Attitudinal Barrier Research Articles

Litigants in Person in Northern Ireland: Barriers to Legal Participation - Final Report

The Litigants in Person in Northern Ireland (LIPNI) research, funded by Nuffield, found that LIPs face intellectual, practical and emotional barriers to being able to participate in legal proceedings, and that these barriers could jeopardise their right to a fair trial under article 6 of the European Convention of Human Rights (ECHR), which requires litigants to be able to participate effectively in legal proceedings. While these barriers exist for many litigants, the research identified an additional attitudinal barrier that LIPs face as a direct result of not having legal representation in court. The two main recommendations from the research were that there was a need for cultural change to ‘normalise’ the presence of LIPs in the court system and embed their perspective in reforms to the court process (to tackle attitudinal barriers) and a need for information materials to support LIPs, developed through user-focused design principles (to tackle intellectual, practical and emotional barriers). This report is a summary of the main report

ERADICATING THE BARRIERS TO INCLUSIVE HIGHER EDUCATION

Introduction . Nowadays, people with disabilities (PWDs) and special educational needs must be empowered with high-quality university education for successful social integration in life. However, the current restricted access to inclusive higher education makes it hard to enhance their professional fulfillment and to find their role and place in the modern society. The aim of the research is the search for the answer how to eradicate barriers to inclusive higher education in the Russian universities. Methodology and research methods . The research is based on inclusive approach to education that enables to adapt the high school system of preparation for individual educational needs of students. The publications on the studied subject was analysed; the experience of the organization of inclusive education in foreign and Russian higher education institutions is studied and generalized. Results and scientific novelty . The attitudinal, physical, and academic barriers to inclusive higher education introduction and effective implementation in the Russian Federation are revealed and described in detail. The methodology of sustainable elimination of these barriers including preliminary evaluation, preparatory, final evaluation and activity stages is offered. The purposes of elimination of each of barriers are opened. Overcoming a physical barrier (by means of re-planning of buildings, re-equipment of classrooms and technical facilities) assumes creation of the inclusive infrastructural environment for the most comfortable training, communication and socialization of students with special educational needs. Full academic access to high-quality education means existence of the adapted educational programs, individual approach to training of PWDs, their psychological and pedagogical support from the faculty and other members of higher education institution. The attitudinal barrier involves socio-rehabilitational and correctional support as well as a complex of actions for socialization of students and development of their interpersonal communication. The question of attitudinal barrier is not appropriately covered by the Russian researchers. Therefore, the author emphasizes the need for overcoming the attitudinal barrier that is caused by the objectives of continuous self-improvement of students with special needs and development of their competitiveness. Furthermore, this barrier significantly influences physical and academic restrictions. Practical significance . The presented action framework for assistance of free access of people with disabilities to high-quality educational services will contribute to personal economic independence of this category of citizens, their successful socialization and professional fulfillment in the future. The research findings could be applied to any levels of professional training in various directions and specialties.

Community reintegration postspinal cord injury: Indian scenario

Patients who suffer from spinal cord injury because of their permanent mobility and/or cognitive impairment will usually face difficulties in reentering into the community. The aim of this paper is to review the relevant architectural and attitudinal barrier, transportation difficulties in the current Indian scenario. MEDLINE®, Embase™, the Science Citation Index, and Google™ Scholar were used to look for relevant articles published in English literature. Rehabilitation should promote the full inclusion and participation of people with disabilities in the physical and psychosocial environment. The past two decades have seen a renewed interest in India to improve services for spinal injured. Although there are number of barriers to successful community reintegration in India; a holistic and empathetic approach to prioritize this issue is the need of the hour. Recent initiatives taken by the government, namely, “Sugamya Bharat Abhiyan - Accessible India” and Person with Disability Act 1995 are welcome steps in this direction.

Barriers to product return management in automotive manufacturing firms in Malaysia

