Val Renault
Research and Training Center on Independent Living

Resilience study examines how people with disabilities live successfully in rural areas

Thu, 05/18/2017

This poster displays different skills, strategies, and supports that help people with disabilities thrive in their rural communities. In the center of the poster is an oak tree with the word “resilience” on the trunk. Two main branches come off the trunk: the first says “coping skills,” and the second says “coping strategies.”  The “coping skills” branch has seven smaller branches. These say “problem solving,” “identifying role models,” “leadership,” advocacy,” “information-seeking,” “using support,” and “using technology.” Each of the seven smaller branches has an acorn that contains a quote illustrating the corresponding skill. These skills and their associated quotes are listed below.  •	Problem solving: “There is a little store I can’t get into, so I have my niece go in and get stuff for me.” •	Identifying role models: “There was this one guy… I watched him jump out of his wheelchair and onto a counter, and I was just, ‘I want to be like that guy.’ ” •	Leadership: “They asked me if I wanted to be on the board, and I said, ‘sure!’ They send me all over the state because I am on the Diversity Council.” •	Advocacy: “I am one of those people that if it’s going to benefit me and also somebody else who is disabled, I won’t take ‘no’ for an answer.” •	Information-seeking: “No one is volunteering any information. I had to get on the phone and resource it and call…”  •	Using support: “In a rural community it’s a family, so you have to get out and make yourself part of the family… You can’t be afraid to ask.” •	Using technology: “I wouldn’t be able to do half of what I do without a phone. It tells me how to get home if I get lost… I wouldn’t go out walking if I didn’t have that.”  The “coping strategies” branch has ten smaller branches. These say, “taking one day at a time,” “reciprocation,” “focus on others,” “taking charge,” “positive self-image,” “sense of purpose,” “positive comparisons,” “analyzing and acknowledging limits,” “sense of independence,” and “persistence.” Each of these ten smaller branches has an acorn that contains a quote illustrating the corresponding strategies. These strategies and their associated quotes are listed below.  •	Taking one day at a time: “Just stay in today and live one day at a time… Make the best of it for today.” •	Reciprocation: “Whenever I go to someone and ask for help, I always try to tie it to something that benefits them. [If] I ask for a cooked meal, I usually say, ‘You can have the same food as me. I’ll pay for it all.’” •	Focus on others: “I’ve got four young grandkids… They call me Poppy. And that was another reason to get on the positive side too: family.”  •	Taking charge: “Exercise improves mood. I feel a lot more able, like I have more control over my muscles… Not only am I more able, I FEEL more able.” •	Positive self-image: “I seem to have a pretty successful time doing what I need to do. I see a lot of ways in which I’m more able than I was a few years ago.” •	Sense of purpose: “I’ve got two grown sons and a baby… I was thinking, ‘You’re going to have to be a role model.’ So that’s what pushed me to do the best for them.” •	Positive comparisons: “I accept my disability and just kind of slow down and say, ‘It’s okay, I’m not in that nursing home no more. You know how horrible that was.’ “  •	Analyzing and acknowledging limits: “The hardest thing for me was to accept the fact that I was disabled, to [the point] where I could laugh again and find things I could still do, like grow a garden.” •	Sense of independence: “I am a very independent person. I try not to push my boundaries too far to where I get stuck. I know my limits, which is good.” •	Persistence: “The best advice I can give is don’t give up, don’t give in. Stay strong. Find out what you can still do.” Below the ground, the oak tree’s roots reach out to water droplets with quotes that illustrate two different types of supports that contribute to resilience. On one side are Formal Supports, which include Personal Care Assistants and Centers for Independent Living and other community programs. On the other side are Informal Supports, which include family, peers, neighbors and community, and spirituality. The quotes associated with each type of support are listed below.  •	Formal Support, Personal Care Assistants: “Because of the medications that I’m on, I spend a lot of time in la-la land. I rely on the support of my worker to help me look things up, to help me keep track of my weekly appointments.” •	Formal Supports, Centers for Independent Living and other community programs: “I think that the CIL is a lot of our biggest lifelines because if it wasn’t for them advocating I don’t think any of us would know where we would be today.” •	Informal Support, Family: “Between them [my parents], the rest of the family, and extended friends, there’s like a Plan B. Okay, what do I need to do today… who’s available that I can call to do that.” •	Informal Support, Peers: “He checks on me and I check on him. We’ve got another friend who checks on us… We always try to stay motivated and it helps me stay motivated when I’m helping somebody else.” •	Informal Support, Neighbors and Community: “That’s one thing I like about rural communities, it is like a little family and they have little get-togethers, and you do become part of a social network.” •	Informal Support, Spirituality: “I really had to let go and believe that God’s going to take care of me and that things are going to be alright.” A text box in the bottom corner of the poster contains the question “Which skills, strategies, and supports do you identify in your life?” The contents of this poster come from The Resilience Study: Exploring Resilience in Adults with Physical Disabilities in Rural Communities. The study was done by RTC:Rural, part of the Rural Institute for Inclusive Communities at the University of Montana, and partners at the Research and Training Center on Independent Living at the University of Kansas.  Authors are Jean Ann Summers, PhD, Dot E. Nary, PhD, Heather Lassman, MSW, and Lauren Smith, MS.  The contents of this poster were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90RT502501400). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this poster do not necessarily represent the policy of NIDILRR, ALCL, or HHS, and you should not assume endorsement by the Federal Government.


