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11/05/2010 1 Improving Community Receptivity by Advocacy: CHEC IT OUT and CHANGE IT! David B. Gray, PhD Jessica Dashner, OTD OTR/L October 29, 2010 54.1 million people in the U.S. have a disability (2000 Census Board, as cited in Dowrick& Keys, 2001) People with disabilities encounter barriers in society (physical and attitudinal) (Gray and Hahn, 1997) ―Community receptivity‖ (as defined by Bricout& Gray, 2006) Barriers decrease participation in community and quality of life (Stark, Hollingsworth, Morgan, & Gray, 2007) Introduction
Transcript of Improving Community Receptivity by Advocacy: CHEC IT OUT ... › sites › rtcil.drupal.ku.edu ›...
11/05/2010
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Improving Community Receptivity by Advocacy: CHEC IT OUT and CHANGE IT!
David B. Gray, PhD
Jessica Dashner, OTD OTR/L
October 29, 2010
54.1 million people in the U.S. have a disability (2000 Census Board, as cited in Dowrick& Keys, 2001)
People with disabilities encounter barriers in society (physical and attitudinal) (Gray and Hahn,
1997)
―Community receptivity‖ (as defined by Bricout& Gray, 2006)
Barriers decrease participation in community and quality of life (Stark, Hollingsworth, Morgan,
& Gray, 2007)
Introduction
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Reasons for Developing the Community Health Environment Checklists (CHEC)
Community environments are not designed to meet the needs of people with disabilities
Participation is impacted by how people are able to use their environments
By identifying barriers and supports in the community environment, features influencing participation will be identified
Important to consider social environment in addition to physical environment
Assessment tool designed to evaluate government and public areas in the community ADA Titles 2 & 3
Began as a generic tool for use by community members interested in making their buildings accessible –
o Easy to use
o Little training required
o Understandable scoring
Provides pragmatic solutions to problems encountered
o Not an ADAAG assessment
o Not for litigation
What is the Community Health Environment Checklists (CHEC) ?
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The purpose of the CHEC is to provide an objective measure of the environment (physical and social) including the features important to persons with disabilities
Can a person with a disability get in to a building do what they need to do and get out
Community Health Environment Checklists (CHEC)
Review existing literature on assessing receptivity
Methods
Key Informant Interviews
Focus Groups
Cognitive Mapping
Survey Draft
Feature Ranking by Individuals with Disabilities
Identifies Most Important Features
Development of Scoring
Interclass Correlations
Brief Training for Raters
CHEC Development Procedures
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Asked People with Disabilities to list where they go in their community and what facilitators and barriers they experience
Cognitive Mapping
15 Key Destinations Sites Government Buildings
Performance Venues
Large Stores
Small Stores
Dining Establishments
Schools and Libraries
Religious Facilities
Self Care Service Providers
Transportation
Health Care Providers
Health Vendors
Professional Service Providers
Indoor Leisure
Outdoor Leisure
Major Tourist Attractions
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Mobility
Restaurants
Doctor’s Offices
Exercise Facilities
Houses of Worship
Low Vision
Restaurants
Doctor’s Offices
Hard of Hearing
Restaurants
Doctor’s Offices
Existing CHEC Instruments
General Building General Building General Building
CHEC Version ICC
CHEC-General Mobility
.950
CHEC-General Hard of Hearing
.963
CHEC-General Low Vision
.921
CHEC-Restaurant Mobility
.890
CHEC-Restaurant Hard of Hearing
.890
CHEC-Restaurant Low Vision
.890
Interclass Correlations
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CHEC-Mobility 22 Features ■ Distances to Enter Building
■ Accessible Parking
■ Level Surfaces
■ Curb Cuts
■ Doors at Entrances
■ Signage for Accessible Paths to
Entrances
■ Doors Inside the Building
■ Loaner Scooters or Wheelchairs
■ Signage for Accessible Elements
■ Single Level
Maneuverable Spaces
Crowding
Floor Surfaces
Counters and Merchandise
Accessible Places to Sit
Adequate Lighting
Accessible Restroom
Drinking Fountain
Accessible Phone
Drive-through Window
Usability
Rescue Assistance
CHEC-M Feature Ranks
1. Entrance
2. Curb Cuts
3. Automatic Doors
4. Accessible Bathroom
5. Elevator/Single Level
6. Distance to Entrance
7. Accessibility features in order
8. Wide Spaces
9. Floor Surfaces
10. Lightweight Doors
11. Parking
12. Spaces not Crowded
13. Accessible places to sit
14. Accessible path/entrance marked
15. Accessibility Signage
16. Accessible Counters
17. Lighting
18. Accessible Phone
19. Accessible Drinking Fountains
20. Area of Rescue
21. Loaner Wheelchair/Scooter
22. Drive Through Window
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Section I ENTERING
THE BUILDING
Community Health Environment Checklist-Mobility (CHEC-M)
FEATURES
Accessible
parking
4. Are there accessible parking
spaces with adequate widths and
aisles?
