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TRANSPORTATION NEEDS: SURVEY OF INDIVIDUALS WITH DISABILITIES

Maureen A. Linden, Derek G. Kamper, Steven I. Reger, Ph.D., Thomas C. Adams The Cleveland Clinic Foundation, Department of Physical Medicine and Rehabilitation Cleveland, OH, USA

Abstract

In order to evaluate the transportation needs of individuals with disabilities, a survey was distributed to the mailing list of the local independent living services organization. In addition to basic demographic data, respondents were asked to report their modes and frequency of travel, fatigue information, seat belt use, driving frequency and accident rates. The results of the survey showed that all respondents use personal vehicles as drivers or passengers for transportation, while two-thirds use public transit. Respondents had a greater tendency to travel while seated in their wheelchairs when using public transit, and reported having difficulty with wheelchair securement and occupant restraint systems in all vehicles. The ability to leave the vehicle in the event of an emergency was also a major concern. Additional attention to comfort, ease of use, and emergency egress is necessary for wheelchair securement and occupant restraint systems, particularly for public transit vehicles.

Background

Transportation plays a vital role in an individual's ability to participate in society. The ability to travel outside the home allows opportunities for employment, recreation, and fulfillment of needs. The current focus in transportation research for individuals with disabilities is to provide the mobility aid users in personal vehicles with adequate protection in the event of an impact. While this issue is of great importance, the daily transportation needs of individuals with disabilities involves other concerns, for example availability and affordability of personal vehicles, scheduling of public and paratransit services, acquisition and management of appropriate adaptive equipment, and ease and comfort of wheelchair securement and occupant restraint. This paper begins to investigate some of these issues by reporting results of a survey of individuals with disabilities.

Research Question

The objective of this survey was to assess transportation issues for individuals with disabilities from the perspective of that population. Analysis of this information provides direction for future transportation research.

Methods

Individuals with disabilities were surveyed in order to evaluate their transportation needs. The survey was mailed with the local independent living service's newsletter. Since this was intended as a pilot survey, follow-up solicitation was not performed. Approximately 1.5% of the 5,000 surveys mailed were returned.

The survey requested information regarding basic demographic data: age, sex, and disability. Return postmarks were used to determine the geographic distribution of the respondents. The survey contained questions regarding travel frequency, driving frequency, seat belt use, and accident rates. Use of public and personal transportation was determined. Additional questions related whether the respondents transferred while traveling to type of mobility aid used and mode of transportation (personal or public transit). Open ended questions allowed free response regarding barriers to seat belt use and driving, as well as general traveling difficulties and safety concerns.

Survey responses were maintained on a database which facilitated searching and indexing of responses to multiple questions. In the results reported below, responses to each question may not total 100% because respondents frequently did not answer all survey questions.

Results

The population responding was approximately 35% male and 65% female. Sixty-three per cent of the respondents resided in the Cleveland metropolitan area, with an additional 11% from Ohio, and 15% from other states. Non-legible post-marks account for the remaining responses. The respondent's age (Table 1) and disability group (Table 2) were categorized. In addition to the disability groups shown, 8% did not list their disability, while approximately 20% of the responses provided sole representation of their disability group.

Table 1: Age of respondents

under 20 7
20-29 10
30-39 20
40-49 20
50-59 18
over 59 22

Table 2: Disability Groups

Spinal Cord Injury 21
Polio 18
Multiple Sclerosis 14
Cerebral Palsy 11
Head Injury   4
Muscular Dystrophy   3
Stroke   3
Spina Bifida   3
Arthritis   3

All of the respondents reported using personal vehicles either as drivers or passengers, while 56% of the respondents use public transit. The majority (62.5%) use transportation daily either as a driver or passenger. Although 22% of the respondents do not drive or use public transit, approximate 40% of this group travels on a daily basis and an additional 40% travel several times a week.

Approximately half (51%) of the respondents do not drive. The most common barriers to driving reported by non-drivers were limited range of motion (54%), financial reasons (41%), weakness (38%), and lack of balance (32%). Of those who drive, 47% drive cars, 32% drive modified vans, 12% drive vans, and 7% drive minivans. Sixty-five per cent of these individuals have not been involved in an accident in the past five years, while only 6% had been involved in more than two and none had been involved in more than four accidents. Over half (54%) of those who drive also use public transit.

Seat belt use is summarized in Table 3. Encouragingly, 69% reported always using a seat belt. Contributing reasons cited included safety (83%), to comply with the law (44%), and to provide balance (43%). Reasons cited for not using seat belts were difficulty in application (13%), discomfort (11%), and interference with driving or other activities (4%).

Half of the respondents reported using a manual wheelchair during transportation, while 29% used power wheelchairs, 15% used scooters, and 7% did not use a mobility aid. Table 4 shows respondent transfer characteristics based on type of mobility aid used for personal and public transportation. In general, for all traveling in their wheelchairs 60% use public transit and 40% use personal vehicle transportation.

Table 3: Summary of Seat Belt Use

Seat Belt Use
Always 69
Often 10
Sometimes 4
Never 7
To Drive 6
As Passenger 1

Table 4: Percent of Respondents who Travel in Wheelchairs

                 

Manual     WC   Power    WC          Scooter       Total
Public Transit    14 21 25  60
Personal Transit      6 22 43  40
Totals  20 43 37 100

Sixty-five per cent of the respondents reported having at least minor problems maintaining balance, while 29% reported no balance problems. Sixty-seven per cent of those without balance problems drive, while only 40% of those with balance problems drive.

Open ended questions requested the respondents to report the aspects of transportation which they found most difficult or unsafe. Vehicle ingress and egress including loading mobility aid into the vehicle and transferring to the vehicle seat was the most frequently reported difficulty, with 20% of the respondents citing this. Seventeen per cent of the respondents reported safety concerns with wheelchair securement and occupant restraint systems, including issues such as ease of use, the ability of the wheelchair user to release these systems in the event of an emergency, and training of public transit vehicle operators in correct securement and restraint techniques. An additional 7% reported their biggest transportation difficulty was scheduling rides and finding appropriately trained drivers.

Discussion

While this pilot survey provided a relatively small sample size and geographic distribution, trends in the data can begin to be identified. Future surveys will continue to address specific questions and distribute the survey to a much broader population.

The majority of the individuals surveyed travel on a daily basis even though over half do not drive and approximately a quarter of those do not use public transit. It is assumed that these individuals are scheduling rides with others or private transit services. It is possible that many of these individuals could use public transit as more public transit providers become compliant with the ADA and travel training programs are utilized.

An individual's desire to transfer to a vehicle seat for travel can be related to their type of mobility aid and whether public or personal transportation is used. As shown in Table 4, wheelchair users have a greater tendency to travel while seated on their mobility aid when using public transit. Since the larger percentage of those traveling in their wheelchairs are using public transit, an increased priority should be placed on addressing wheelchair securement issues for public transit vehicles.

The most common reason reported for not using seat belts was difficulty in their application. Additionally, using wheelchair securement systems was one of the most frequently cited difficulties. Concern was also expressed over release of securement system and vehicle egress in the event of an emergency. Further work is needed to ensure that wheelchair securement and occupant restraint systems are easy and convenient to use and can be released by the wheelchair user in the event of an emergency.

Acknowledgments

The authors would like to acknowledge Margaret Meyer, Cleveland Services for Independent Living, who assisted with the distribution of this survey.

Maureen A. Linden Department of Physical Medicine and Rehabilitation Cleveland Clinic Foundation 9500 Euclid Avenue Cleveland, OH 44195 USA (216) 445-9306

Transportation Survey