Barriers and Translational Solutions to Improving Community Living Outcomes among People of Color with Disabilities with Opioid Use Disorder: A Focus Group Perspective.

This investigation examined vocational rehabilitation, substance abuse, and mental health service providers' perceptions about barriers and potentially translational solutions to poor community living outcomes for people of color with disabilities (i.e., African Americans, Latinx, Native Americans and Alaskan Natives, Asian Americans, and Pacific islanders) who have opioid use disorder. We conducted one focus group discussion (N = 12) that identified the proliferation of opioids in the community, treatment access, employment, and transportation as community living outcome barriers. The findings point to the need for further research that address poor outcomes among target group members.

Emerging Conceptual Frameworks for Co-Serving Veterans of Color Across the State-Federal Vocational Rehabilitation Program: SVRAs, AIVRPs, and VA-VR&E.

Existing models of interagency collaborations serving the United States (U.S.) Armed Forces veterans of color, i.e., African Americans, Latinx, Native Americans/Alaskan Natives and Asian Americans and/or Pacific islanders are sparse, and few co-service partnership models are available. This article proposes two different emerging conceptual frameworks, i.e., state vocational rehabilitation agency (SVRA) and the U.S. Department of Veterans Affairs Veterans Readiness and Employment Program (VA-VR&E) co-service model, and American Indian Vocational Rehabilitation Program (AIVRP) and VA-VR&E co-service model designed to enhance successful employment outcomes for these veterans. Diffusions of innovations Theory was used to develop the Co-Service Models. A set of recommended approaches that these agencies and researchers can consider are presented.

Factors in Utilization of Telehealth Treatment by Rural African-Americans with Opioid Use Disorder and Disabilities.

This study explored factors that impact telehealth service utilization for treatment of African Americans with disabilities with opioid use disorder in rural communities. A focus group was conducted involving 12 different mental health, substance use, and rehabilitation counseling professionals. The analysis was completed using NVivo (Version 12). The results identified critical barriers that included historical distrust of technology and healthcare systems, digital divide/unavailability of Internet modems, fear of losing confidentiality, and agency non-approval. The benefits were improved communication, reduction of stigma, continuity of care, and convenience of collaboration. The findings indicate the need for additional research in this topic area.

National Benchmark Study of Employment Equity Among Multiply Marginalized Persons of Color with Disabilities During the COVID-19 Pandemic: A Bootstrap Approach.

BACKGROUND: Research examining state vocational rehabilitation agency (SVRA) sponsored service patterns during the COVID-19 pandemic is needed to improve employment outcomes among multiply marginalized persons of color with disabilities (i.e., African Americans, Asian Americans, Native Americans or Alaska Natives, Latinx, and Native Hawaiians/Pacific Islanders). Scarce attention has been paid to examining outcome inequities in the crisis. OBJECTIVE: This study applied a stratified bootstrap data expansion approach to assess the relationship between race/ethnicity, gender, level of educational attainment at closure and employment outcomes among target group members. METHODS: National fiscal year (FY) 2019 Rehabilitation Services Administration (RSA)-911 case records (N =114,229) closed between January 20, 2020 (date of first reported COVID-19 infection in the U.S.) to June 30 2020 were extracted and re-sampled across multiple trials using bootstrap procedures to increase logistic regression model accuracy. RESULTS: The findings indicated that African Americans, Asian Americans and Native American or Alaska Natives were statistically significantly less likely to achieve successful employment than non-Latinx Whites. Success probabilities in the COVID-19 pandemic were 'poorest' for Native American or Alaska Native VR consumers followed by African Americans, Asian Americans, Latinx, non-Latinx Whites, and then Native Hawaiians/Pacific Islanders. African Americans and Native Americans or Alaska Natives were more often closed unsuccessful because they could not be located when compared to non-Latinx Whites. CONCLUSIONS: These findings call for new targeted SVRA service initiatives.

Assistive Technology Workplace Accommodation and Employment among Diverse Populations with Disabilities: Does Race/Ethnicity Matter?

The purpose of this study was to examine the relationship between assistive technology workplace accommodation (AT-WA) usage and employment status among racial/ethnic populations with disabilities. Chi-square tests and logistic regression were used to analyze secondary data from the 2015 Kessler Foundation National Employment and Disability Survey (KFNEDS). Results indicated that significantly more consumers who used AT-WA were currently working, and a significantly greater proportion of them were White. Moreover, a significantly lower proportion of those who did not use AT-WA had less expected odds of being currently employed. Specific implications are discussed to inform practices, policy, and/or future research.

Community Living Outcome Factors for People of Color with Disabilities and Concomitant Opioid Use Disorder: A Scoping Review.

