Selected Contributions to Disability in Rural Communities: RTC:Rural’s Research
is Designed for Context, Use, and Impact
Rural American is spread out over more than 90% of the nation’s land mass. There are 32,070
towns with 10,000 or fewer residents – half of those with fewer than 1,000 residents. Yet, the
population of these towns is roughly equivalent to the top 97 cities – about 57 million. People with
disabilities living in rural areas face many of the same issues as their urban counterparts but experience
them in distinct and different ways. For example, people with disabilities living in both urban and rural
communities face transportation problems. In urban communities, problems include the lack of
convenient stops or escalator down times. In rural communities, issues focus on limited service or no
public transportation at all.
Rural communities operates on a thin margin of resources with tightly linked and balanced
systems where a change at one component can have multiple and unintended consequences for many
others. Often, when we design interventions to target individuals, we find that we are affecting the
whole community. As such, rural communities present a huge laboratory for natural and planned
experimentation. In particular, because rural solutions often are designed for resource poor
environments, workable solutions are more easily scaled up and applicable to urban areas.
RTC:Rural’s Research Strategy for Impact
Conducting research in rural areas calls for a research approach that is addresses problems that
occur across communities but are responsive to local circumstances. We refer to our research approach
as contextually appropriate applied research. To us social validity is as important as internal or external
validly (e.g., Seekins & White, in press; Wolf, 1978). To accomplish this, we involve representatives from
among the research population in the development, testing, and dissemination of the research using
Participatory Action Research or Community Based Participatory Research strategies (Fawcett,
Mathews, and Fletcher, 1980; Minkler & Wallerstein, 2008: Rogers & Shoemaker, 1971; Schumacher,
1973 Whyte, 1991). In general, this means that, while we use the standard research tools, community
members identify important problems to be addressed, help design procedures that are acceptable, and
judge the significance of the outcomes. We believe this approach produces valued products that are
more likely to be adopted and used. We also believe this approach helps build the overall capacity of
communities and networks to address problems themselves. Interestingly, these design features make
our products applicable in more resource rich environments such as cities or metropolitan areas.
The Rural Research Agenda
The rural research agenda is broad. In its totality, it should address both individual and
environmental factors, and any type of rehabilitation for any impairment group and any age cohort. We
narrow our focus to the systems and issues addressed in the Rehab Act and NIDRR Long Range Plan.
Specifically, we focus on employment, health, and community participation. Further, we tend to work
through the main systems authorized under these acts, namely vocational rehabilitation and
independent living. As we focus on these issues and systems, we look for creative connections to build
community capacity. For example, we have built connections with transportation providers, economic
development agencies, and public health providers to name a few. This consistent focus on systems has
built trust over time and allowed us to pursue the next step of integrating the agenda of people with
disabilities into the mainstream rural agenda and adopting practices from rural development to achieve
disability and rehabilitation goals.
Selected Contributions and Impacts
Our research goal are to develop innovative, evidence-based practices to solve problems faced
by people with disabilities and to provide information suitable for building rural policies at the state and
national levels. Several of our policy recommendations have been adopted or adapted (e.g., selfemployment model policies). We have developed and currently support the adoption of 27 evidencebased practices and several new policies. ( LINK) In addition, eight new practices and new policies are
emerging from our current research (LINK). Our accomplishments are summarized below.
RTC:Rural Impact through Research
Our research can best be organized into the three general areas of interest: rural employment
and economic development, rural community development and independent living, and rural health and
disability. A brief summary of our contributions in these areas is presented along with citations to
support our claims.
Rural employment and economic development. In the area of employment, our selfemployment research activities contributed to the national movement that expanded self-employment
opportunities for people with disabilities (Arnold & Ipsen, 2005; Ipsen, Arnold, & Colling, 20050). We
also developed and evaluated an innovative approach to job creation through rural economic
development that created 79 businesses and 192 new jobs in one rural community (Ipsen et al., 2006).
These outcomes were verified by the Utah State Legislative Auditor General in 2006.
Rural community development and independent living. We provided empirical evidence to
support the National Council on Independent Living’s (NCIL) and APRIL’s advocacy efforts to increase
funding for consumer directed IL services, (NCIL, 2001, 2008). Our groundbreaking research in American
Indian disability issues led to the creation of a national technical assistance center funded by the
Rehabilitation Services Administration, Social Security Administration, and Department of Labor. The
Traveller’s Cheque program, our empirically-demonstrated, voucher-based rural transportation
program, has been replicated in more than 12 states (Gonzales, Kasnitz, Seekins, & Stombaugh, 2006).
