Barriers and Strategies Validation Study

Read our preliminary findings here. (88 Kb)

View the checklists for providers here (24 Kb) and the checklist for advocates here. (22 kb)

Principal Investigator:Gloria Krahn, PhD, MPH; Rie Suzuki, PhD

The purpose of this study is to create a brief listing of common and important barriers to routine health care access and potential strategies to overcome them for people with disabilities based on published reports. This list will then be reviewed by a group of adults with disabilities in order to validate its completeness. The results of this study will be used in study R3.

Hypothesis: Adults with disabilities will confirm the barriers and strategies to health care access identified by literature review.

Study Design: Literature review with validation through member-checking to result in a brief listing of common and important barriers to routine health care access and potential strategies to overcome them for use by outpatient clinic staff and persons with disabilities.

Samples: (1) Systematic review of all articles on barriers to health care and strategies to overcome them identified by a literature search with the following parameters: peer-reviewed articles addressing health care barriers and access for adults with disabilities, published in the preceding 5 years (to assure currency), and relevant to the US health care system. (2) Disability commenters for the member-check phase will include at least 5 disability advocates regarded as experts in health, and at least 50 people who experience disabilities. Participants will be drawn from disability networks across the country.

Data Collection and Measurement: Articles to be included in the literature review will be collected through a systematic search of current databases including MEDLINE, PsychInfo,CINHAL. Strategic key words and subject headings will be used to retrieve articles related to health care accessibility for people with disabilities and other vulnerable populations.

Data Analysis: A systematic search will identify potentially relevant articles that will be reviewed at the abstract or paper level for inclusion/exclusion based on established criteria.  Research articles will be reviewed for both barriers and strategies to address the barriers. Once the sample of studies has been identified, data will be abstracted using a research abstraction form.  Two reviewers will independently review the included studies, with checks on reliability. Findings will be summarized into a list of barriers and of facilitators to accessing primary health care by persons with disabilities., with the expectation that the barriers list should be meaningful to disability advocates and health care providers. The reviewers will compare their lists and reconcile any differences.

Validation and potential addition to the barriers and strategies checklist will occur through member-checking (Creswell, 2003). Members will include at least 50 people with disabilities and staff from at least two health clinics who will respond to the general listing of barriers and strategies and prioritize those items to include on a checklist.

Anticipated Findings: A list of barriers and strategies to overcoming barriers to accessing primary health care that has been validated by adults with disabilities. The validated list will be summarized as a checklist.  Findings of the systematic review will be published in a journal article and will be used in R3 to inform health care providers and administrators as potential intervention areas.