The practical potential of self-advocacy for improving safety outcomes for school-aged workers

Young workers are over-represented in workplace injury statistics and there is growing interest in addressing their vulnerability and safety exposure. Such concerns have been raised within a broader discursive framework of responsibilisation which has seen a transfer of responsibility for workplace safety from employer to worker. This article examines the potential for self-advocacy as a strategy for improving the safety of young workers through the provision of resources to articulate and act on workplace rights. The study utilises data derived from 48 group interviews involving 216 high school students (13–16 years of age) at 19 high schools in Queensland, Australia, who were asked to discuss their knowledge and experience of workplace rights and responsibilities. The limitations of the safety self-advocacy approach are explored, including the social, developmental and organisational issues that might affect the ability or willingness of school-aged workers to self-advocate. The findings reveal that the notion of self-advocacy is internalised by young people before they even enter the formal labour market but that in practice, attempts by young people to enact rights to safety are often dismissed or undermined.

The Relationship Between Social Support and Self-Advocacy in College Students With Disabilities

This study explored the connection between social support and self-advocacy in college students with disabilities. The College Students with Disabilities Campus Climate Survey (Lombardi, Gerdes, & Murray, 2011) was used to gather data from undergraduate students at a midsize western private university. Social support was found to be a significant predictor of self-advocacy in college students with disabilities. Peer support, family support, and faculty teaching practices made up the construct of social support. Peer support and faculty teaching practices were found to be significant predictors of student self-advocacy. Family support was not found to be significant. The data was examined for group differences between genders, disability types, and disability status (high incidence disabilities versus low incidence disabilities). No significant group differences were found. These findings suggest helping students build social support will increase their level of self-advocacy, which in turn may increase academic success.

Creating a Space for Self-Transformation: Factors of Success for Adult Literacy Learners with Specific Learning Difficulties

A significant number of adults in adult literacy programs in Ontario have specific learning difficulties. This study sought to examine the holistic factors that contributed to these learners achieving their goals. Through a case study design, the data revealed that a combination of specific learning methods and strategies, along with particular characteristics of the instructor, participant, and class, and the evidence of self-transformation all seemed to contribute to the participant's success in the program. Instructor-directed teaching and cooperative learning were the main learning methods used in the class. General learning strategies employed were the use of core curriculum and authentic documents, and using phonics, repetition, assistive resources, and using activities that appealed to various learning styles. The instructor had a history of both professional development in the area of learning disabilities as well as experience working with learners who had specific learning difficulties. There also seemed to be a goodness of fit between the participant and the instructor. Several characteristics of the participant seemed to aid in his success: his positive self-esteem, self-advocacy skills, self-determination, self-awareness, and the fact that he enjoyed learning. The size (3-5 people) and type of class (small group) also seemed to have an impact. Finally, evidence that the participant went through a self-transformation seemed to contribute to a positive learner identity. These results have implications for practice, theory, and further research in adult education.

Reflections on being a first generation self-advocate: belonging, social connections, and doing things that matter

Background Despite good policy intentions, people with intellectual disability continue to be socially excluded. Social geographers suggest the potential of self-authored spaces as catalysts for social inclusion. One such space, self-advocacy, is commonly perceived as part of a political movement for social change rather than a vehicle for social inclusion of its members. This paper investigated what involvement in self-advocacy has meant to long-term members of a self-advocacy group in Victoria, Australia. Methods In-depth interviews were conducted with 12 self-advocates about their reflections on involvement in the group. These data together with the commentary of 5 self-advocates during interviews with 18 self-advocacy supporters about their recollections of involvement in the group were transcribed and analysed thematically. Findings Through their involvement in self-advocacy, members of the group had gained a sense of belonging, social connections, and purposeful occupation, which included paid project work, lobbying, and organisational leadership and management. Conclusions This study suggests that self-advocacy groups can be places that foster social inclusion, potentially offering “membership” of an exclusive group, a wider social movement and of mainstream society.