The increasing of global warming and depletion of natural resources has become a concern for society, government and industry. There is a growing importance on recovery of used materials and products amongst industry players. The Malaysian government has conducted many green campaigns and provided incentives for some green practices; however, the adoption of product return and recovery management is still low amongst automotive manufacturers. Therefore, it is important to understand the obstacles towards product return adoption so that the countermeasures can be thought of to overcome this situation. The objective of this paper is to investigate the barriers of product return management amongst automotive manufacturing firms in Malaysia. A total of 228 automotive manufacturers and assemblers were identified as the sampling frame, which was selected based on the census sampling method due to the limited sample size of the study. The data was analysed using the Partial Least Squares (PLS) with the measurement model had shown sufficient model fit and the structural model revealed that the data supported the hypothesised model. The large effect size and higher than zero values of the predictive capabilities imply that the model has sufficient variance explained for the predictive capability of the hypotheses testing of the study. Based on the results, this study has found that the resource barrier has a significant effect on the level of adoption of product returns. Specifically, the resource barrier and the extent of the manufacturing return adoption were positively related (β = 0.361, p < 0.01), resource barrier and the extent of the distribution returns (β = 0.252, p < 0.05), and resource barrier and the extent of the customer returns (β = 0.333, p < 0.01). The result reflects that automotive manufacturers have a lack of resources to afford the product return implementation; as a matter of fact, high initial investments in terms of finances, human resources, and time are required for the product return adoption. Other variables of the study, such as the attitudinal and perception barrier, information barrier, and technical barrier, were found to be insignificant with the adoption of product return management. As a conclusion, this study discovered that the resource barrier was the major obstacle that impeded the automotive manufacturers in Malaysia from adopting the product return management. The outcome is expected to help policy makers, manufacturers as well as stakeholders in setting appropriate policies and strategies to improve the product return and recovery management adoption.

The rights of persons with Disability Bill, 2014: How "enabling" is it for persons with mental illness?

India ratified the United Nations Convention on the Rights of Person with Disabilities (UNCRPD) in 2007. This is a welcome step towards realizing the rights of the persons with disability. The UNCRPD proclaims that disability results from interaction of impairments with attitudinal and environmental barriers which hinders full and active participation in society on an equal basis with others. Further, the convention also mandates the signatory governments to change their local laws, to identify and eliminate obstacles and barriers and to comply with the terms of the UNCRPD in order to protect the rights of the person with disabilities, hence the amendments of the national laws. Hence, the Government of India drafted two important bill the Right of Persons with Disabilities Bill, 2014 (RPWD Bill, 2014) and Mental Health Care Bill, 2013 (MHC Bill, 2013). There is no doubt that persons with mental illness are stigmatized and discriminated across the civil societies, which hinders full and active participation in society. This situation becomes worse with regard to providing mental health care, rehabilitation and social welfare measures to persons with mental illness. There is an urgent need to address this issue of attitudinal barrier so that the rights of persons with mental illness is upheld. Hence, this article discusses shortcomings in the Right of Persons with Disabilities Bill, 2014 (RPWD Bill, 2014) from the perspective of persons with mental illness. Further, the article highlights the need to synchronize both the RPWD Bill, 2014 and Mental Health Care Bill, 2013 to provide justice for persons with mental illness.

Ethnic and adoption attitudes among Guatemalan University students.

Intercountry adoptions from Guatemala were highly controversial, because of the large numbers of children being adopted to the USA, along with evidence of corruption and child theft. Since the implementation of the Hague Convention on Intercountry Adoption in 2008, Guatemala’s central authority for adoption has prioritized domestic placements for children over intercountry adoption. A possible attitudinal barrier to domestic adoption in Guatemala—negative attitudes and prejudice against Indigenous people—was investigated through questionnaires measuring attitudes toward adoption and attitudes toward and social distance from the two major ethnic groups (Ladino and Indigenous). Guatemalan university students (N = 177, 61 % men) were recruited from basic required courses at a private university. Results showed that attitudes toward adoption in general were more favorable than toward interethnic adoption, with the most negative attitudes toward adoption of Ladino children by Indigenous parents. Multiple regression and analysis of covariance models revealed that female gender, experience with adoption and more positive attitudes about Indigenous persons were associated with more positive attitudes toward adoption. The findings imply that negative attitudes toward Indigenous persons are associated with negative attitudes toward adoption, and serve as barriers to promoting domestic adoption in Guatemala.

Using UV photoaged photography to better understand Western Australian teenagers' attitudes towards adopting sun-protective behaviors.

This study aimed to determine whether the viewing of a personal photoaged photograph had the capacity to alter Western Australian teenagers' pro-tanning attitudes. Semi-structured interviews were conducted with fifteen teenagers. The teenagers' pro-tanning attitudes prior to viewing their photoaged photograph are encapsulated in the study's central theme: 'You've got to look after your skin and use sunscreen, but I always forget!'. Post-viewing their photoaged facial image many teenagers reiterated their intentions to adopt (when they remembered) skin-protective measures. However, photoaged photography did not alter other teenagers' intention to tan. NEW KNOWLEDGE: Teenagers who choose to continue to tan were aware of the long-term health risks associated with ultra-violet over-exposure. However, their desire remained strong to emulate the media promoted image of bronzed youth being popular individuals. Indeed, the social benefits of being considered attractive to their peers became an attitudinal barrier to the teenagers' adoption of skin-protective behaviours. Those teenagers who changed their pro-tanning attitudes following their viewing of their ultra-violet photoaged photograph did so because of the shock they received when they saw their sun-damaged facial image. This suggests that photoageing photography can be effective with many adolescents because it reduces the cause-and-effect delay that exists between the occurrence of sun-damage and its visual presentation in later-life. Greater effort needs to be focused on increasing teenagers' understanding of how sun-damage occurs, when it is appropriate to apply sunscreen, as well as in changing the prevailing media image of an attractive body being a tanned body.

