NAVIGATING BARRIERS TO ACCESSIBLE TRAVEL: STRATEGIES TO IMPROVE COMMUNITY INTEGRATION FOR INDIVIDUAL WITH SPINAL CORD INJURIES

N.C. R. Tamayo¹, J. Balhorn², J. Burger², E. Heinlein², N. Hinderer²

¹Tamayo Physiatry, LLC, Cleveland, United States, ²Cleveland Clinic Rehabilitation Hospital, Copley, United States

Background: Travel is reported as the most disrupted social activity for persons with spinal cord injuries (PwSCI) (Carpenter, 2007) but is desired and needed in the same way as their non-disabled counterparts. Travel is also one way to help PwSCI re-integrate back into the community, promote independence, and improve overall quality of life (Yau et al 2004). Thus, becoming travel active does not only encompass traveling to domestic or international destinations but also includes a successful reintegration to the community post injury. However, The National Spinal Cord Injury Statistics Center reported 38% of PwSCI had not spent a night away from home in the past year, of which 25% did not leave their houses even once a week. While successful community reintegration requires overcoming many barriers, with appropriate research, planning and patience, it is feasible for PwSCI to travel to the destinations of their choosing, whether that be Paris or a local concert.

Purpose: To develop a training program to empower PwSCI navigate barriers to travel.

Methods: A mini-manual was developed from a larger SCI travel guide (currently in publication) based on American Spinal Injury Association (ASIA) Standards, SCI traveler resources, and professional contributions. Ten PwSCI were chosen based on qualifying criteria. Participants completed a pre- and post- survey to assess their knowledge and confidence. Travelers chose one of three offered experiences after a training on use of the guide conducted in a small group, virtual setting. Travelers used their trainings and the mini-manual to plan and execute the outing. A pre- and post- support group with all participants was used for qualitative data collection and participant support.

Results: Eight participants completed the program. One dropped due to rising COVID cases and another due to family matters. Our results showed: (1) the program lessened the anxiety with travel and increased the knowledge and confidence to plan, go, navigate barriers, and handle emergencies; (2) the need for accurate online accessibility information to decrease unforeseen challenges; (3) the importance of peer support in contributing to the participants’ success and desire to do other activities and travel beyond their community; (4) the improvement in participants’ confidence and likelihood to travel within and outside their communities after completing the program. Challenges still occurred during the outings, including lack of accessibility knowledge and issues with the built environment.

Conclusions: The use of support groups, the mini-manual, and training on the manual created successful experiences for PwSCI. The project was successful in addressing barriers to community reintegration and travel for SCI individuals. Participant feedback made it clear the importance of incorporating such training into a PwSCI's reintegration back to the community for improved quality of life.

Implications: Next steps include publishing The SCI Traveler Guide, improving accessibility information and access for local outings, adapting the ADA section of the travel guide to reflect disability rules for partnering countries in collaboration with professionals and persons with disabilities in those countries, and partnering with American Spinal Injury Association, national and international rehabilitation teams, and the American Physical Therapy Association for information dissemination.

Funding acknowledgements: This project was sponsored by The Rehab Collaborative Network - Tamayo Physiatry, LLC.

Keywords:
Spinal cord injury
Accessibility
Travel

Topics:
Neurology: spinal cord injury
Professional issues: diversity and inclusion
Professional issues

Did this work require ethics approval? No

Reason: This project did not contain human subjects research but rather was an internal project evaluation. The internal project evaluation was not designed to generate generalizable knowledge but to understand the effectiveness of the SCI Traveler Manual that was created from the established American Spinal Injury Association (ASIA) Standards, SCI traveler resources, and professional contributions. We believe this project created innovative ways in which established methods and knowledge have been used to meet the needs of persons with spinal cord injuries returning to travel. This project was reviewed by all involved parties to ensure collaboration and agreement between authors.