A Comparison of Providing Services to Individuals with Disabilities in a Rural and Urban Area

Adolescents with disabilities report lower self-perceived quality of life and poor health outcomes due to disparities such as access to community resources. Both young people with intellectual disabilities and their families have less access to health-related services. Due to the existence of barriers due locality (i.e. rural versus urban) and disability status, a deeper understanding of the interplay of these barriers is needed. PURPOSE: To examine barriers and facilitators to providing services to individuals with disabilities in a rural versus urban area. METHODS: Individual interviews were conducted by trained facilitators with service provides in one rural county in southeast Georgia (N = 12) and in one urban county in north central Georgia (N = 11). Each interviewer used an interview guide adapted from the National Survey of Children with Special Health Care Needs 2009-2010. The guides covered questions specific to the families and barriers and facilitators to services. All interviewers were recorded for transcription. An a-priori code list was created based on the interview guide. Additional codes were added after the initial coding. Once a final code list was developed, all transcripts were coded. Content analysis was used to identify emergent themes and supporting quotes. RESULTS: Content analysis of the transcriptions revealed 12 emergent themes in each contexts. Both rural and urban service providers indicated that families of children with disabilities faced many challenges. Service providers in the rural area reported facing complex barriers to providing services to families of youth with disabilities including cost, lack of insurance, and lack of transportation. Families in the rural area faced additional barriers to opportunities for physical activity within the community that in turn affected their motivation to access needed services. Although service providers in the urban area faced difficulties in providing services, many of their clients had at least partial access to the services they needed. CONCLUSIONS: Professionals in rural areas face multiple, complex barriers to providing services to families of children with disabilities