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1

Alston, Reginald J., and Simphiwe Mngadi. "The Interaction Between Disability Status and the African American Experience: Implications for Rehabilitation Counseling." Journal of Applied Rehabilitation Counseling 23, no. 2 (June 1, 1992): 12–16. http://dx.doi.org/10.1891/0047-2220.23.2.12.

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This article provides information that is useful to rehabilitation counselors and human service professionals providing services to African Americans with disabilities. The potential double bias of being African American and disabled is examined in the article. Special focus is on the similarities in stigmas experienced by persons with disabilities and members of the African American community and how the interaction between minority race status and disability status effects the delivery of rehabilitation services to African Americans. The client-centered approach is described and suggested as a theoretical orientation to be adopted by rehabilitation counselors to lessen the impact of a double stigma on this population.
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2

Feist-Price, Sonja, and Debra A. Harley. "Career Counseling and Development Strategies for African Americans with Disabilities." Journal of Applied Rehabilitation Counseling 27, no. 2 (June 1, 1996): 23–29. http://dx.doi.org/10.1891/0047-2220.27.2.23.

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This paper seeks to promote greater awareness of the importance of understanding issues specific to providing career counseling and development services to African Americans with disabilities. This goal is accomplished in three ways. First, this paper identifies issues relevant to African Americans with disabilities. Second, existing career counseling strategies will be analyzed in regards to the needs of African Americans with disabilities. Lastly, attention is devoted towards identifying career counselling interventions that are effective in meeting the complex needs of African Americans with disabilities who are interested in attaining occupational success.
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Wilson, Keith B., Tyra Turner, Jiawei Liu, Debra A. Harley, and Reginald J. Alston. "Perceived Vocational Rehabilitation Service Efficacy by Race/Ethnicity: Results of a National Customer Survey." Journal of Applied Rehabilitation Counseling 33, no. 3 (September 1, 2002): 26–34. http://dx.doi.org/10.1891/0047-2220.33.3.26.

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The purpose of this study was to examine whether African Americans, European Americans, and other races and ethnicities with disabilities differed in perceived job placement efficacy of vocational rehabilitation (VR) services in the United States. Binary logistic regression was employed to predict how African Americans, European Americans, and other races and ethnicities would view VR services in assisting them to get Jobs. The test statistic revealed that race/ethnicity and perceived VR service efficacy among VR customers were not statistically significant. However, as the number (answering yes on the NIHS) of African Americans, European Americans, and other races and ethnicities increased, they perceived that the VR services they received did not assist them in getting a Job. Future research considerations for VR administrators and counselors are discussed.
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Sample, Eddie B., Li Li, and Dennis Moore. "ALCOHOL USE, ETHNICITY, AND DISABILITY: A COMPARISON OF AFRICAN-AMERICAN AND CAUCASIAN GROUPS." Social Behavior and Personality: an international journal 25, no. 3 (January 1, 1997): 265–76. http://dx.doi.org/10.2224/sbp.1997.25.3.265.

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Previous research has consistently reported that alcohol consumption among the general population varies across cultural groups. However, studies investigating risk factors and drinking patterns of African-Americans and Caucasians with disabilities have been limited. The current study explored the factors of alcohol use among African-Americans and Caucasians with disabilities who were seeking rehabilitation services in three mid-western states of the USA. Multivariate data analysis revealed that African-Americans were more likely to use alcohol than their Caucasian counterparts when other demographic and disability variables were controlled. Additionally, separate multiple-regression models differentiated patterns between African-Americans and Caucasians in selected variables on alcohol use. Cultural issues and implications for rehabilitation services are discussed.
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5

Baloch, Natasha A., and Wesley G. Jennings. "A Preliminary Investigation of the Intersection of Race and Disabilities among Inmates in the U.S. State Prison System." International Journal of Offender Therapy and Comparative Criminology 63, no. 4 (October 12, 2018): 597–609. http://dx.doi.org/10.1177/0306624x18805599.

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The American prison system is overcrowded with minorities in general, and African Americans, in particular. The Department of Justice notes that more than 50% of the prison population have some type of mental disability. In this study, we examine the intersection between race and disabilities in the U.S. State prison system. Using the Rehabilitation Services Administration data set, the study highlights the prevalence and type of disabilities in the prison inmate population. Results demonstrate that African American inmates are overrepresented among inmates with disabilities, are more likely to have mental disabilities relative to physical disabilities, and these results hold for various types of mental disabilities including cognitive, psychosocial, and other mental disabilities. Study limitations and directions for future research are also discussed.
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Ward-Sutton, Courtney, Natalie F. Williams, Corey L. Moore, and Edward O. Manyibe. "Assistive Technology Access and Usage Barriers Among African Americans With Disabilities: A Review of the Literature and Policy." Journal of Applied Rehabilitation Counseling 51, no. 2 (June 1, 2020): 115–33. http://dx.doi.org/10.1891/jarc-d-19-00011.

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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.
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7

Johnson, Jean E., Corey L. Moore, Fariborz Aref, Andre L. Washington, Courtney Ward, and Kelsey Webb. "National Survey of State Vocational Rehabilitation Agency and Veterans Affairs Interagency Collaborations: An Emerging Conceptual Framework for Co-Serving Veterans of Color with Disabilities." Journal of Applied Rehabilitation Counseling 48, no. 4 (December 1, 2017): 54–64. http://dx.doi.org/10.1891/0047-2220.48.4.54.

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This national study examined the perceptions of state vocational rehabilitation agency (SVRA) administrators (N = 39) about SVRA and United States Department of Veterans Affairs Vocational Rehabilitation and Employment (VA-VR&E) Program co-service practices that could facilitate improved employment outcomes among veterans of color (i.e., African Americans, Native Americans or Alaskan Natives, Latinos, and Asian Americans or Pacific Islanders) with disabilities. The investigators collected data using a survey of promising co-service practices and collaborations, and their subsequent analysis yielded 11 key themes that were catalogued into the following five domains; job placement services, referral services, cultural diversity, co-service agreements, and co-agency procedures. Generated findings informed the development of an emerging conceptual framework for a new “SVRA and VA-VR&E Co- Service Model” presented herein that could be considered for future evaluation and adoption by these agencies.
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Johnson, Jean E., Corey L. Moore, Ningning Wang, Perry Sanders, and John Sassin. "Diffusion of Innovations Theory and Veterans of Color: A Framework for Promoting the Adoption of Effective State Vocational Rehabilitation Agencies, American Indian Vocational Rehabilitation Programs, and Veterans Affairs-Vocational Rehabilitation & Employment Co-Service Practices in Vocational Rehabilitation." Journal of Applied Rehabilitation Counseling 47, no. 1 (March 1, 2016): 7–16. http://dx.doi.org/10.1891/0047-2220.47.1.7.

