Foreign entities are not eligible to compete for, or receive, awards made under this announcement. Faith-based and community organizations that meet the eligibility requirements are eligible to receive awards under this funding opportunity announcement.
Laws and policies protecting the civil rights of people with disabilities have helped to promote their inclusion and participation in the home, community, and workplace. Nonetheless, among people with disabilities, individual functional abilities, demographic characteristics, socioeconomic status, access to personal and other supports, and the characteristics of one’s geographic location and built environment, continue to interact and result in low levels of community participation (Anaby et al., 2014; Botticello, Rohrback, & Cobbold, 2014; Chiarello et al., 2016; Satariano et al., 2014; Rosenberg et al, 2012; Samuel et al., 2013; U.S. Department of Health & Human Services, 2020; White et al., 2010; White & Summers, 2017).
Barriers to independent living and community participation among people with disabilities include individual characteristics (Centers for Disease Control and Prevention, 2020); fragmented service delivery systems (Sowers, Claypool & Musumeci, 2016); lack of affordable, accessible housing (Lakhani et al., 2020); lack of reliable, accessible transportation (Beyzak et al., 2019); and difficulty obtaining well-qualified personal attendants (Laws & Hewitt, 2020; Kessler Foundation & National Organization on Disability, 2010). Other examples of environmental barriers to community integration include pervasive stigma and discrimination against people with psychiatric disabilities who often live in segregated congregate housing or are homeless or incarcerated (Draine et al., 2002; Kavanaugh et al., 2017; National Council on Disability, 2008; Salzer et al., 2014; Yanos et al., 2018).
Barriers to community integration exist for people with a wide range of disabilities. For example, people who experience the long-term effects of moderate and severe traumatic brain injury often have limited ability to function in social contexts (Binder et al, 2019; Eapen & Cifu, 2018; Stubbs et al., 2020). People with intellectual and developmental disabilities are perhaps the least integrated due to the nature of their disability, including limitations in intellectual functioning and adaptive behavior and their need for systematic care and support (President’s Committee for Persons with Intellectual Disabilities, 2011, 2016; Shalock, 2014; Wehmeyer et al., 2007). People with blindness and low vision experience a lack of environmental accommodations that often exclude them from participating in social and communal activities (Hodge & Eccles, 2013; Vaughn & Schroeder, 2018). Hearing loss and deafness, particularly among the aged, can have a profound impact on community participation, especially when comorbid depression, cognitive decline, and lack of social support limit contact with the outside world (Rutherford et al., 2018).
To date, few studies have systematically and rigorously tested interventions or strategies that promote community living among people with disabilities. Given the complexity of factors that are associated with community living and participation outcomes, there is a need for high quality research to examine the effectiveness of multi-faceted, multi-level interventions that address some combination of individual-level characteristics and environmental-level barriers in order to promote community living among people with disabilities.
NIDILRR establishes this Rehabilitation Research and Training Center (RRTC) to conduct research on interventions toward improved community living outcomes for people with disabilities, and to provide research-based training, technical assistance, and informational materials to people with disabilities, service providers, and other relevant stakeholders.
Anaby, D., Law, M., Coster, W., Bedell, G., Khetani, M., Avery, L., & Teplicky, R (2014). The mediating role of the environment in explaining participation of children and youth with and without disabilities across home, school, and community. Archives of Physical Medicine and Rehabilitation. 95, 908-917.
Binder, A. S., Lancaster, K., Lengenfelder, J., Chiaravalloti, N. D., & Genova, H. M. (2019). Community integration in traumatic brain injury: the contributing factor of affect recognition deficits. Journal of the International Neuropsychological Society: JINS, 25(8), 890-895.
Bezyak, J. L., Sabella, S., Hammel, J., McDonald, K., Jones, R. A., & Barton, D. (2019). Community participation and public transportation barriers experienced by people with disabilities. Disability and rehabilitation, 1-9.