This scoping review mapped the pertinent extant published and grey literature and policy to assess factors that promote positive community living outcomes among people of color with disabilities and concomitant opioid use disorder (OUD) in the United States (U.S.). Forty-three publications covering OUD and people of color with disabilities and people of color with disabilities and community living content were reviewed. Select community living barriers and potential interventions were identified for people of color with disabilities in general; however, the review failed to classify such factors for those with OUD. Authors offered recommendations for practice, research, and policy.

A Scoping Review of Opioid Use Disorder Treatment Barriers and Telehealth for African Americans with Disabilities in Rural Communities.

This article provided a comprehensive overview of challenges that African Americans with disabilities residing in rural areas often face in the United States when accessing telehealth treatment to mitigate opioid misuse. A scoping literature review was conducted focusing on this target population, telehealth, disabilities, opioid treatment, and rural healthcare systems. Systematic searches on eight electronic databases were carried out in line with the study's aims. The results identified treatment benefits and advantages, expansion challenges, and multicultural considerations for telehealth delivery. There may be a need to increase rehabilitation research in this area to inform needed changes in policies and practice.

Peer Multiple Mentor Model (P3M) for Training Disability/Health and Rehabilitation Equity Researchers: Case Study at a Historically Black College/University.

Post-doctoral mentorship and training is considered a critical research capacity building approach vital to successful research career development. Existing models, however, may be insufficient for improving research skills among fellows at minority-serving institutions. This study evaluated a Peer Multiple Mentor Model (P3M) at a historically Black college and/or University (HBCU) designed to provide advanced research training to post-doctoral fellows and alleviate long-standing employment, health and function, and community participation inequities among multiply marginalized people of color with disabilities. The results showed that fellows experienced improved research skills, scientific productivity, and collaboration/networking opportunities. The model represents a promising research training pipeline component.

Assistive Technology Access and Usage Barriers Among African Americans With Disabilities: A Review of the Literature and Policy.

The purpose of this article was to provide a comprehensive overview of the available peer-reviewed and gray literature on assistive technology (AT) access and usage barriers among African Americans with disabilities. Authors completed a historical review (Onwuegbuzie & Frels, 2016) of the extant literature on AT and disability public policy mandates by framing the context on AT access and usage disparities among African Americans with disabilities and discussing AT impacts on employment for African Americans. The authors also presented recommendations that might be considered by the field for increasing AT access and usage among African Americans with disabilities. It is clear that AT and associated assistive products are important commodities to the lives of individuals with disabilities in the United States; however, there are historical inequities between African Americans and Whites. As a result of these findings, the authors implore rehabilitation counselors in education and practice to further examine ways to alleviate the AT access and usage gaps for African Americans with disabilities within public policy, vocational rehabilitation service delivery, and institutional infrastructure systems.

Ex-post-facto analysis of competitive employment outcomes for individuals with mental retardation: national perspective.

Disparities in proportions of competitive job placements and provision of vocational rehabilitation services by level of mental retardation were identified for 28,565 individuals. Chi-square results reveal that consumers with mild mental retardation are significantly more likely to achieve competitive jobs compared to those with more severe levels. Logistic regression indicated that the odds of achieving a competitive job for consumers receiving job placement services, business/vocational training, and counseling were nearly two times that of individuals not receiving such services. Findings suggest that a significantly lower proportion of these services were provided to consumers with severe/profound mental retardation. Implications of findings for service, research, and policy are discussed.

Targeting HIV prevention on African American crack and injection drug users.

The use of drugs in the African American community, particularly crack cocaine, has been linked to sexual risk-taking behavior, which increases the likelihood that persons will become infected with Human Immuno Virus. In order to more fully understand risk-taking behavior and to target interventions among African American men and women, this study used data collected from 1277 individuals residing in Lexington and Louisville, Kentucky, who were recruited into National Institute on Drug Abuse (NIDA) Cooperative Agreement Project from 1993 to 1998. The study compared African Americans treated for Sexually transmitted diseases (STDs) (n = 292) with African Americans who reported never being treated for a STD (n = 504) with regard to HIV information, awareness, and the number of HIV tests between those with and without STD exposure. Additionally, we examine gender differences among African Americans who have and have not been exposed to STDs on risk behaviors and HIV knowledge, awareness, and testing. It was hypothesized that African American drug users in the STD group would engage in more risk behaviors than those who reported no STDs. Results indicated that individuals in both groups, the STD exposure group and the no STD group, engaged in similar HIV-risky behaviors. However, the STD group used a greater number of different drugs in their lifetime. The STD group reported they were more likely to get HIV and were more frequently tested for HIV. Females with an STD history were more likely to have been in drug user treatment and to perceive themselves as homeless. Both males and females in the STD group were more likely to report involvement in exchanging sex.