Understanding the Attitudinal Environment as Experienced by Adults with Physical Disabilities: A Qualitative Study

Abstract

<h3>Research Objectives</h3> To identify where adults with physical disabilities experience the attitudinal environment, the continuum of those attitudes, and how they impact emotional and psychological health and well-being. <h3>Design</h3> Qualitative, using data from both in-person and remotely held focus groups and individual interviews. <h3>Setting</h3> Low-income and racially marginalized communities in Flint and Detroit, Michigan. <h3>Participants</h3> 55 adults with moderate to severe long-term physical disabilities. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Themes associated with participants' experiences of the attitudinal environment extracted form focus groups and individual narratives. <h3>Results</h3> Interviews and focus groups lasted approximately two hours. Analyses revealed that participants did not experience societal attitudes as simply positive or negative, and that the contexts in which these attitudes were expressed were not limited to interpersonal interactions. Rather, participants articulated a spectrum of overlapping attitudes ranging from understanding and supportive, to not understanding, to being viewed and treated as less than human. These attitudes were experienced in three overarching contexts: (1) interpersonal interactions, (2) social institutions, structures, and programs that provide or deny needed accommodations, resources, support, and protection, and (3) the built environment. <h3>Conclusions</h3> Understanding how societal attitudes are interpreted, the spectrum of those attitudes, and the contexts in which they are experienced is important because they impact emotional and psychological health and well-being, as well as physical health. Findings can impact how civil rights and health-related policies reflect and influence—and thus reinforce and maintain—the current attitudinal environment, and how policy change can benefit from targeted work to enhance awareness and attitudes about disability and people with disability at the individual, institutional, and systemic levels.Social structures reflect and influence societal attitudes and have material consequences on the lives of adults with physical disabilities. <h3>Author(s) Disclosures</h3> We have no conflicts of interest.