Botticello, A., Rohrback, T., & Cobbland, N. (2014). Disability and the built environment: an investigation of community and neighborhood land uses and participation for physically impaired adults. Annals of Epidemiology. 24, 545-550.
Centers for Disease Control and Prevention ( 2020). Disability inclusion. Accessed online October 30, 2020 at: https://www.cdc.gov/ncbddd/disabilityandhealth/disability-inclusion.html
Chiarello, L., Bartlett, D., Palisano, R., McCoy, S., Fiss, A., Jeffries, L., & Wilk, P. (2016). Determinants of participation in family and recreational activities of young children with cerebral palsy. Disability and Rehabilitation. February 15, 1-4.
Draine, J., Salzer, M. S., Culhane, D. P., & Hadley, T. R. (2002). Role of social disadvantage in crime, joblessness, and homelessness among persons with serious mental illness. Psychiatric Services, 53(5), 565-573.
Eapen, B. C., & Cifu, D. X. (2018). Rehabilitation after traumatic brain injury. Elsevier Health Sciences.
Hodge, S., & Eccles, F. (2013). Loneliness, social isolation and sight loss: a literature review conducted for Thomas Pocklington Trust. Accessed online October 28, 2020 at: https://eprints.lancs.ac.uk/id/eprint/68597/1/loneliness_social_isolati…
Kavanagh, A. M., Aitken, Z., Baker, E., LaMontagne, A. D., Milner, A., & Bentley, R. (2016). Housing tenure and affordability and mental health following disability acquisition in adulthood. Social science & medicine, 151, 225-232.
Kessler Foundation & National Organization on Disability (2010). The ADA, 20 Years Later: The Kessler Foundation/NOD 2010 Survey of Americans with Disabilities. Accessed online October 28, 2020 at: https://www.socalgrantmakers.org/sites/default/files/resources/Suvery%2…
Lakhani, A., Zeeman, H., Wright, C. J., Watling, D. P., Smith, D., & Islam, R. (2020). Stakeholder priorities for inclusive accessible housing: A systematic review and multicriteria decision analysis. Journal of Multi‐Criteria Decision Analysis, 27(1-2), 5-19.
Laws, C. B., & Hewitt, A. S. (2020). Introduction to the Special Issue: Understanding the Direct Support Workforce in the United States. Intellectual and Developmental Disabilities, 58(3), 189-191.
National Council on Disability (2008). Inclusive livable communities for people with psychiatric disabilities. Washington, DC: Author.
President’s Committee for Persons with Intellectual Disabilities (2011). Critical supports that promote independence, full and lifelong community inclusion. Washington, DC: Author.
President’s Committee for Persons with Intellectual Disabilities (2016). Strengthening an inclusive pathway for people with intellectual disabilities and their families. Washington, DC: Author.
Rosenberg, D., Huang, D., Simonovich, S., and Belza, B (2013). Outdoor built environment barriers and facilitators to activity among midlife and older adults with mobility disabilities. The Gerontologist. 53 (2): 268-279.
Rutherford, B. R., Brewster, K., Golub, J. S., Kim, A. H., & Roose, S. P. (2018). Sensation and psychiatry: linking age-related hearing loss to late-life depression and cognitive decline. American Journal of Psychiatry, 175(3), 215-224.
Salzer, M. S., Brusilovskiy, E., Prvu-Bettger, J., & Kottsieper, P. (2014). Measuring community participation of adults with psychiatric disabilities: Reliability of two modes of data collection. Rehabilitation Psychology, 59(2), 211.
Samuel, P., Lacey, K., Giertz, C., Hobden, K., & LeRoy, B. (2013). Benefits and quality of life outcomes from transportation voucher use by adults with disabilities. Journal of Policy and Practice in Intellectual Disabilities. 10(4), 277-288.