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This article proposes the adoption of co-service practices between state vocational rehabilitation agencies (SVRAs), American Indian vocational rehabilitation programs (AIVRPs), and Veterans Affairs-Vocational Rehabilitation and Employment (VA-VR&E) programs as a means to increase employment outcomes for veterans of color (i.e., African Americans, Latinos, Native Americans, and Asians) with disabilities. Collaborative agency practices are shown to contribute to successful outcomes. However, there is less discussion on how to promote adoption of co-service practices between these agencies. The purpose of this article is to discuss the need for interagency collaborations and Diffusion of Innovations Theory as an approach for promoting adoption of co-service practices across these agency contexts to increase employment services and outcomes for these veterans. Recommended approaches that can be considered for advancing the current state-of-the-science on improving SVRAs and VA -VR&E, and AIVRPs and VA -VR&E co-service strategies for placing these veterans into competitive integrated employment are presented.
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Dutta, Alo, Madan Kundu, Kanako Iwanaga, Nicole Ditchman, and Fong Chan. "Transition Engagement of African American Youth With Disabilities: A Serial Mediation Model." Exceptional Children 86, no. 3 (November 13, 2019): 276–92. http://dx.doi.org/10.1177/0014402919884542.

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The purpose of this study was to draw from self-determination and self-efficacy theories to evaluate psychological constructs (autonomous motivation, competency, and outcome expectancy) as mediators of the relationship between working alliance and engagement in transition–vocational rehabilitation (VR) services among African American students with disabilities. A serial multiple mediation analysis was computed to evaluate the mediators of transition-VR service engagement in a sample of 88 African American high school students with disabilities. We found that working alliance was positively associated with active engagement in transition-VR services (total effect), whereas the direct effect of working alliance on engagement was not significant after controlling for the effects of autonomous motivation, competency, and outcome expectancy, supporting significant mediation effects. Findings suggest that a strong working alliance between students and rehabilitation counselors and transition specialists can foster autonomous motivation, competency, and outcome expectancy, resulting in higher levels of engagement in transition-VR services.
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Asbury, Charles A., Sylvia Walker, Almeta Stokes, and Reginald Rackley. "Psychosocial Correlates of Attitude Toward Disability and Desire to Work in African Americans with Disabilities." Journal of Applied Rehabilitation Counseling 25, no. 4 (December 1, 1994): 3–8. http://dx.doi.org/10.1891/0047-2220.25.4.3.

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Over the past twelve years a number of valuable and revealing studies have addressed service utilization and employment issues pertinent to minorities with disabilities. Research conducted by Atkins (1980) and Belgrave and Walker (1991a; 1991b) provides considerable evidence that utilization and successful completion of rehabilitation programs by minority persons, especially African Americans, is often associated with factors such as (1) attitude toward disability, (2) attitude toward self, and (3) perceptions and expectations of the rehabilitation process. Attitude toward disability has also been linked to employment in a study by Jenkins and Amos (1983) where it was reported that subjects considered their disability as a barrier. There were also implications in this study that attitudes toward their disability might also influence the extent to which the subjects would manifest a desire to work. There is a need, however, for more systematic study of psychosocial variables that may be uniquely operable among African Americans with disabilities. The more we understand these dynamics the more we can equitably adapt our efforts in the interest of enabling all clients to become more independent and self-sufficient. This information is especially critical for African Americans since it has been reported that among those of working age, one in seven have disabilities (Bowe, 1983).
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11

Tabron, Lolita A., and Karen Ramlackhan. "Hypocrisy, State Policy, and African American Students With Disabilities: The Guise of Access." Educational Policy 33, no. 1 (October 26, 2018): 181–204. http://dx.doi.org/10.1177/0895904818807308.

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We critically examined the odds of earning a college preparatory diploma for African American high school seniors receiving special education services under Texas’s Top 10% Policy (TTPP). Critical policy analysis was used to explore the meritocratic guise of college access for African American youth with disabilities, and through DisCrit, theorized TTPP’s broader effect on the social stratification and creation of policy “winners” and “losers.” Results from multilevel logistic regression models indicate African American students are nearly twice as likely to be identified with disabilities as their peers and are the least likely to earn a college preparatory diploma in Texas.
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12

Moore, Corey L., James Micheal Ferrin, Nineveh Haysbert, Sharon Brown, Paul Cooper, Jerry Diebel, Andre Washington, et al. "Employment Outcome Rates of African American Versus White Consumers of Vocational Rehabilitation Services: A Meta-Analysis." Journal of Applied Rehabilitation Counseling 40, no. 3 (September 1, 2009): 3–10. http://dx.doi.org/10.1891/0047-2220.40.3.3.

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This research examined the relationship between race/ethnicity and rehabilitation outcomes as measured by closure status for VR consumers across two different target populations: persons with mental retardation and those who are deaf/hard-of-hearing. The researchers employed a meta-analysis to test the association between the predictor and criterion variables using select Rehabilitation Services Administration (RSA-911) driven studies. Data analyzed represent consumer case file information collected during the fiscal years of 1995-1996 through 1997-1998, the time period following passage of the 1992 Rehabilitation Act Amendments and implementation of the resulting Rehabilitation Cultural Diversity Initiative. The meta-analysis identified a significant relationship between race/ethnicity and closure status for each target population. African Americans with hearing loss and those with mental retardation were significantly less likely to achieve closure success when compared to Whites with respective disabilities. These findings and several implications for practice/service and disability policy are discussed.
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Ethridge, Glacia, Angel Riddick Dowden, and Michael Brooks. "The Impact of Disability and Type of Crime on Employment Outcomes of African American and Latino Offenders." Journal of Applied Rehabilitation Counseling 48, no. 4 (December 1, 2017): 46–53. http://dx.doi.org/10.1891/0047-2220.48.4.46.