Score Yes if there are accessible spaces and at least one space
a total width of 8 feet (including parking spot and aisles).
Score No if there are no accessible spaces or if the spaces do
not have adequate widths and aisles.
Score N/A if there is no parking available for the building.
If you are unsure if there is parking ask an employee.
(For picture see Glossary #1 and #2).
Yes No
N/A
5. Are the accessible spaces located
closest (or most central) to the
accessible entrance or accessible
route with minimal traffic to cross in
order to enter the building?
Score Yes if accessible spaces are closest to the accessible
route and most central to the entire group of businesses.
Score No the parking spots closest to the accessible route are
not “accessible parking”
OR Score NO if accessible spots are not central to the entire
group of businesses and not on accessible route.
Score N/A if there is no parking available for the building
If you are not sure if there is parking for a building, ask an
employee.(For a picture, see glossary #3)
Yes No
N/A
6. Does the facility have an
enforcement procedure to ensure
that accessible parking is used by
only those who need it?
Score Yes if when management was asked:
“What would you do and what are your employees to do if a
customer reports that an accessible parking space is being
used by someone who doesn’t need it?” He/She answered that
the police would be notified immediately of the situation, or
that the manager would ask the person to move the car to a
regular parking space.
Score N/A if there is no parking.
Yes No
N/A
Captioning
Low background noise
Seating arrangement (near walls or near speaker)
Low background music
Adequate lighting
Assistive technologies (listening devices/video phones/capTel phones/microphones)
Employees who speak slowly and clearly
Provision of pagers or buzzers (restaurants)
Alternative communication (pen and paper)
■ Interpreter ■ Seating type (small or round
tables, booths) ■ Minimal crowd ■ Training on use of assistive
technology ■ Acoustics (sound absorbing wall
and floor covering) ■ Text or visual aids
(signage/posters/monitors) accompanying oral messages
■ Assistance from stranger/employee/co-worker to locate item or repeat messages
■ Self check-out ■ Access to alternative room ■ Suggestions box ■ Proximity to employee for
lip reading
CHEC-Hard of Hearing 20 Features
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CHEC-HOH Feature Ranks 1. Low background noise
2. Captioning
3. Seating arrangement (near walls or near speaker)
4. AT (listening devices/video phones/capTel phones/microphones)
5. Employees who speak slowly and clearly
6. Minimal crowd
7. Seating type (small or round tables, booths)
8. Text or visual aids (signage/posters/monitors) accompanying oral messages
9. Low background music
10. Acoustics (sound absorbing wall and floor covering)
11. Adequate lighting
12. Proximity to employee for lip reading
13. Assistance from stranger/employee/co-worker to locate item or repeat messages
14. Training on use of assistive technology
15. Provision of pagers or buzzers (restaurants)
16. Access to alternative room
17. Alternative communication (pen and paper)
18. Self check-out
19. Suggestions box
20. Interpreter
Section I USING THE BUILDING
Community Health Environment Checklist-Hearing (CHEC-HOH)
FEATURES
Acoustics
ITEMS
1) Are sound absorbing materials on the walls
SCORING RULES Score Yes if site has drapes, tapestries, upholstery, or papered walls. Score No if the site does NOT have drapes, carpet or papered walls.
