Perceived Barriers and Facilitators to Implementation of Inclusive Policy, Systems, and Environmental Changes

Cassandra Herman, Kerri Vanderbom, Karma Edwards and Yochai Eisenberg ()
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Cassandra Herman: Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd., Chicago, IL 60608, USA
Kerri Vanderbom: Prevention and Health Promotion, Butte County Public Health Department, Chico, CA 95928, USA
Karma Edwards: Center for Advancing Health Communities, National Association of Chronic Disease Directors, Decatur, GA 30030, USA
Yochai Eisenberg: Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd., Chicago, IL 60608, USA

Disabilities, 2023, vol. 4, issue 1, 1-14

Abstract: People with disabilities (PWDs) are often excluded from health-promoting activities in their communities. Inclusive policy, systems, and environmental (PSE) changes can promote access to healthy lifestyle choices for PWDs. However, implementation of inclusive PSEs in community-based settings is challenging and we lack an understanding of what factors impact implementation of inclusive PSEs. The purpose of this study was to examine barriers and facilitators experienced by community coaches while planning and implementing inclusive PSEs. Semi-structured interviews (n = 10) were conducted with coaches as part of the Reaching People with Disabilities through Healthy Communities project. Interviews were coded using directed content analysis guided by the Theoretical Domains Framework and were categorized into barriers and facilitators within the COM-B framework (which identifies Capability, Opportunity, and Motivations as components that can impact Behavior). The opportunities domain, consisting of social influences and environmental context and resources, most impacted disability-inclusive PSE implementation. Within this domain, facilitators included community support, strong partnerships, technical assistance from experts, and alignment with ongoing initiatives. Barriers included the community’s lack of knowledge about disability, fear regarding resources needed for inclusive changes, and lack of resources (time, staff, funding). Supports addressing the opportunities domain should be considered to facilitate the implementation of disability-inclusive PSEs to build healthy, accessible communities for all.

Keywords: disability; inclusion; health promotion; implementation (search for similar items in EconPapers)
JEL-codes: I (search for similar items in EconPapers)
Date: 2023
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