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Individuals with criminal histories who struggle to gain employment may choose to turn to illegal activity or seek state and federal program assistance to support themselves and their families. African Americans and Hispanic/Latinos with disabilities and criminal histories experience barriers (i.e., disability, criminal history, and race/ethnicity) that often prevent them from obtaining or maintaining competitive integrated employment. The purpose of this article was to examine the extant literature pertinent to disability and criminal history as employment obstacles among African American and Hispanic/Latino ex-offenders. As the foundation, the article categorizes employment outcomes for these target population by disability and criminal history, discusses how state vocational rehabilitation agencies can develop a criminal history service delivery model to improve employment outcomes, presents implications for improving employment outcomes, and explores future research.
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14

Pebdani, Roxanna N. "Factors Related to Early Termination From Work for Youth With Disabilities." Australian Journal of Rehabilitation Counselling 20, no. 2 (November 28, 2014): 100–113. http://dx.doi.org/10.1017/jrc.2014.11.

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This study of young adults with disabilities in transition explored what factors contributed to young adults with disabilities terminating early from a transition program. Data from 6,227 young adults with disabilities aged 17–22 living in one of eight major metropolitan areas in the United States were utilised (58.7% of the sample were male, 63.1% were African-American, and 71.4% had a learning disability). All participants were enrolled in a school-to-work transition programme in which service providers place students into paid internships. Service providers at the eight sites collected data while working with participants, and then collected follow-up data at three and twelve months post-programme completion or termination. Hierarchical Linear Modelling was used to explore how personal factors impacted early termination, while controlling for variation at the site level. Results showed the three main reasons for early termination from work to be: programme initiated termination, interpersonal conflicts with coworkers or supervisors and transportation issues. Additionally, the multilevel model that controlled for variance at the site level demonstrated that Asian-American young adults with disabilities were less likely to terminate early from work. These results can help individuals who work with young adults with disabilities, provide supplemental services to students who may need additional assistance to succeed in a transition programme.
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Ji, Eun, James Schaller, Barbara Pazey, and Kate Glynn. "Education and Employment Outcomes from the RSA Data File for Transition-Age African American, White, and Hispanic Youth with Learning Disabilities." Journal of Applied Rehabilitation Counseling 46, no. 3 (September 1, 2015): 15–24. http://dx.doi.org/10.1891/0047-2220.46.3.15.

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Relationships among consumer demographic variables, services, and employment outcomes for 25,218 15 to 18 year old youth with learning disabilities were examined using the Rehabilitation Services Administration database from 2012. The 25,218 individuals were randomly split for cross-validation purposes into Sample One and Sample Two. A separate logistic regression was run for each sample. Variables significant for both samples included being African American, college and occupational training, and job placement. The correct classification of the logistic regression for Sample One was 67.1% and for Sample Two it was 66%. African American males had significantly lower successful employment rates than White or Hispanic males. African American females had significantly lower successful employment rates than White or Hispanic females. Mean earnings per week for White males and females combined were significantly higher than African American males and females combined. Hypotheses for the above findings include White and Hispanic youth using job placement resources at educational institutions, cultural mistrust, and rehabilitation counselors following youth’s expressed preferences. Implications for practice include engaging ethnically diverse consumers in vocational rehabilitation through an empowerment approach and viewing family involvement in transition planning as a continuum.
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Hartman, Ellie C., Weneaka Jones, Rachel Friefeld Kesselmayer, Emily A. Brinck, Audrey Trainor, Alicia Reinhard, Rita K. Fuller, Amanda Schlegelmilch, and Catherine A. Anderson. "Demographic and Transition Service Predictors of Employment Outcomes for Youth Receiving Supplemental Security Income." Career Development and Transition for Exceptional Individuals 44, no. 2 (January 28, 2021): 97–109. http://dx.doi.org/10.1177/2165143420984797.

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Racially and ethnically diverse youth with disabilities receiving Supplemental Security Income (SSI) benefits were randomly assigned to usual services, including available school and vocational rehabilitation (VR) transition services, or enhanced case management and transition services through the Wisconsin Promoting Readiness of Minors in SSI (PROMISE) federal demonstration grant. A hierarchical logistic regression analysis demonstrated increased age, being African American, having a psychiatric disability, and transition services predicted higher youth employment rates. However, enhanced PROMISE transition services were no longer significant in the presence of VR services, suggesting the effect of enhanced services was mediated by increasing engagement in VR. Limitations and implications are discussed regarding the relationship between school and state VR transition services and postsecondary competitive integrated employment outcomes.
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Cardoso, Elizabeth da Silva, Alo Dutta, Chung-Yi Chiu, Ebonee T. Johnson, Madan Kundu, and Fong Chan. "Social-Cognitive Predictors of STEM Career Interests and Goal Persistence in College Students With Disabilities From Racial and Ethnic Minority Backgrounds." Rehabilitation Research, Policy, and Education 27, no. 4 (2013): 271–84. http://dx.doi.org/10.1891/2168-6653.27.4.271.

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Objective: To examine the relations of science, technology, engineering, and mathematics’s (STEM) self-efficacy, outcome expectations, interests, and contextual supports and barriers to STEM educational goals in college students with disabilities from racial and ethnic minority backgroundsDesign: Quantitative descriptive research design using hierarchical regression analysis (HRA)Participants: 115 underrepresented minority students with disabilities receiving services from the National Science Foundation (NSF) funded Minority-Disability (MIND) Alliance in STEM project at Hunter College, City University of New York and Southern University at Baton Rouge for the years 2008−2011.Outcome Measures: The Social-Cognitive STEM measuresResults: The HRA results indicated that gender, advanced placement (AP) classes, father’s educational level, academic milestone self-efficacy, and STEM interest were significant predictors of goal persistence in African American and Hispanic college students with disabilities. The final model accounted for 57% of the variance in STEM persistence, which is considered a large effect size.Conclusion: The research findings provide good support for the use of the social cognitive career theory (SCCT) framework to identify predictors of STEM persistence and to design academic retention services and career development interventions for college students who are underrepresented minorities with disabilities.
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Shogren, Karrie A., and Leslie A. Shaw. "The Impact of Personal Factors on Self-Determination and Early Adulthood Outcome Constructs in Youth With Disabilities." Journal of Disability Policy Studies 27, no. 4 (September 19, 2016): 223–33. http://dx.doi.org/10.1177/1044207316667732.