Yes No
N/A
2) Are sound absorbing materials present as flooring
Score Yes if floor covering is a sound absorbing material Score No if floor covering is NOT a sound absorbing material (e.g. marble, hard wood, tile)
Yes No
N/A
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CHEC-Low Vision 18 Features Accessible crosswalks
Painted curbs
Clear smooth pathways for outdoor walking
Clearly-marked exterior stairs/ramps with handrails for support
Clearly-marked wayfinding signs
Adequate exterior lighting
Accessible entrance
Clear/Smooth pathways for interior walking
Clearly-marked signs
Clearly-marked interior stairs/ramps with handrails for support
Adequate ambient lighting
Glare-reducing features
High environmental contrast
Accessible elevators
Employee assistance
Special seating
Adequate task lighting
Materials in alternative formats
CHEC-LV Feature Ranks
1. Glare-reducing features
2. Materials in alternative formats
3. Adequate exterior lighting
4. Adequate task lighting
5.Clearly-marked interior stairs/ramps with handrails for support
6.Clearly-marked signs
7. Clear smooth pathways for outdoor walking
8. Accessible crosswalks
9. Clearly-marked exterior stairs/ramps with handrails for support
10. Adequate ambient lighting
11. Clear/Smooth pathways for interior walking
12. High environmental contrast
13. Clearly-marked wayfinding signs
14. Employee assistance
15. Accessible elevators
16. Accessible entrance
17. Painted curbs
18. Special seating
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Section II USING THE BUILDING
Community Health Environment Checklist-Vision (CHEC-LV)
FEATURES Glare Reducing Features
ITEMS
25. Are there features to
reduce glare?
SCORING RULES
Score Yes if the floor covered
in matte tile or carpet AND
windows are tinted or have
window coverings such as
blinds.
Yes No
N/A
26. Is there a high level of
contrast between the floor
and walls?*
*See Contrast Guide
Score Yes if the floor and
walls have a contrast of 70%
or higher. Score Yes if the baseboards
have a contrast of 70% or
higher with the wall and floor.
Yes No
N/A
Community Health Environment Checklists (CHEC) Utility
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Overall Utility of the CHEC The CHEC is a objective, valid and reliable
measure of environmental accessibility
Accessibility and Receptivity can be characterized at the Destination/Site Level
Building site CHEC score
Section scores
Accessibility and Receptivity can be characterized at the Community Level –
Total CHEC Scores on a sample of destination sites
CHEC-Building Testing
Assessing 150 buildings in St. Louis, Missouri using the CHEC-M, CHEC-LV and CHEC-HOH
10 sites in each destination category were randomly selected using 411.com and yellowpates.com
Results were used to compare sites in across and within categories
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Acce
ssib
ilit
y P
erc
en
tag
e
CHEC-GM CHEC GV CHEC GHLV HOH M
0
10
20
30
40
50
60
70
80
90
100
CVS Dierbergs Jennifer's Ladue Schnucks Target MedicineShoppe
Walgreens West Pine Williams
Acce
ssib
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erc
en
tag
e
Accessibility of Health Vendors
CHEC-M CHEC-LV CHEC-HOH
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0
10
20
30
40
50
60
70
80
90
100
Old Navy Target WalMart HomeDepot
Lowes OfficeDepot
Office Max Artmart Crate &Barrel
REI
Accessib
ilit
y P
erc
en
tag
e
Accessibility of Large Stores
CHEC-M CHEC-LV CHEC-HOH
0
10
20
30
40
50
60
70
80
90
100
Acce
ssib
ilit
y P
erc
en
tag
e
CHEC-M Health Vendor Section Scores
Enter Building Using Building Restrooms Amenities Usability/Rescue Assist
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0
10
20
30
40
50
60
70
80
90
100
Old Navy Target WalMart Home Depot Lowes Office Depot Office Max ArtMart Crate & Barrel REI