Insurance status, use of mental health services, and unmet need for mental health care in the United States.

The purpose of this study was to provide updated national estimates and correlates of service use, unmet need, and barriers to mental health treatment among adults with mental disorders. The sample included 36,647 adults ages 18-64 (9,723 with any mental illness and 2,608 with serious mental illness) from the 2011 National Survey on Drug Use and Health. Logistic regression models were used to examine predictors of mental health treatment and perceived unmet need. Substantial numbers of adults with mental illness did not receive treatment (any mental illness, 62%; serious mental illness, 41%) and perceived an unmet need for treatment (any mental illness, 21%; serious mental illness, 41%). Having health insurance was a strong correlate of mental health treatment use (any mental illness: private insurance, adjusted odds ratio [AOR]=1.63, 95% confidence interval [CI]=1.29-2.06; Medicaid, AOR=2.66, CI=2.04-3.46; serious mental illness: private insurance, AOR=1.65, CI=1.12-2.45; Medicaid, AOR=3.37, CI=2.02-5.61) and of lower odds of perceived unmet need (any mental illness: private insurance, AOR=.78, CI=.65-.95; Medicaid, AOR=.70, CI=.54-.92). Among adults with any mental illness and perceived unmet need, 72% reported at least one structural barrier and 47% reported at least one attitudinal barrier. Compared with respondents with insurance, uninsured individuals reported significantly more structural barriers and fewer attitudinal barriers. Low rates of treatment and high unmet need persist among adults with mental illness. Strategies to reduce both structural barriers, such as cost and insurance coverage, and attitudinal barriers are needed.

Environmental barriers and subjective health among people with chronic spinal cord injury: A cohort study

ObjectiveAlthough previous studies have found environmental barriers to be associated with social participation and life satisfaction after spinal cord injury (SCI), few studies exist reporting their effects on subjective health after SCI. Our purpose was to identify the prevalence of perceived environmental barriers and their effects on subjective health in persons with chronic SCI who completed two repeated measurements during a 5-year longitudinal study.DesignThis is a prospective cohort study. Environmental barriers were measured at baseline by the Craig Hospital Inventory of Environmental Factors-Short Form. Subjective health was measured at baseline and 5-year follow-up by days of physical and mental health not good. Other control variables included sex, race, age at injury, years since injury, and injury severity at baseline.SettingData were collected at a specialty hospital and analyzed at a medical university in the Southeastern USA.ParticipantsA total of 1635 participants completed both baseline and follow-up surveys.ResultsTwenty per cent of participants reported at least one policy barrier, 46% at least one physical and structural barrier, 22% at least one attitudinal and support barrier, 26% at least one barrier to services and assistance, and 13% at least one barrier at work or school. After controlling for sex, race, age at injury, years since injury, and injury severity, the physical and structural barriers, and services and assistance barriers measured at baseline significantly predicted subjective physical and mental health measured at follow-up.ConclusionEnvironmental barriers are prevalent among people with chronic SCI. They are important predictors for future subjective health.

A Pilot Study of a Culturally Targeted Video Intervention to Increase Participation of African American Patients in Cancer Clinical Trials

Abstract Purpose. Barriers to clinical trial participation among African American cancer patients are well characterized in the literature. Attitudinal barriers encompassing fear, distrust, and concerns about ethical misconduct are also well documented. To increase trial accrual, these attitudes must be adequately addressed, yet there remains a lack of targeted interventions toward this end. We developed a 15-minute culturally targeted video designed to impact six specific attitudes of African American cancer patients toward therapeutic trials. We conducted a pilot study to test in the first such intervention to increase intention to enroll. Patients and Methods. The primary study outcome was self-reported likelihood to participate in a therapeutic trial. Using a mixed methods approach, we developed the Attitudes and Intention to Enroll in Therapeutic Clinical Trials (AIET) instrument, a 30-item questionnaire measuring six attitudinal barriers to African American trial participation. We enrolled 108 eligible active treatment patients at a large urban cancer institute. McNemar's test for matched pairs was used to assess changes in attitudes and likelihood to enroll in a clinical trial at baseline and immediately after the video. Pre- and post-video AIET summative scores were analyzed by paired t-test for each attitudinal barrier. Results. Patients' likelihood of enrolling in a clinical trial significantly increased post-video with 36% of the sample showing positive changes in intention [McNemar's χ2 = 33.39, p &amp;lt; .001]. Paired t-tests showed significant changes in all six attitudinal barriers measured via AIET summative scores from pre- to post-video. Conclusion. These data suggest utility of our video for increasing African American participation in clinical trials.

