Use of the Americans with Disabilities Act by persons with rheumatic diseases and factors associated with use.

Abstract

This study examined use of the Americans With Disabilities Act (ADA) among persons with rheumatic diseases and assessed which factors were associated with use. A mail survey was conducted among adult patients recruited from 21 rheumatology practices. Subjects answered questions about their inclination to use the ADA in the community or at work and about factors thought to be associated with use. The outcome was stage of behavior change, the behavior being use of the ADA. Ordinal logistic regression identified independent correlates of the outcome. Of 631 subjects, 47% experienced an ADA-resolvable barrier to community activity, and 63% of 183 employed subjects needed a job accommodation or experienced health discrimination. However, only 7% of the full sample and 10% of the employed subgroup had used the ADA. Factors associated with use were detailed knowledge, perception of being disabled, skill in requesting use, and health professional use suggestion. Although many persons with rheumatic diseases experience community barriers or need workplace accommodations, they currently underutilize the ADA. Use could be enhanced by health professional suggestion and referral or by community programs designed to address the factors identified.