The Federal Transportation Administration used our work on rural disability transportation as an
evaluation element of its Program Assessment and Rating Tool (PART) report to the Office of
Management and Budget (Office of Management and Budget, 2007). We have conducted the first
state-wide assessment of visitability of private homes and the first state wide assessment of the
accessibility of small towns using statistical sampling procedures (Seekins, Traci, Cummings, Oreskovich,
& Ravesloot, 2008; Seekins, Arnold & Ipsen, 2012). We have also developed and demonstrated a
measure of participation using real-time ecological momentary assessment methods; providing an
innovative method for measuring treatment outcomes in a manner consistent with the ICF (Seekins,
Ipsen, & Arnold, 2008).
Rural health and disability. We developed and empirically demonstrated the cost effectiveness
of a health promotion program for adults with disabilities, the Living Well with a Disability program. The
New Freedom Initiative identified the cost-effective Living Well with a Disability as a model program,
which has been replicated in over 30 states serving approximately 15,000 individuals (New Freedom
Initiative, 2001). Recently, this program model was systematically replicated to extend health
promotion to vocational rehabilitation clients, the Working Well with a Disability program (Ipsen,
Ravesloot, Arnold, & Seekins, Accepted with minor revisions). A spin off product, the Secondary
Conditions Surveillance Instrument and its companion screening instrument have been adopted by
other researchers and practitioners.
Summary
Our brand of community based applied research is uniquely suited for disability and
rehabilitation research in rural communities. It builds long-term relationships for addressing issues
efficiently. It is compatible with the ecological model of disability. It builds the capacity of those
systems established by the Act. It creates tools that practitioners use. It contributes to policy
improvements. Finally, we have found that by designing for rural applications – in “resource lean”
environments – the innovations have ready application in the “rich” urban context.
References
Arnold, N. & Ipsen, C. (2005). Self-employment policies: Changes through the decade. Journal of
Disability Policy Studies, 16, 115-122.
Fawcett, S.B., Mathews, R.M., & Fletcher, R.K.. Some promising dimensions for behavioral community
psychology. Journal of Applied Behavior Analysis.1980; 3: 319-342.
Gonzales, L.; Kasnitz, D; Seekins, T; Stombaugh, D. (2006) Accessible rural transportation: An
evaluation of the Traveler's Cheque voucher program. Community Development: Journal of the
Community Development Society, 37(3), 106-115.
Ipsen, C., Arnold, N., & Colling, K. (2005). Self-employment for people with disabilities: Enhancing
services through interagency linkages. Journal of Disability Policy Studies 15(4), 231-239.
Ipsen, C., Seekins, T., Arnold, N., & Kraync, K. (2006). A citizen led program for rural community
economic development: Two case studies. Journal of the Community Development Society, 37, 53-69.
Minkler and Wallerstein, (2008). Community-Based Participatory Research for Health: From Process to
Outcomes.
National Council on Independent Living (NCIL) (2001). Drive for 75 outreach materials. Arlington, VA:
Author.
National Council on Independent Living (NCIL) (2008). House Appropriations Subcommittee on Labor,
Health, and Humans Services, and Related Agencies, March 13, 2008 hearing on FY2009 appropriations.
NCIL Testimony on FY 2009 funding for Independent Living Program if the Rehabilitation Act of 1973,
as amended (Title VII, Part C)
Office of Management and Budget (OMB) (2007). Detailed Information on the Federal Transit
Administration - State Administered Public Transit Grant Programs Assessment. Retrieved September 20,
2007 at http://www.whitehouse.gov/omb/expectmore/detail/10009005.2007.html
Rogers, E.M.. & Shoemaker, E.F.. Communication of innovations: A cross-cultural approach. (2nd ed.)
New York: The Free Press. 1971.
Schumacher, E.F. Small to beautiful: Economies as if people mattered. New York: Harper and Row;
1973.
Seekins, T., Arnold, N., & Ipsen, C. (2012). A case study of grading accessibility of community
infrastructure. Journal of Urban Planning and Development.
Seekins, T., Ipsen, C., & Arnold, N. (2007). Using Ecological Momentary Assessment to measure
participation: A preliminary study. Rehabilitation Psychology, 52 (3), 319-330.
Seekins, T., Traci, M.A., Cummings, S., Oreskovich, J., & Ravesloot, C. (2008). Assessing
environmental factors that affect disability: Establishing a baseline of visitability in a rural state.
Rehabilitation Psychology, 53(1), 80-84.
Whyte, W.F.. Participatory action research. Newbury Park: Sage Publications. 1991.