Satariano, W. A., Kealey, M., Hubbard, A., Kurtovich, E., Ivey, S. L., Bayles, C. M., ... & Prohaska, T. R. (2016). Mobility disability in older adults: at the intersection of people and places. The Gerontologist, 56(3), 525-534.
Schalock, R. L. (2014). Intellectual disability. The Encyclopedia of Clinical Psychology, 1-7.
Sowers, M., Claypool, H., & Musumeci, M. (2016). Streamlining Medicaid home and community-based services: Key policy questions. Retrieved from The Kaiser
Commission on Medicaid and the Uninsured website: http://files. kff. org/attachment/issue-brief-streamlining-medicaid-home-and-community-based-services-key-policy-questions.
Stubbs, J. L., Thornton, A. E., Sevick, J. M., Silverberg, N. D., Barr, A. M., Honer, W. G., & Panenka, W. J. (2020). Traumatic brain injury in homeless and marginally housed individuals: a systematic review and meta-analysis. The Lancet Public Health, 5(1), e19-e32.
U.S. Department of Health & Human Services (2020). Healthy People 2030: Persons with disabilities. Accessed online October 28, 2020 at: https://health.gov/healthypeople/objectives-and-data/browse-objectives/…
Vaughan, C. E., & Schroeder, F. K. (2018). Social and cultural perspectives on blindness: Barriers to community integration. Charles C Thomas Publisher.
Wehmeyer, M., Chapman, T. E., Little, T. D., Thompson, J. R., Schalock, R., & Tasse, M. J. (2009). Efficacy of the Supports Intensity Scale (SIS) to predict extraordinary support needs. American journal on intellectual and developmental disabilities, 114(1), 3-14.
White, G, Simpson, J, Gonda, C, Coble, Z, & Ravesloot, C. (2010). Moving from independence to interdependence: A conceptual model for better understanding community participation of centers for independent living consumers. Journal of Disability Policy Studies. 20, 223-240.
White, G. W., & Summers, J. A. (2017). People with disabilities and community participation. Journal of Prevention & Intervention in the Community, 45(2), 81-85.
Yanos, P. T., Stefancic, A., Alexander, M. J., Gonzales, L., & Harney-Delehanty, B. (2018). Association between housing, personal capacity factors and community participation among persons with psychiatric disabilities. Psychiatry Research, 260, 300-306.
Priority- Rehabilitation Research and Training Center (RRTC) on Interventions to Promote Community Living Among People with Disabilities.
The Administrator of the Administration for Community Living establishes a priority for a Rehabilitation Research and Training Center (RRTC) on Interventions to Promote Community Living Among People with Disabilities. The RRTC must conduct rigorous research, training, technical assistance, and dissemination activities that contribute to improved community living and participation outcomes among people with disabilities. Under this priority, the RRTC must contribute to the following outcomes:
(a) New knowledge about the efficacy of interventions that can be used to improve community living and participation outcomes among people with disabilities. The RRTC must contribute to this outcome by conducting two rigorous research projects toward evidence-based interventions to improve community living and participation among people with disabilities. At least one of the research projects must be conducted at the intervention-efficacy or scale-up evaluation stage of research. One of the projects may be conducted at the intervention-development stage of research. NIDILRR’s stages of research are defined elsewhere in this section of the funding opportunity announcement. The interventions to be studied must be multi-faceted and multi-level, addressing some combination of individual-level characteristics (e.g., health, functional abilities, training and education levels, socioeconomic status) and environmental-level barriers (e.g., transportation, housing, health care access), that are related to community living outcomes of the target populations or sub-populations of people with disabilities. The studies must use a sufficiently rigorous design that assesses the impact of the intervention on community living outcomes, while measuring and controlling for relevant individual and environmental characteristics. To facilitate the conduct of this research, the RRTC must include the following information in its original application:
(1) A description and justification of the population or populations of people with disabilities who are the focus of the proposed research projects;
(2) A description of how the RRTC will engage with people with disabilities and other stakeholders to collect and maintain high quality samples of sufficient size. This description must include information about how the RRTC will ensure that people from racial and ethnic minority backgrounds will be included in study samples in sufficient numbers to generate knowledge that is relevant to the full racial and ethnic diversity of the population of people with disabilities being studied. The RRTC must describe and justify the racial and ethnic distribution of people with disabilities who will participate in the proposed research activities; and
(3) A description and justification of the stage or stages of research for each proposed project. If a project includes research that can be categorized under more than stage, including research that progresses from one stage to another, those stages must be clearly specified. These stages, exploration and discovery, intervention development, intervention efficacy, and scale-up evaluation, are defined in this funding opportunity announcement.