Attitudes and barriers to clinical practice guidelines in general and to the guideline on Parkinson’s disease. A National Survey of German neurologists in private practice

Although much progress has been made in the development of clinical practice guidelines (CPGs), there are few strategies for dissemination and implementation of these guidelines. This study examines the attitudes of neurologists to CPGs and barriers to CPG implementation, with a particular focus on the Parkinson's disease CPG (PD-CPG). A cross-sectional survey was performed in 2007 with a representative sample of 213 neurologists in private practice in Germany. The main outcome measures were the Tunis Attitudinal Scale and barrier assessment of CPGs. In addition, the awareness, applicability, and usefulness of the PD-CPG were assessed. Most of the neurologists agreed that CPGs are intended to improve the quality of care (82.2%; n = 171), are good educational tools (59.4%; n = 120), and are an unbiased synthesis of expert opinion (58.9%; n = 119). The main barriers to guideline implementation were lack of time (39.3%; n = 81), inability to reconcile patient preferences with guideline recommendations (34.3%; n = 71), and lack of awareness (32.5%; n = 67). A total of 187 (88.2%) of the neurologists were aware of the PD-CPG, of whom 163 (92.6%) found it "beneficial" and 173 (94.6%) applied it in daily practice. Nevertheless, only 51 (28.8%) of neurologists considered that the guidelines led to an improvement in the quality of care. However, 63 (32%) favored a special guideline for patients. Qualitative data analysis revealed more positive than negative aspects of the PD-CPG; positive comments included "treatment facilitation", "a stepped therapy schema" and "increasing self-efficacy". Criticism mostly concerned the lack of relevance to everyday practice and the rigidity of the guidelines. Neurologists in private practice have a generally positive attitude to guidelines. The PD-CPG is well-known and often used, but its impact on quality of care is considered to be only modest. Thus, further research is needed to address issues of daily practice in future versions of the PD-CPG and to investigate the effects of implementation at the physician and patient levels.

Triggering anti-smoking advice by GPs: Mode of action of an intervention stimulating smoking cessation advice by GPs

Objective To assess the mode of action of an intervention (GP desktop resource, GDR) that increased the frequency of general practitioner (GP) advice to stop smoking. Methods Analyses were undertaken to differentiate between three hypotheses regarding the mode of action of the GDR. That the GDR acts: (1) by altering GPs’ attitudes, (2) independently of attitudes in prompting GPs to intervene with smokers or (3) by altering the relationship between attitudes and behaviour. Results The GDR was an independent predictor of the number of patients advised to stop smoking ( β = .345, p < .001). Concern about the doctor–patient relationship was the only attitude variable that independently predicted advice giving, in this case negatively ( β = −.465, p < .001). Possession of the GDR did not alter GPs’ views on whether intervening with smokers harmed the doctor–patient relationship, but did weaken the relationship between this attitude item and the number of patients advised to stop smoking ( β = .595, p < .001 for the interaction). Conclusion This study is the first to show that concern over the doctor–patient relationship was an independent predictor of advice giving while in other studies it has merely been noted as something that GPs express concern about. A simple device designed to trigger action on the part of GPs appeared to work by mitigating the negative effect of an attitudinal barrier to action. It would be interesting to explore this phenomenon more generally in relation to health promotion activities on the part of health professionals. Practice implications Recommendations that GPs engage in health promotion activities with their patients need to consider that GPs’ concerns over harming the doctor–patient relationship may deter them from making such interventions. The GDR appears to be effective in prompting GPs to advise their smoking patients to stop and its widespread distribution to GPs should be considered.