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Data from the National Longitudinal Transition Study–2 (NLTS2) were used to examine the impact of three personal factors—race/ethnicity, gender, and family income—on self-determination (i.e., autonomy, psychological empowerment, self-realization) and early adulthood outcome constructs. Findings suggest for those with high-incidence disabilities, family income predicts postsecondary education outcomes. And males with high-incidence disabilities have greater access to services and accommodations as adults, but lower use of financial supports (i.e., use of government support programs). African American youth across disability categories reported lower levels of financial independence. Females with intellectual disability reported greater social relationships but lower levels of financial support and employment. Implications for future research, policy, and practice are discussed.
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Giesen, J. Martin, and Anne Hierholzer Lang. "Predictors of Earnings Enabling Likely Roll Departure for SSDI Beneficiaries With Visual Impairments in Vocational Rehabilitation." Journal of Disability Policy Studies 29, no. 3 (June 17, 2018): 166–77. http://dx.doi.org/10.1177/1044207318780363.

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We examined individual, socioeconomic, disability, service, and state-level factors predicting vocational rehabilitation (VR) closure earnings exceeding substantial gainful activity for Social Security Disability Insurance (DI) beneficiaries in VR who were blind or visually impaired (BVI). We used 2011 RSA-911 (Rehabilitation Services Administration) data from 3,505 individuals exiting VR. Using multilevel modeling, we found positive relationships for beneficiaries who were male, younger, African American; held higher education levels; were without additional disabilities; had higher earnings and DI benefits at application; received services related to job placement and on-the-job supports; did not receive “work basics” (job-readiness) training; received training/support services in rehabilitation technology and other supports; and resided in states with lower unemployment rates. Interactions with VR agency structure revealed compensatory effects—negative relationships for being female and for being older were overcome by receiving services in a blind (rather than combined) agency. We concluded that prior work experience of a DI-beneficiary consumer contributes substantially to high earnings likely to lead to benefits termination due to work for the BVI consumer exiting VR and may serve to level race/ethnicity differences in outcome. Policy recommendations include retaining separate VR agencies for BVI consumers and strongly encouraging work experiences for consumers in VR.
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Tsagaris, George Steve, Mamadou Mansor Seck, Janet Keeler, and Robert Rowe. "Geographic information system analysis of developmentally disabled adult offenders." Journal of Intellectual Disabilities and Offending Behaviour 7, no. 1 (March 14, 2016): 4–13. http://dx.doi.org/10.1108/jidob-09-2015-0028.

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Purpose – Adult offenders diagnosed with developmental disabilities have been referred for services to a Northeast Ohio county agency. The purpose of this paper is to examine their repartition in the three areas of the county as determined by zip codes, their involvement with the criminal justice system, types of offenses they committed, their indictment, and the court outcomes. Design/methodology/approach – This study used a geographic information system (GIS) mapping based on secondary data collected from the 2008 to 2012 American Community Survey and a random sample of 160 participants selected from an agency database including 850 clients. Findings – The authors found that the concentrations of offenders in the core city, inner, and outer suburbs of the county were, respectively 71.7, 19.6, and 8.7 percent. The largest racial groups included African Americans (112; 70 percent) and Whites (33; 20.6 percent). Male offenders (155; 96.9 percent) outnumbered female offenders. Of the offenses committed, 42.9 percent were crimes against persons including kidnapping, abduction, assault, followed by crimes against property (22.2 percent), and crimes against society (26.4 percent). As they appeared before Mental Health Court or Non Mental Health Court judges, the court outcome evolved from community control for six months to prison sentence of 120 months. Research limitations/implications – These findings will enable agency professionals to look for protective as well as risk factors that are prevalent in each area of this NEO county and make plans for more effective, preventative, and clinical service provision. Originality/value – The use of GIS for data analysis represents an innovation in the research field involving adult offenders with developmental disability as it allows professionals to look for protective as well as risk factors that are prevalent in their clients’ immediate environment.
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Dowden, Angel Riddick, Glacia Ethridge, and Michael Brooks. "The impact criminal history has on the employability of African American and Latino populations with disabilities receiving state vocational rehabilitation services: Implications for adding a criminal history variable to the RSA-911 data." Journal of Vocational Rehabilitation 45, no. 2 (August 22, 2016): 213–24. http://dx.doi.org/10.3233/jvr-160824.

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Shah, Mansi, Jessica Tilton, and Shiyun Kim. "Factors Influencing Enrollment in the Medication Therapy Management Clinic at an Academic Ambulatory Care Clinic." Journal of Pharmacy Practice 29, no. 2 (August 3, 2014): 106–9. http://dx.doi.org/10.1177/0897190014544791.

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Purpose: In 2001, the University of Illinois Hospital and Health Sciences System (UI Health) established a pharmacist-run, referral-based medication therapy management clinic (MTMC). Referrals are obtained from any UI Health provider or by self-referral. Although there is a high volume of referrals, a large percentage of patients do not enroll. This study was designed to determine the various factors that influence patient enrollment in the MTMC. Methods: This study was a retrospective chart review of demographic and patient variable data during years 2010 and 2011. Disabilities, distance from MTMC, mode of transportation, past medical history, and appointment dates were extracted from the medical records. Results were analyzed using descriptive statistics and logistic regression analysis. Results: A total of 103 referrals were made; however, only 17% of patients remain enrolled in MTMC. The baseline demographics included a mean age of 63 years, 68% female, 70% African American, and 81% English speaking. Patients lived an average of 8 miles from MTMC; most utilized public or government-supplemented transport services; 24% of patients reported some type of disability, most commonly utilizing a walker or a wheelchair. On average, patients were prescribed 13 medications with hypertension (70%), diabetes (56%), and hyperlipidemia (48%) being the most common chronic disease states. The reason for referral included medication management, education, medication reconciliation, and disease state management. Five patients were unable to be contacted to schedule an initial appointment. Additionally, 18 patients failed their scheduled initial appointment and did not reschedule. Logistic regression analysis demonstrated distance traveled for clinic visit, age, and history of hypertension affected the probability of patients showing for their appointments (chi-square = 19.7, P < .001). Conclusion: This study demonstrated that distance from MTMC is the most common barrier in patient enrollment; therefore, strategies to improve patient access are necessary.
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Singh, Gopal K., Mehrete Girmay, Michelle Allender, and Ramey T. Christine. "Digital Divide: Marked Disparities in Computer and Broadband Internet Use and Associated Health Inequalities in the United States." International Journal of Translational Medical Research and Public Health 4, no. 1 (June 10, 2020): 64–79. http://dx.doi.org/10.21106/ijtmrph.148.