(b) Serving as a national resource center related to promoting community living outcomes among people with disabilities by conducting knowledge translation activities that include, but are not limited to:
(1) Collaborating with centers for independent living or other relevant disability service-provider entities to design, develop, implement, or evaluate strategies to increase utilization of the research findings;
(2) Providing information and technical assistance related to community living programs and interventions, to people with disabilities and their representatives, disability service providers, and other key stakeholders;
(3) Providing training, including graduate, pre-service, and in-service training, to people with disabilities and their representatives, service providers, and other key stakeholders to facilitate improved community living outcomes for people with disabilities. This training may be provided through conferences, workshops, public education programs, in-service training programs, and similar activities;
(4) Disseminating research-based information and materials related to improving community living outcomes among people with disabilities;
(5) Involving people with disabilities and other key stakeholder groups in the design of activities conducted under paragraphs (a) and (b) of this priority, in order to promote the new knowledge generated by the RRTC; and
(6) Conducting a state-of-the-science conference on interventions to improve community living outcomes among people with disabilities. The RRTC must hold this conference by the fourth year of the grant cycle and publish a comprehensive report on the final outcomes of the conference by the end of the fourth year of the grant cycle. This conference must include and highlight research findings and materials from the RRTC, and from other relevant research efforts.
Definitions - Stages of Research:
Exploration and discovery means the stage of research that generates hypotheses or theories through new and refined analyses of data, producing observational findings and creating other sources of research-based information. This research stage may include identifying or describing the barriers to and facilitators of improved outcomes of individuals with disabilities, as well as identifying or describing existing practices, programs, or policies that are associated with important aspects of the lives of individuals with disabilities. Results achieved under this stage of research may inform the development of interventions or lead to evaluations of interventions or policies. The results of the exploration and discovery stage of research may also be used to inform decisions or priorities.
Intervention development means the stage of research that focuses on generating and testing interventions that have the potential to improve outcomes for individuals with disabilities. Intervention development involves determining the active components of possible interventions, developing measures that would be required to illustrate outcomes, specifying target populations, conducting field tests, and assessing the feasibility of conducting a well-designed intervention study. Results from this stage of research may be used to inform the design of a study to test the efficacy of an intervention.
Intervention efficacy means the stage of research during which a project evaluates and tests whether an intervention is feasible, practical, and has the potential to yield positive outcomes for individuals with disabilities. Efficacy research may assess the strength of the relationships between an intervention and outcomes and may identify factors or individual characteristics that affect the relationship between the intervention and outcomes. Efficacy research can inform decisions about whether there is sufficient evidence to support “scaling-up” an intervention to other sites and contexts. This stage of research may include assessing the training needed for wide-scale implementation of the intervention and approaches to evaluation of the intervention in real-world applications.
Scale-up evaluation means the stage of research during which a project analyzes whether an intervention is effective in producing improved outcomes for individuals with disabilities when implemented in a real-world setting. During this stage of research, a project tests the outcomes of an evidence-based intervention in different settings. The project examines the challenges to successful replication of the intervention and the circumstances and activities that contribute to successful adoption of the intervention in real-world settings. This stage of research may also include well-designed studies of an intervention that has been widely adopted in practice, but lacks a sufficient evidence base to demonstrate its effectiveness.