Teaching literacy to students with significant disabilities: strategies for the K-12 inclusive classroom

Foreword - Douglas Fisher Acknowledgments Introduction About the Author 1. Literacy and a Free Appropriate Public Education Key Concepts What Is Literacy? Literacy and Federal Mandates in Education Barriers to Literacy Instruction for Students With Significant Disabilities Attitudinal Barrier Low Expectations Limited Opportunities Limited Means of Accessing Literacy Limited Time The Age Factor Literacy and Quality of Life Issues Self-Esteem Self-Determination Independence Information Gathering Organization Learning Entertainment Why Teach Reading to Students With Severe Disabilities? 2. Literacy and Communication Key Concepts The Relationship Between Communication and Literacy Building Relationships Reading Together The Benefits of Play Interactions Emergent Literacy for Students of All Ages Augmentative and Alternative Communication Devices Building Shared Experiences for Literacy Development Documentation of Shared Experiences Drawings Photograph Books Tactile Books Summary Frequently Asked Questions 3. Planning Literacy Activities Key Concepts General Considerations Literacy Rich Environments Benefits of Learning in a General Education Classroom Access to the Core Curriculum Not Just Physical Presence Identifying Literacy Goals What Are the Literacy Goals of the Individual and the Family? Determining Present Literacy Skills Analyzing the Environment and the Need for Literacy Skills Identifying When Literacy Skills Can be Taught Throughout the Day Creating Literacy-Learning Opportunities for All Ages Integrated Related Services Developing Literacy Materials for Individual Students Age Appropriateness Individual Consuderations Physical Considerations Visual Considerations Cultural Considerations Interesting Material High Quality Assistive Technology Computer Access Summary Frequently Asked Questions 4. Teaching Literacy Skills Key Concepts Concerns With Some Past Practices General Considerations When Teaching Literacy Skills Offering Choices Following Interest Level Providing Opportunities Make Accessible On the Spot Accommodations Meaningful Literacy Experiences The Use of a Daily Planner Within Task Directions Self-Monitoring Checklists Language Experience Stories Interactive and Fun Clear Literacy Goals in Mind Drawing Attention to Conventional Literacy Balanced Literacy Approach Specific Instructional Strategies Draw Attention to the Stimulus and Shape the Response Model the Behaviors of Reading and Writing Check for Comprehension Wait for a Response Provide Corrective Feedback and Praise Fade Instructional Support Teaching Generalization of Skills Summary Frequently Asked Questions 5. Evaluating Progress: Next Steps Key Concepts Alternative Assessments Interview Observations Review of Past Records The Link to IEP Goals and State Standards Adapting State Standards on Literacy Developing Appropriate IEP Goals and Objectives Passive Versus Active IEP Goals and Objectives Standard Linked IEP Objectives Procedures for Measuring Student Progress Data Collection Easy to Use Forms Portfolio Assessment Using Data for Instructional Purposed Determining Next Steps Review Literacy Goals Raise Expectations What Are the Logical Next Steps? Summary 6. The Future for Literacy Access and Instruction Key Concepts Improved Strategies to Support Literacy Goals Strengthening Early Intervention Services Future Advances in Technology Bridging the Research-to-Practice Gap Impact on Personnel Preparation Impact on Quality of Life Resources Glossary References List of Tables List of Figures Index

Political Support, Political Skepticism, and Political Stability in New Democracies

Conventional wisdom holds that high levels of system support serve as an attitudinal barrier to democratic breakdown. In unconsolidated democracies, however, where democratic norms are regularly violated, the authors hypothesize that a healthy dose of political skepticism toward the political system, neither extreme rejection nor uncritical support of the system, would be associated with greater attitudinal resistance to breakdown in the form of a military coup. Using survey data from Peru, the authors confirm this expectation, showing that the relationship between system support and approval of military coups follows a V-curve pattern. This research fails to find support for the contention that a greater involvement in associational life or a greater degree of interpersonal trust predispose people to reject coups. The authors found other factors, such as rejection of the use of direct tactics for political purposes, support for the incumbent, and age, that are better predictors of coup support and rejection.

Recipient and Provider Perspectives of Barriers to Rural Prenatal Care

Barriers to prenatal care have been linked to inappropriate service usage and poor health outcomes of mothers and infants. This study describes barriers to prenatal care, as identified by low-income recipients and providers of prenatal care in a small rural county in the Midwest. A prospective survey design and focus group were used. An unexpected finding occurred. Almost half of the recipients identified no barriers to prenatal care; however, these women still received less than adequate prenatal care. Providers identified the attitudinal barrier of women as not valuing prenatal care, but the women did not. Some women were found to need information about availability and eligibility for Medicaid and other services. issues surrounding prenatal care for rural women are complex and subtle. Community health nursing can inform and influence community leaders and members about prenatal care services for rural low-income women.