Acce
ssib
ilit
y P
erc
en
tag
e
CHEC-M Large Store Section Scores
Enter Building Using Building Restrooms Amenities Usability/Rescue Assist
0
10
20
30
40
50
60
70
80
90
100
Walgreens Jennifer's Williams Schnucks TheMedicine
Shoppe
CVS Target Dierbergs Ladue West Pine
Accessib
ilit
y P
erc
en
tag
e
CHEC-LV Health Vendor Section Scores
Exterior of Building Interior of Building Lighting & Contrast Amenities
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0
10
20
30
40
50
60
70
80
90
100
OfficeMax
OfficeDepot
HomeDepot
Lowes Wal Mart Target Old Navy Artmart REI Crate &Barrel
Accessib
ilit
y P
erc
en
tag
e
CHEC-LV Large Store Section Scores
Exterior of Building Interior of Building Lighting & Contrast Amenities
0
10
20
30
40
50
60
70
80
90
100
Walgreens Jennifer'sPharmacy:
WilliamsPharmacy
SchnucksPharmacy
The MedicineShoppe
CVS Pharmacy Target:Pharmacy
Dierbergs:Pharmacy
LaduePharmacy LLC
West PinePharmacy
Acce
ssib
ilit
y P
erc
en
tag
e
CHEC HOH Health Vendor Section Scores
Building Sounds Communication Employee Assistance Room Arrangement Ammenities
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0
10
20
30
40
50
60
70
80
90
100
Office Max Office Depot Home Depot Lowes Wal Mart Target Old Navy Artmart REI Crate & Barrel
Acce
ssib
ilit
y P
erc
en
tag
e
CHEC HOH Large Store Section Scores
Building Sounds Communication Employee Assistance Room Arrangement Ammenities
Site Specific CHECs
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Addition of features unique to destination category
Combine Mobility, Hearing, and Vision on one form
Inclusion of specific measurements for recommendation purposes
Examples:
Doctor’s Offices
Restaurants
Site Specific CHECs
Measures accessibility of general (public) spaces in addition to features inside the office
Addresses mobility, vision, and hearing on one form
Collects additional data needed to make recommendations/suggestions for change
CHEC-Doctor’s Office (CHEC-DO)
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CHEC-DO Section I
ARRIVING AT THE
OFFICE/CLINIC
ITEM RULE
Covered Pick Up/Drop Off
Area
1. Is there a covered pick-up/drop-
off area near an accessible entrance?
H V M
Score Yes if there is a pick-up or drop-off area
with an overhang, awning, or other structure
that blocks people from natural elements (e.g.,
sun, rain) located near the accessible entrance.
Score No if there is a pick-up or drop-off area
with a structure that blocks people from natural
elements, but the structure is not near an
accessible entrance.
Score No if there is no structure that blocks
people from natural elements present near an
accessible entrance.
Yes
No
Directories
Directories may either be on
the wall or free-standing.
Directories give a listing of
healthcare providers,
locations of provider offices
(e.g. Floor number, office
numbers) in a large
healthcare facility.
2. If the building is a large health care
facility, is there a directory located as
close to the accessible entrance as
possible?
H V M
Score Yes if there is a directory located as close
to the accessible entrance as possible.
Score No if there is a directory, but it is not
located as close to the accessible entrance as
possible.
Score N/A if the building is not a large
healthcare facility.
Yes
No
N/A
Distance from accessible
entrance to directory:
______ ft.
3. If the building is a large health care
facility, is there an informed greeter
available as close to an accessible
entrance as possible?
V
Score Yes if there is an informed greeter as close
to the accessible entrance as possible.
Score No if there is an informed greeter, but the
greeter is not as close to the accessible entrance
as possible.
Score N/A if the building is not a large
healthcare facility.