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Background: Despite the considerable increase in computer and internet use over the past two decades, few studies have examined socioeconomic, demographic, and health characteristics associated with computer and internet use in the United States. Community-level differences in computer and internet use and associated disparities in health and mor tality indicators have not been analyzed. This study examines these associations at the individual and community level using national census, health, and mortality data. Methods: We analyzed data from the 2017 American Community Survey (ACS) Micro-data Sample, the 2013-2017 ACS Summary File, 2013-2017 National Vital Statistics System, and 2019 County Health Rankings and Roadmaps. Health and socioeconomic characteristics associated with broadband internet and computer use among adults aged ≥18 were modeled by logistic regression (N=2,385,595). Results: In 2017, 89.7% of Asian/Pacific Islanders (APIs) had broadband internet service, compared with 66.0% of American Indians/Alaska Natives (AIANs), 77.2% of Blacks/African-Americans, 78.8% of Hispanics, and 83.5% of non-Hispanic Whites. APIs (97.4%) were more likely than other racial/ethnic groups to own or use a computer (including smartphones), while AIANs (80.3%) were less likely. Socioeconomic gradients in internet and computer use were marked. Those below the poverty level and with less than a high school education reported 18 and 15 percentage points lower rates of internet and computer use respectively. Compared to metropolitan areas, nonmetropolitan areas had lower internet access (80.3% vs. 69.7%) and computer use (88.4% vs. 80.5%). Rural areas and small urban towns had the lowest level of internet and computer use. Risks of disabilities and lack of health insurance were greater among persons with lower broadband internet and computer access. Communities with low internet and computer use had seven years shorter life expectancy than communities with high use and were at increased risks of mortality from various chronic conditions, poor health, mental distress, hospitalization, smoking, obesity, and physical inactivity. Conclusions and Implications for Translation: Significant socioeconomic and racial/ethnic disparities in internet and computer use and associated health inequalities exist in the US. Closing the social divide in internet and computer use can positively impact individual empowerment, educational attainment, economic growth, community development, access to health care and health-related information, and health promotions efforts. Key words: • Digital divide • broadband internet • computer use • disability • health insurance • causespecific mortality • morbidity • health behaviors Copyright © 2020 Singh et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
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O'Sullivan, Deirdre, and Stephen J. Notaro. "Racial Identity and Perceptions of People with Disabilities as Romantic Partners: A Pilot Study." Journal of Applied Rehabilitation Counseling 40, no. 4 (December 1, 2009): 27–30. http://dx.doi.org/10.1891/0047-2220.40.4.27.

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This study explored the relationship between racial groups, racial identity, and attitudes toward dating a person with a physical disability. It was hypothesized that African Americans would have higher levels of racial identity than Caucasian Americans. Furthermore, it was hypothesized that because of shared minority group status, African Americans would have more positive attitudes than Caucasians toward dating someone described as having a physical disability. African American participants were found to have higher levels of racial identity than Caucasian participants, but had significantly more negative attitudes regarding dating a person with a physical disability than Caucasians. A discussion of racial identity, as well as implications for rehabilitation counselors, is included.
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LeBlanc, Sandra, and Julie F. Smart. "Power, Perception, and Privilege: White Privilege and the Rehabilitation of Mexican Americans." Journal of Applied Rehabilitation Counseling 36, no. 2 (June 1, 2005): 12–19. http://dx.doi.org/10.1891/0047-2220.36.2.12.

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Rehabilitation counselors are gatekeepers to services in the state/federal vocational rehabilitation agency. Further, it is safe to state that the majority of these counselors are white, non-Hispanic Americans. Juxtaposed with these twin realities is the growing number of Hispanic/Latino Americans with disabilities, the greatest number of whom are of Mexican origin. Therefore, it becomes necessary for rehabilitation counselors to examine the concepts, history, and results of white privilege. In rehabilitation, white privilege may affect the higher rates of disabilities experienced by Mexican Americans and the fact that once Mexican Americans acquire these disabilities, they experience more secondary conditions and complications (than white, non-Hispanics). Acceptance for services in the state/federal VR system can be influenced by white privilege. Once accepted for services, white privilege can create distance and a power differential between the rehabilitation counselor and the Mexican American client. In addition, biases and inaccurate (and unconscious) perceptions of the counselor may lead to inaccurate assessments and underestimation of the Mexican American client's potential for rehabilitation. Practice recommendations which empower the Mexican American client are presented.
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Snowden, Lonnie R., Ray Catalano, and Martha Shumway. "Disproportionate Use of Psychiatric Emergency Services by African Americans." Psychiatric Services 60, no. 12 (December 2009): 1664–71. http://dx.doi.org/10.1176/ps.2009.60.12.1664.

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27

Whaley, Arthur L. "Cultural Mistrust and Mental Health Services for African Americans." Counseling Psychologist 29, no. 4 (July 2001): 513–31. http://dx.doi.org/10.1177/0011000001294003.

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The underutilization of mental health services by African Americans may be due, in part, to their cultural mistrust. The purpose of this article is twofold: (a) to conduct a meta-analysis of the correlations between cultural mistrust in African Americans and their attitudes and behaviors related to mental health services use, comparing them to the correlations between cultural mistrust and measures relevant to other psychosocial domains, and (b) to test some methodological hypotheses about the Cultural Mistrust Inventory, the most popular measure of cultural mistrust. The meta-analysis suggests that the negative effects of Blacks’ cultural mistrust in interracial situations are not unique to counseling and psychotherapy but represent a broader perspective. The meta-analysis also suggests that development of the Cultural Mistrust Inventory with a male-only college sample did not compromise its external validity. The implications of these results for the provision of mental health services to African Americans are discussed.
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Harris, Joyce L. "Aging and Ethnicity: Communication Services for Older African-Americans." Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) Populations 3, no. 2 (July 1997): 3–5. http://dx.doi.org/10.1044/cds3.2.3.

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29

Jackson, Shelley R., Gayle Hafner, Daniel O’Brien, and Georges Benjamin. "Approaches to Implementing the Olmstead ADA (Americans with Disabilities Act) Ruling." Journal of Law, Medicine & Ethics 31, S4 (2003): 47–48. http://dx.doi.org/10.1111/j.1748-720x.2003.tb00747.x.