LAWRENCE — Living in a small town can be challenging for anyone. For people with disabilities, rural areas can create even more serious barriers to accomplishing the things they want to do.

However, with the help of a trait known as resilience, many people with disabilities who live in rural areas have achieved a good quality of life and are able to participate in their communities.

“Some people do well in life because they face few obstacles to meeting their goals: they are healthy, they have parents who are well-educated and have the resources to provide their children with a good education, and they have the support they need,” said Jean Ann Summers, research director at the University of Kansas Research and Training Center on Independent Living, or RTC/IL.

The resilience study – which is still ongoing – didn’t focus on this group of people, though.

“Other people do well in life despite the obstacles that they face," Summers said.  "They may have grown up poor, they may have a disability, they may live in a community where few jobs or other opportunities are available. And yet they thrive. They are able to achieve their goals and have a satisfying life in the community in spite of the odds that are against them. We say those people are ‘resilient.’”

Summers and her collaborators Dot Nary, assistant research professor at the RTC/IL, and Heather Lassmann, graduate research assistant, set out to identify what Summers calls “the secrets of success” that resilient people with disabilities employ to successfully live in rural communities. Their work is part of larger project based at the University of Montana Research and Training Center on the Ecology of Rural Disability.

“The study is important because if we can find out what people who are naturally resilient do, we can design a program to teach others how to be resilient,” Nary said.

According to Summers, the thought process behind the study is much different than the approach medical or health care practitioners consider when trying to support people with disabilities or chronic illnesses.

“For example, in the medical model we would approach ‘fixing’ a broken leg by putting a cast on the leg,” Summers said. “But a resilience model would focus on what it takes to make that leg grow strong, with the right nutrition and exercise, to prevent further breakage of those bones in the future.”

The study applied this model in two phases. First, researchers conducted two focus groups of people living in rural communities who were nominated by staff at centers for independent living as people who display resilience.

“In the focus groups, we asked the participants to talk about the supports that were helpful to them in enabling them to participate fully in the community,” Nary said. “We also asked them to talk about any attitudes or philosophy that helped them succeed in reaching their goals.”

The researchers used what they learned in the focus groups to identify a series of supports, both formal and informal, along with coping skills like advocacy and strategies like humor or focusing on others that contribute to a person being resilient. They illustrated these findings in a tree-shaped graphic, which identifies the roots and branches that contribute to resilience.

In the second phase of the study, now ongoing, the researchers partnered with their colleagues at the University of Montana, who had conducted a large-scale national survey of people in rural communities. Using that survey data, they identified a new group of people with disabilities who they defined as resilient for two reasons: they had more than two risk factors, that is obstacles to success, and their survey responses indicated they were successfully participating in their communities.

Summers and Nary are now interviewing these individuals by phone to get a deeper understanding of what contributes to resilience.

“We are hearing things that are similar to what we heard in the focus groups,” Summers said, “but we’re also looking at other personal or environmental factors that contribute positively. For example, a particular city may offer unique environmental or social features that make participation easy for people with disabilities.”

She expects the final report to be completed this fall.

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