focus Groups

• Transportation
• Language
• Cultural Mistrust
• Low Expectations of Job Placement
• Lack of Knowledge of the Rehabilitation Process
• Concepts of Time
• Technology

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Telephone InterviewsMethodology

• Dates December 15, 2003 to January 9, 2004.
• Research subjects CRP staff
• Interviewees selected from the training databases
  of the CRP-RCEPs in Regions 2, 6, 9, and 10
• Targeted cities
• Seattle, Los Angeles, Albuquerque, Dallas, New
  Orleans, and New York City.
• Sample size
• 45 subjects from the 6 cities

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Telephone Interviews Sampling

• Purposive sample drawn from databases of the
  regional CRP-RCEPs.
• Interviews completed (45 total)
• Seattle 8
• Los Angeles 6
• Albuquerque 7
• Dallas 7
• New Orleans 10
• New York City 7

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Interview Questions

• How does your agencys mission statement address
  consumers from diverse backgrounds?
• How does your agency encourage minority consumers
  to continue with their rehabilitation services?
• What strategies does your agency use to help
  minority consumers become employed?

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Interview Questions

• How would your describe the diversity of your
  Staff in terms of race and ethnicity?
• Your Consumers?
• Your Community?
• How significant are the following barriers to
  building diversity in your agency?
• Transportation Language Cultural mistrust Low
  expectations of job placement Lack of knowledge
  of the rehabilitation process Concepts of time
  Technology.

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Web-Based Survey Methodology

• Dates October-November, 2004
• Research subjects Currently employed state VR
  counselors
• Targeted states Texas, New Mexico, Louisiana
• Sample size 169 respondents
• Texas 135
• New Mexico 15
• Louisiana 16

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Web-based Survey Sampling

• Purposive sampling, non-random.
• Targeted all state VR counselors in a small
  number of states.
• Response rate varied dramatically from state to
  state.
• Texas VR counselors are disproportionately
  represented in the sample.

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Web Survey Questions

• In your opinion, do barriers exist that limit
  access to community rehabilitation programs
  (CRPs) by minority consumers?
• For each of the 7 barriers identified,
• What effect does it have on minority
  participation in CRPs?
• Major barrier
• Minor barrier
• Has no effect

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Web Survey Questions

• Based upon your experience as a VR counselor,
  what OTHER barriers keep consumers from minority
  backgrounds from participating in CRPs?

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Findings from Telephone Interviews and Web-based
Survey

• Confirmation of 7 Barriers
• Identification of Other Barriers
• Recommendation of Strategies and Interventions

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Findings Emerging Themes

• There are no barriers.
• The 7 barriers are real and operate
• Within the person with a disability.
• In the environment.
• Within a particular culture.
• There are additional barriers.

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Theme 1 No Barriers

• 52 of respondents answered No to the question,
• Do barriers exist that limit access to CRPs by
  minority consumers?
• In my experience there are no barriers in my
  area to minority participation in CRPs.
• I do not know why they dont participate.

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Other Themes These Barriers are Real, But

• Responses differed according to WHERE the given
  barrier exists or operates
• Within the person with a disability,
• Within the environment,
• Social or physical
• Within a given culture.
• Majority, minority, or VR agency culture

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Theme 2 Within the Person

• Consumers may not be motivated to participate.
  They have complacency for their current
  circumstances
• Lack of communication skills.
• The ONLY barrier is when they do not speak
  English.
• Lack of education (no GED or HS diploma).

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Theme 3 Within the Social Environment

• Fear of being labeled as something less than
  normal.
• Stigma associated with having a disability.
• Stigma, and the minority consumer would rather
  rely on family resources.

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Theme 4 Within the Physical Environment

• Land geography because we are such a rural area.
  There are few job opportunities for minorities on
  pueblos and in remote outlying areas, especially
  with the lack of transportation.
• Many of our clients travel by bus so onsite
  visits to the CRP are time consuming and not
  practical.

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Theme 5 Within Majority Culture

• There is mistrust, which has its basis in a
  community which is very diverse, but whose
  understanding of variation is to some extent
  based on unfounded ideas or, sadly, bias or
  racism.

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Theme 6 Within Minority Culture

• Cultural pride, not to take charity.
• Cultural misunderstandings and differences,
  especially when women come from societies that do
  not value them.
• Cultural tendencies to keep their family members
  with disabilities private.
• In minority communitiesthere is a lack of
  information and knowledge that VR exists and what
  our role is

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Theme 7 Within Agency Culture

• Across the board, there is much to be done to
  prepare providers to work with culturally diverse
  populations.
• Sometimes counselor or provider misconceptions
  perpetuate stereotypes, limit options offered,
  and cause them to short change clients and not
  consider all options or opportunities.

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Other Barriers Identified by Respondents

• Lack of availability of jobs.
• Lack of availability of services.
• Financial disincentives Fear of losing other
  benefits due to employment.
• Unemployment, workmans comp, SSI, food stamps,
  public housing, TANF

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Why Is Diversity Research Important?

• Managing a peaceful transition from a US which
  is dominated by white European culture to one
  which is truly multiracial, and very different
  from Europe, will be the greatest single
  challenge the US will face in the coming
  generation. Failure would destroy the American
  dream, but the transition will test the tolerance
  and adaptability of the nation more sternly than
  perhaps any other change in its remarkable
  history.
• McRae, H. (1994). The World in 2020. Boston
  Harvard Business School Press.