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The Department of Health and Human Services, Office for Civil Rights (OCR) enforces Section 504 of the 1973 Rehabilitation Act and Title II of the Americans with Disabilities Act. OCR works through complaint investigations and compliance reviews, as well as outreach, technical assistance, and public education to promote voluntary compliance. In the Olmstead decision of June 1999, the Supreme Court held that the ADA’s “integration regulation” requires state and local government to administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities. The decision changed the focus from whether a right to more integrated services exists, to under what circumstances and how services will be provided. The New Freedom Initiative announced by President Bush in February 2001 is a broadbased initiative to remove barriers to community living for people with disabilities and promote swift implementation of the Olmstead decision.
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Wilson, Keith B., Tyra Turner, and Ronald L. Jackson. "Vocational Rehabilitation Services Received after Successful Closure: A Comparison by Race." Journal of Applied Rehabilitation Counseling 33, no. 1 (March 1, 2002): 26–34. http://dx.doi.org/10.1891/0047-2220.33.1.26.

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The purpose of this study was to investigate whether successfully closed (Status 26) African Americans and White Americans differed in the type of vocational rehabilitation (VR) services received. Authors used the chi-square and phi coefficient to ascertain the association and significance between the independent and dependent variables, respectively. The results revealed the three services most commonly received by African Americans were maintenance, transportation, and adjustment training. The three services most commonly received by white Americans after successful case closure included college or university training, physical and mental restoration, and diagnostic or assessment, processes. In addition, job placement, job referral, and “other” were statistically significant for African Americans and miscelIaneous for White Americans, The races did not differ on business or vocational training, counseling, and on-the-Job training. The article also identifies some implications for VR counselors.
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Jarama, S. Lisbeth, and Faye Z. Belgrave. "A Model Of Mental Health Adjustment Among African Americans With Disabilities." Journal of Social and Clinical Psychology 21, no. 3 (September 2002): 323–43. http://dx.doi.org/10.1521/jscp.21.3.323.22530.

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32

Hampton, Nan Zhang, and Vickie Chang. "Quality of Life as Defined by Chinese Americans with Disabilities: Implications for Rehabilitation Services." Journal of Applied Rehabilitation Counseling 30, no. 3 (September 1, 1999): 35–41. http://dx.doi.org/10.1891/0047-2220.30.3.35.

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The purpose of this study was to explore dimensions of quality of life (QOL) perceived by Chinese Americans with disabilities with reference to improve vocational rehabilitation services to this group. Forty-three Chinese Americans/immigrants with physical disabilities participated in the study. A focus group technique was used to collect data. The participants identified the following nine dimensions of QOL: (1) contributing to society; (2) self-reliance; (3) enjoying the same rights as others; (4) not having to worry about food, clothing, housing, and transportation; (5) physical health; (6) emotional health; (7) relationships; (8) individual safety; and (9) stability and prosperity of the nation. Participants also defined six problems that prevented them from living a good life. Implications of the results for rehabilitation counselors and researchers are discussed in light of the impact of Chinese culture and immigration on the QOL of Chinese Americans/immigrants with disabilities.
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Chandler, Quaneshia S. "The negative stereotypes about mental health, and African-American College students’ willingness to seek counseling." Global Journal of Psychology Research: New Trends and Issues 9, no. 2 (September 30, 2019): 32–42. http://dx.doi.org/10.18844/gjpr.v9i2.4208.

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Mental health issues, such as excessive stress, anxiety and depression, are common among the college students. Students from minority populations disproportionally experience these issues, which impacts their overall functioning. It is well known that African Americans and others underutilise mental health service and are more likely to discontinue services even when they seek such services. Given this observation, the present study examines the attitude of African American college students towards seeking mental health services. Specifically, the study will highlight negative stereotypes attached to seeking mental health services, and how these impact the willingness of African American college students to seek mental health services. The study will explore ways to combat these negative stereotypes. Additionally, the study will also discuss the many barriers that come in to play with African Americans in seeking mental health opportunities. Keywords: Stereotypes, African Americans, mental Health, counseling, willingness.
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Hampton, Nan Zhang. "Meeting the Unique Needs of Asian Americans and Pacific Islanders with Disabilities: A Challenge to Rehabilitation Counselors in the 21st Century." Journal of Applied Rehabilitation Counseling 31, no. 1 (March 1, 2000): 40–46. http://dx.doi.org/10.1891/0047-2220.31.1.40.

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This article focuses on the unique rehabilitation needs of Asian Americans and Pacific Islanders (AAPIs) with disabilities. The prevalence of disabilities among AAPIs is reviewed based on the available data in the literature. Cultures of AAPIs and barriers preventing AAPIs with disabilities from seeking or receiving vocational rehabilitation services are discussed. Recommendations are presented on how to improve vocational rehabilitation counseling services in the 21st century for this underserved population.
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35

Dana, Richard H. "Mental health services for African Americans: A cultural/racial perspective." Cultural Diversity and Ethnic Minority Psychology 8, no. 1 (February 2002): 3–18. http://dx.doi.org/10.1037/1099-9809.8.1.3.

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36

Grady, John, and Damon P. S. Andrew. "Equality of Access to Emergency Services for People with Disabilities under the Americans with Disabilities Act." Journal of Legal Aspects of Sport 17, no. 1 (February 2007): 1–25. http://dx.doi.org/10.1123/jlas.17.1.1.

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37

Rimmer, James H., Terry Nicola, Barth Riley, and Todd Creviston. "Exercise training for African Americans with disabilities residing in difficult social environments." American Journal of Preventive Medicine 23, no. 4 (November 2002): 290–95. http://dx.doi.org/10.1016/s0749-3797(02)00517-2.

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38

Townsend, Apollo, Alice L. March, and Jan Kimball. "Can Faith and Hospice Coexist." Journal of Transcultural Nursing 28, no. 1 (July 9, 2016): 32–39. http://dx.doi.org/10.1177/1043659615600764.

