DOI: 10.3886/e198226v1
title: Developing Research Priorities for Facilitating Community Living and Participation in Rural Areas

description: Study Summary



Title:

Understanding Factors related to Community Living and
Participation in Rural Areas

Sponsor:

National Institute on Disability, Independent Living, and
Rehabilitation Research (NIDILRR, Grant 90RTCP0001-01-00)

Principal Investigator:

Mark Salzer, Ph.D., Professor, Department of Social and
Behavioral Sciences, Director, Temple University Collaborative on Community
Inclusion of Individuals with Psychiatric Disabilities, Temple University.

Objective:

This study aims to explore the barriers and facilitators to
community participation among individuals with serious mental illness (SMI) in
rural areas, to gather insights for expanding and developing interventions that
promote community participation in rural communities.

Background:

Community participation is crucial for the health and
well-being of individuals with SMI, but it tends to be lower in rural areas due
to various factors like distance to opportunities, lack of transportation, and
difficulties in engaging local organizations.

Methodology – Stakeholder Perspectives on Barriers and Facilitators of
Community Participation:

- Recruitment: We partnered with a
managed care organization and an association of rural county mental health
policymakers in Pennsylvania to identify rural counties that were interested in
participating in data collection efforts. Three rural counties expressed
interest. In-person meetings were scheduled with individuals with SMI and their
family members, and provid­ers from each of these counties on two separate
occasions.

- Participants: 87 individuals from six stakeholder groups,
including individuals with SMI, family members, service providers, agency
administrators, county mental health administrators, and behavioral health
managed care.
<br>- Data Collection: Two half-day facilitated group events in
two rural counties of Pennsylvania, either in-person or online for a total of
six meetings. The questions asked in the first meetings in both counties were:
1) what activities are important to people with SMI and rural areas, and 2)
what are some of the barriers and facilitators to participation in rural areas.
Participants were each given three sticky dots to place on their top three
important activities and their top three barriers. The question asked in the
second meeting was about potential solutions to the barriers presented in the
first meeting. Participants discussed aspects of community participation,
barriers, facilitators, and priorities for interventions. Participants in the
first and second sessions could be different, and the person who attended the
first session didn’t have to attend the second, and vice versa.
<br>- Data Analysis: Qualitative analysis to identify themes and
patterns related to community participation in rural areas. A count of the top
activities and barriers based on those selected by participants with the dots.

Methodology – Pennsylvania Association of Psychiatric Rehabilitation
Services (PAPRS):

- Participants: 87 attendees of a 90-minute virtual session
of the annual PAPRS conference participated in the study. Conference attendees
were service providers that primarily work in psychiatric rehabilitation
programs or in recovery-oriented non-clinical services such as peer support,
residential rehabilitation, or service coordination. The conference session was
specifically described as pertaining to providers who work or live in rural
areas with a focus on identifying barriers to community inclusion and
participation and strategies to mitigate them among individuals with SMI in
rural areas.
<br>- Data Collection: During the first 30 minutes of the
session, participants were given a presentation providing background research
on community inclusion and participation of individuals with SMI, were informed
about the research procedures, and consented to participate in the study.
Attendees were then randomly assigned into 8 breakout groups of approximately
10 participants each. During the remaining 60 minutes they primarily worked in
their groups to answer the following questions: 1) what are the possible
barriers to community participation in rural areas?, and 2) what are some
current facilitators or potential strategies that could be used to promote
community participation in rural areas? Each group took notes on a Google
document that was accessible to the research team for qualitative analysis. <br>- Data Analysis: The study employed directed content coding,
initially categorizing data based on pre-existing research on community
participation barriers and facilitators, with the first author coding responses
using these categories. Emergent categories were later developed for
non-fitting responses, followed by a review and consensus process involving a
second and third coder for any discrepancies.

Key Measures:

- Qualitative Measures: Discussions and activities focusing
on experiences with community participation, barriers, facilitators, and
potential solutions.

Confidentiality:

Measures were in place to ensure participant privacy and
confidentiality. No personal health information was collected.
description: N/A
description: Response Rates: N/A
description: Please see the attached manuscripts and the file "Study and Data Summary.docx".