Yes
No
N/A
Distance from accessible
entrance to greeter:
________ ft.
CHEC-DO Section II WAITING/CHECK IN AREA
ITEM RULE
Accessible check in and check
out area
12. Is the check-in counter at an
accessible height for a person using a
wheelchair?
M
Score Yes if the height of the check-in counter is
36 inches or less.
Score No if the check-in counter is more than 36
inches.
Yes No
Counter height: ____________ in.
13. Is the check-in area free from a
frosted glass window or other visual
obstruction?
V
Score Yes if the check-in area is open so a person
can communicate directly with a receptionist
Score No if there is frosted glass or another
barrier present at the check in area.
Yes No
14. Are there alternative forms of communication offered during the check-in process for someone who is deaf or has hearing loss? H
Score Yes if an interpreter, messaging system, or
other form of communication is offered to an
individual who is deaf or experiences hearing loss
Score No if there is no alternative form of
communication offered.
Yes No
Accessible seating in waiting
area
15. Is there accessible seating in the
waiting area?
M
Score Yes if there options of accessible places to
sit that are integrated into the waiting room area,
including a space for someone seated in a
wheelchair.
Score No if there are no options of accessible
seating integrated into the waiting area.
Score N/A if the facility does not have a waiting
area.
Yes No
N/A
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CHEC-DO Section III EXAM ROOM and EQUIPMENT
ITEM RULE
21. Is there an accessible bathroom in the office or clinic area? H V M
Score Yes if there is a bathroom that is accessible located in or near the examination area. Score No if there is an accessible bathroom, but it is not located in or near the examination area. OR Score No if there is a bathroom that is in or near the examination area, but it is not accessible. OR Score No if there is no bathroom.
Yes No
Maneuverable spaces 22. Is there space to maneuver in the exam room? M
Score Yes if there is a 60” diameter clear floor space in the examination or treatment room. Score No if there is not a 60’’ diameter clear floor space in the examination or treatment room.
Yes No
Diameter of clear floor space: ___________in.
Height-adjustable exam table 23. Is there a height-adjustable exam table?
Score Yes if there is an examination table that can be lowered to a height of 18’’ from the floor. Score No if there is no examination table that can be lowered to a height of 18’’ from the floor. Score N/A if the facility does not have examination tables.
Yes No
N/A
Height of exam table: ___________in.
Accessible screening and diagnostic procedures
24. Is the diagnostic and screening equipment (x-ray equipment, mammography machine) accessible? M
Score Yes if the diagnostic and screening equipment is accessible to a person who uses a wheelchair. Score No if the diagnostic and screening equipment is not accessible to a person who uses a wheelchair. Score N/A if the facility does not have diagnostic or screening equipment.
Yes No
N/A
25. Is there an alternative form of communication used to communicate with someone who is deaf or has hearing loss during diagnostic and screening procedures? H
Score Yes if there are alternative forms of communication used during diagnostic and screening procedures (interpreter, written communication, and lip-reading). Score No if there are no alternative forms of communication used during procedures. Score N/A if the site does not perform diagnostic or screening procedures.
Yes No
N/A
Accessible scale 26. Is there a scale that can be used to weigh someone in a wheelchair? M
Score Yes if there is a scale that a person in a wheelchair can roll onto to be weighed. Score No if there is no scale that a person with a wheelchair can roll onto to be weighed. Score N/A if the facility does not have scales to weigh patients/clients.
Yes No
N/A
Accessible changing room 27. Is there an accessible changing room for someone to put on or take off a gown, if necessary, during examination procedures? M
Score Yes if there is a changing room with at least a 60’’ diameter of clear floor space, and a seat/bench that is no more than 18’’ from the floor. Score No if there is a changing room, but there is not enough clear floor space or a seat/bench at the appropriate height. Score N/A if the facility does not offer changing rooms.
Yes No
N/A
Diameter of clear floor space: __________in.
Minimal background noise 28. Is there minimal background noise? H
Score Yes if there is minimal background noise in the examination or treatment area. Score No if there is not minimal background noise in the examination or treatment area.