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African Americans are twice as likely as Caucasian Americans to choose aggressive hospital treatment when death is imminent. Repeat hospitalizations are traumatic for patients and drain patient and health system resources. Hospice care is a specialized alternative that vastly improves patient quality of life at end-of-life. This study was conducted to determine if hospices partnering with African American churches to disseminate hospice education materials could increase utilization of hospice services by African Americans. Members of two African American churches ( N = 34) participated in focus group discussions to elicit beliefs about hospice care. Focus group transcripts were coded and comments were grouped according to theme. Six themes were identified. Lack of knowledge about hospice services and spiritual beliefs emerged as the top two contributing factors for underutilization of hospice services. Study findings support partnerships between hospices and African American churches to provide hospice education to the African American community.
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Moore, Corey L. "Outcome Variables that Contribute to Group Differences Between Caucasians, African Americans, and Asian Americans who are Deaf." Journal of Applied Rehabilitation Counseling 33, no. 2 (June 1, 2002): 8–12. http://dx.doi.org/10.1891/0047-2220.33.2.8.

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The purpose of this research was to identify those dimensions of outcome variables (i.e., number of VR services provided, cost of case services, income, and number of hours worked at closure) that make the greatest contribution to group differences between Caucasians, African Americans, and Asian Americans who are deaf. Multivariate analysis of variance (MANOVA) and post hoc descriptive discriminant analysis (DDA) were utilized to evaluate 1,108 case records obtained from the RSA-911 database for fiscal year 1997. DDA results indicated that African-Americans were provided with significantly more VR services and achieved significantly lower levels of income when compared to Caucasians and Asian Americans. Results are presented for the discriminating variables and the implications of findings for research and practice are discussed.
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40

O'Brien, G. V., and C. Ellegood. "The Americans with Disabilities Act: A Decision Tree for Social Services Administrators." Social Work 50, no. 3 (July 1, 2005): 271–79. http://dx.doi.org/10.1093/sw/50.3.271.

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41

Chapman, David S. "Passenger Vessel Design and the ADA—Americans with Disabilities Act." Marine Technology and SNAME News 33, no. 01 (January 1, 1996): 11–13. http://dx.doi.org/10.5957/mt1.1996.33.1.11.

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The marine industry faces a challenge in making passenger vessels accessible to persons with disabilities. With the passage of the Americans with Disabilities Act, freedom of access has become the law of the land. Accessibility issues pertaining to vessel design include embarking and disembarking the vessel, paths of travel aboard the vessel (doorways, thresholds, aisles), multideck access, accessible bathrooms and other services, and emergency evacuation. Accessibility extends beyond the wheelchair user to include the blind and visually impaired, the deaf, and others. The design community, working with the passenger vessel owners and persons with disabilities, has an opportunity to develop creative solutions to the numerous problems of vessel accessibility.
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42

Crowe, Remle P., Roger Levine, Jennifer J. Eggerichs, and Melissa A. Bentley. "A Longitudinal Description of Emergency Medical Services Professionals by Race/Ethnicity." Prehospital and Disaster Medicine 31, S1 (November 28, 2016): S30—S69. http://dx.doi.org/10.1017/s1049023x16001072.

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AbstractObjectiveThe objective of this paper was to compare demographics, employment variables, satisfaction, and motivation for entering the field of Emergency Medical Services (EMS) between members of under-represented races/ethnicities and members of the majority group.MethodsA cohort of nationally certified EMS professionals was followed for 10 years through annual surveys; however, race/ethnicity was only available for 9 years (2000-2008). Descriptive statistics and 95% confidence intervals (CIs) were calculated and significance was determined by lack of CI overlap.ResultsFrom 2000 through 2008, the range of proportions of nationally certified EMS professionals by race/ethnicity was as follows: whites: 83.5%-86.0%, Hispanics: 4.2%-5.9%, and African-Americans: 2.5%-4.6%. There were no significant changes in the proportion of minority EMS professionals over the study period. Hispanics and African-Americans combined increased slightly from 6.7% of the population in 2000 to 9.9% in 2008. Likewise, the proportion of all under-represented races/ethnicities increased slightly from 2000 (14.0%) to 2008 (16.5%). Females were under-represented in all years. Nationally certified African-Americans were significantly more likely to be certified at the Emergency Medical Technician (EMT)-Basic level (compared with the EMT-Paramedic level) than whites in all but one survey year. The proportion of Hispanics registered at the EMT-Basic level was significantly higher than whites in three survey years. Accordingly, a larger proportion of whites were nationally registered at the EMT-Paramedic level than both African-Americans and Hispanics. A significantly larger proportion of African-Americans reported working in urban communities (population >25,000) compared with whites for nine of the 10 survey years. Similarly, a significantly larger proportion of Hispanics worked in urban communities compared with whites in 2002 and from 2005 to 2008. For satisfaction measures, there were no consistent differences between races/ethnicities. Among factors for entering EMS, the proportion of whites who reported having a friend or family member in the field was significantly higher than African-Americans in all years and significantly higher than Hispanics in four of the nine years.ConclusionThe ethnic/racial diversity of the population of nationally certified EMS professionals is not representative of the population served and has not improved over the 2000-2008 period. Similar to other health care professions, Hispanics and African-Americans are under-represented in EMS compared with the US population. This study serves as a baseline to examine under-represented populations in EMS.CroweRP, LevineR, EggerichsJJ, BentleyMA. A longitudinal description of Emergency Medical Services professionals by race/ethnicity. Prehosp Disaster Med. 2016;31(Suppl. 1):s30–s69.
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43

Lee, Minsun, Wenyue Lu, Tyrell Mann-Barnes, Jin-Hyeok Nam, Julie Nelson, and Grace X. Ma. "Mental Health Screening Needs and Preference in Treatment Types and Providers in African American and Asian American Older Adults." Brain Sciences 11, no. 5 (May 5, 2021): 597. http://dx.doi.org/10.3390/brainsci11050597.

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Older African Americans and Asian Americans in the U.S. underuse mental health services, despite their vulnerability to diverse mental health problems. This study examined their perspectives on the importance of various mental health problems, mental health treatment, and provider type preference. A total of 243 participants residing in Philadelphia were recruited through community-based organizations. Chi-square, ANOVA, and logistic regression were conducted to examine ethnic differences in demographic characteristics, mental health screening needs, and treatment preferences. African Americans were more likely to endorse the screening needs for depression (AOR: 3.77; 95% CI: 1.19–11.93, p < 0.05) and less likely to endorse the screening needs for suicide (AOR: 0.24; 95% CI: 0.08–0.76, p < 0.05) compared to Asian Americans. For treatment preferences, African Americans were more likely to seek help from primary care physicians (AOR: 8.26; 95% CI: 1.71–32.86, p < 0.01) and less likely to prefer medication as a treatment option (AOR: 0.36; 95% CI: 0.09–0.79, p < 0.05) than Asian Americans. African Americans and Asian Americans prioritized mental health screening needs differently and had different treatment preferences, indicating that matching community needs and preferences regarding mental health services is critical to improve mental service utilization rates in the targeted populations.
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Alston, Reginald J. "African Americans with Disabilities and the Social Security Administration's Return-to-Work Incentives." Journal of Disability Policy Studies 14, no. 4 (March 2004): 216–21. http://dx.doi.org/10.1177/10442073040140040301.

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45

Kibria, Gholam. "Professional And Legal Challenges Of Teaching Students With Disabilities In Postsecondary Education." College Teaching Methods & Styles Journal (CTMS) 1, no. 1 (July 21, 2011): 57. http://dx.doi.org/10.19030/ctms.v1i1.5219.

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With the passage of The Americans with Disabilities Act (ADA), students with disabilities have legal supports for reasonable accommodation with respect to physical accessibility, programs, and services. As a result, the number of students with disabilities who are enrolling at the postsecondary level has increased dramatically. The paper focuses on the challenges that faculty and administration have to face in meeting the needs of students with disabilities in postsecondary education and the reasonable accommodations that they could adapt to make education more meaningful to students with disabilities.
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46

Lee, Eun-Jeong, Jinhee Park, Jina Chun, and Sukyeong Pi. "State Vocational Rehabilitation Services and Employment Outcomes for Asian Americans with Psychiatric Disabilities." Community Mental Health Journal 56, no. 5 (January 10, 2020): 854–66. http://dx.doi.org/10.1007/s10597-020-00547-1.

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47

Chen, Roy K., Song-Jae Jo, and Chandra M. Donnell. "Enhancing the Rehabilitation Counseling Process: Understanding the Obstacles to Asian Americans' Utilization of Services." Journal of Applied Rehabilitation Counseling 35, no. 1 (March 1, 2004): 29–35. http://dx.doi.org/10.1891/0047-2220.35.1.29.

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Improving rehabilitation services for Asian Americans with disabilities through the rehabilitation counseling process remains as an ongoing challenge. Despite being the fastest growing ethnic group in the United States, past studies have reported low utilization rates of vocational rehabilitation and mental health services among this population. This article (a) describes Asian American views on disabilities from religious, philosophical, and spiritual perspectives; (b) reviews factors that may contribute to their being underserved in the rehabilitation; (c) discusses the influence of family dynamics on the rehabilitation process; (d) underscores unique employment challenges facing the Asian Immigrant community; and (e) draws out the implications of such an analysis for rehabilitation counseling.
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48

Keenan, Walter R., Joseph W. Madaus, Allison R. Lombardi, and Lyman L. Dukes. "Impact of the Americans With Disabilities Act Amendments Act on Documentation for Students With Disabilities in Transition to College: Implications for Practitioners." Career Development and Transition for Exceptional Individuals 42, no. 1 (November 18, 2018): 56–63. http://dx.doi.org/10.1177/2165143418809691.

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The Americans With Disabilities Act Amendments Act of 2008 expanded the legal definition of disability to establish broader coverage for individuals with disabilities, including college students, than the definition in the Americans With Disabilities Act of 1990. The new interpretation of the definition of disability shifted the main purpose of documentation from proving eligibility for services as a person with a disability to determining appropriate academic accommodations. This change in the law, and subsequent Department of Justice regulations, enhances the importance of documentation from a student’s secondary education experience that may provide relevant information concerning functional limitations and the need for academic accommodations. This article provides practical guidance to high school professional staff in preparing disability documentation for students’ transition to college.
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Pattin, Anthony J., and Ledric Sherman. "Experiences Among African American Community Members With Pharmacy-Based Immunization Services in Detroit, Michigan." Journal of Pharmacy Technology 34, no. 6 (September 19, 2018): 259–65. http://dx.doi.org/10.1177/8755122518801288.

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Background: Although vaccination rates improved modestly in the United States during the 2014-2015 season, racial and ethnic disparities in the use of vaccines persist. Pharmacy-based immunization programs expand access to immunization services; however, African Americans in one metropolitan community did not have the same level of access to this service as non-Hispanic whites. Objective: To examine the experiences of African Americans with pharmacy-based services and identify how pharmacies and pharmacy organizations can better service patients in urban communities with similar dynamics. Methods: This qualitative study utilized focus group discussions among African American residents in Detroit, Michigan, where there are reported disparities in access to pharmacists that immunize to learn more about their experiences with pharmacy-based immunization services. Results: Three major themes emerged: the pharmacy location is often more convenient and accessible than doctors’ offices, there is clear communication with the pharmacist, and perceived lower immunization fees at pharmacies. Participants found pharmacies easier to access in their community for immunization services. Consistent interaction with familiar pharmacists and pharmacy staff members facilitated strong relationships and dialogue between pharmacists and patients. Patients perceived costs for vaccines to be less at the pharmacy than at their physicians’ offices. Conclusions: Participants reported positive experiences with pharmacy-based immunization services and expansion of these services may influence more African Americans to receive recommended vaccines in this community.
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Dilworth-Anderson, Peggye, Geraldine Pierre, and Tandrea S. Hilliard. "Social Justice, Health Disparities, and Culture in the Care of the Elderly." Journal of Law, Medicine & Ethics 40, no. 1 (2012): 26–32. http://dx.doi.org/10.1111/j.1748-720x.2012.00642.x.

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This paper addresses two interconnected concepts — health disparities and social justice — as they pertain to screening, diagnosis of disease, and health care access among minority elders in the American society. Health disparities are defined as differences in treatment provided to members of different racial or ethnic groups that are not justified by the underlying health conditions or treatment preferences of patients. Disparities currently exist in many aspects of American health care. For example, when compared to whites, the infant mortality rate is higher for African Americans; health insurance coverage is lower for Latinos and African Americans; and ethnic minorities experience poorer care and survival rates for HIV, even after controlling for other confounding factors including income, insurance, health status, and severity of disease. Among older Americans, health status varies by race, income, and gender. Older minority Americans have consistently been shown to have worse health than whites of the same age group across measures of disease, disability, and self-assessed health. When compared to whites, elderly Latinos have higher rates of diabetes and disabilities, and older African Americans have more chronic conditions.
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