Yes No
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Restaurants were assessed using the CHEC-M and CHEC-RM/CHEC-RH/CHEC-RV
Raters entered the restaurants as patrons
Measured the physical environment (Entrance, space inside, restrooms, etc.)
Assessed social receptivity (asked server or manager about customer service)
CHEC Restaurant Assessments
Section I ARRIVING AT RESTAURANT
Community Health Environment Checklist- Restaurant Edition (CHEC-R)
FEATURES Space for Wheelchair in Reception Area
ITEMS 1. Is there a reception area? M1
SCORING RULES 1. Score Yes if there is a reception area. Score No if there is NOT a reception area.
Yes No
2. Is there a clear, wide space for a person using a wheelchair to move around the reception area? M2
2. Score Yes if there is a 5-foot circular space for a person using a wheelchair in the reception area. Score No if there is not a 5-foot circular space in the reception area. Score N/A if the restaurant does not have a reception area.
Yes No
N/A
Amount of space for wheelchair: ________ x ________ ft.
Accessible Waiting Area
3. Are there accessible places to sit that are integrated into the waiting area seating? M3
3. Score Yes if there are accessible places that are integrated into the waiting area seating. Score Yes if the accessible space is at least 30 inches wide and 32 inches deep. Score No if there are no accessible spaces integrated into the waiting area seating. Score No if the accessible space is less than 30 inches wide and 32 inches deep. Score N/A if the restaurant does not offer a waiting area.
Yes No
N/A
Amount of space for seating: ________ x ________ in.
Acoustics 5. Are there H5 materials that buffer sound?
Score Yes if the restaurant has materials that buffer sound (e.g., drapes, carpet, or papered walls). Score No if the restaurant does NOT have any materials that buffer sound.
Yes No
Materials: ______________________________
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Restaurant Average Assessment Scores
0
10
20
30
40
50
60
70
80
90
100
CHEC-GM CHEC-RM CHEC-RV CHEC-RH
Accessib
ilit
y P
erc
enta
ge
Miss Saigon – Delmar Blvd in University City, MO
Very well lit, light wall colors, very quiet inside, separate dining rooms
Tables very spread out, options for large circular tables and accessible tables
Restroom mostly accessible
Positive Restaurant Example
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Johnny’s Bar – Russell Street St. Louis, MO
No accessible entrance
No accessible parking
No accessible bathroom—no access from wheelchair
Crowded, and LOUD
No service accommodations
―Awful! Servers were rude!‖
Negative Restaurant Example
Obtain a contact when sites are visited Compilation and explanation of CHEC
scores Explanation of positive and negative
features in the building that affect participation
Resources to make improvements to current barriers
CHEC Assessment packet is available upon request
Dissemination: CHEC Reports
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Google Maps = FREE
Link to maps from web
Ability to edit/change
Dissemination: Google Maps
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Maximum
Summary of the CHEC
Receptivity and Accessibility can be characterized at the Community Level Total CHEC Scores on a sample of destinations
Receptivity of ―accessible restrooms‖ of entire community (features by destination)
Receptivity and Accessibility can be characterized at the Destination Level Total CHEC score of the destination or Area of a
building (this building)
Section scores
Receptivity of features (seating)
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Developing community partnerships Outcome measurement for Community
Engagement Initiatives ◦ Pre-Post Analysis
Train Paraquad, Inc. Community Advocate Group to administer assessments ◦ Primarily participants with mobility
and vision impairments
Develop additional site and impairment specific versions
Future Directions
Holly Hollingsworth, PhD
Susan Stark, PhD
Kerri Morgan
Denise Curl Dickerson
Jackie Webel, Meghan Gottlieb, Lisa Garrett
Graduate Students
Emilie Marty
Rachel Dargatz
Susan Crumbaugh
Jaclyn Tarloff
Acknowledgments
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David B. Gray
314-286-1658
Jessica Dashner
314-286-1640
Contact Information