Apoyando proyectos de vida inclusivos: claves para transformar las prácticas socioeducativas de personas adultas con discapacidad intelectual

En el marco del modelo social de la discapacidad cobran importancia la autodeterminación y autogestión de las personas con discapacidad intelectual, replanteando la relación de poder entre profesionales y usuarios. Por ello, la transformación de las prácticas socioeducativas en la construcción y logro de proyectos de vida personalizados constituye un reto para los servicios dirigidos a personas adultas con discapacidad. El objetivo del presente artículo es mostrar, a partir de la revisión de literatura y el análisis de buenas prácticas, algunos elementos clave que facilitan esta transformación. En primer lugar, se presentan las líneas principales de la nueva conceptualización de las personas con discapacidad intelectual como protagonistas de sus proyectos de vida. Seguidamente, y después de contextualizar brevemente el escenario formado por los servicios de adultos en España, se presentan algunas estrategias e instrumentos básicos para la transformación de las prácticas educativas. En las conclusiones se incide en los retos que estas claves plantean en nuestro contexto

A collaborative group method of inclusive research

Funding bodies in Australia and the United Kingdom require research on issues that affect the lives of people with intellectual disability to be inclusive. Debate continues about the nature and benefits of inclusive research, which has become an umbrella term encompassing a broad spectrum of approaches.

Reflections on doing inclusive research in the 'making life good in the community' study

BACKGROUND: The involvement of people with intellectual disability in research is framed as inclusive, denoting their active participation in its processes. However, questions are raised about ownership and control, genuineness of involvement, and the need for honest accounts to develop practice. Such issues are particularly pressing in Australia, where there is the absence of a strong self-advocacy movement to partner with academics or hold them to account. METHOD: Action research was used to reflect on and progressively refine the support provided by a research mentor to a co-researcher with intellectual disability employed on a large multimethod study. RESULTS AND CONCLUSIONS: Accepting the co-researcher's strengths and designing support on the job rather than teaching them to "pass" before venturing out in the field are important in ceding control. Support required for a co-researcher is more than practical and involves developing a relationship that can actively challenge views and foster reflection. Ownership of questions and disseminating of outcomes are hampered by contextual factors such as tender processes, short-term positions, and a failure to acknowledge the support required to present findings.

Inclusion in political and public life: the experiences of people with intellectual disability on government disability advisory bodies in Australia

BACKGROUND: Civil and political participation lies at the core of citizenship. Increasingly, people with intellectual disability are members of disability advisory bodies. This study investigated the political orientations of advisory body members with intellectual disability, their participatory experiences, and the types of support they received. METHOD: The 9 people with intellectual disability who in 2005 were members of disability advisory bodies at a state, national, and Victorian local government level were interviewed, together with 12 other members or secretariat staff of these bodies. Observations were also conducted of advisory body meetings. RESULTS: The political perspective of members with intellectual disability varied, but all had a background in self-advocacy. They found the work hard but rewarding and encountered both practical and intangible obstacles to participation. Members received varying types of practical support, but a supportive collegial milieu was characteristic among members who felt most confident about their participation. CONCLUSIONS: The milieu, structures, and processes of advisory bodies must all be adjusted to accommodate people with intellectual disability if they are to participate meaningfully.

How do older people with sight loss manage their general health? A qualitative study

Purpose: Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Methods: Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Conclusion: Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

Organizational response to employment under the ADA of workers with psychiatric disabilities: Four case studies

Title 1 of the Americans with Disabilities Act (ADA) requires all employers, public and private, with more than fifteen employees to provide reasonable accommodation to qualified individuals with disabilities if the accommodation would, within limits, allow the individual to perform the essential functions of the job. Seven years after Congress enacted the law and five years after the initial provisions became effective, little information is available about the experience of organizations faced with requests for workplace accommodation.^ The question addressed in this study is: How are organizations responding to the ADA mandate to fit individuals with psychiatric disabilities in the workplace? The data sources are three organizations that allowed access to this sensitive information, and a fourth that had two disability discrimination charges filed against it.^ A brute-force case method approach applied to the four organizations yields the following information: Attorneys are hesitant to allow inquiry into company policy owing to fear of litigation; workers are not disclosing and requesting accommodation; tacit accommodation of long-standing employees appears to be a regular practice; knowledge of the intent of the ADA makes a difference in terms of equality of treatment; and insensitivity to employee privacy results in an adversarial situation.^ Implications are relevant to the need to improve lines of communication between human resource, EEO, supervisory, and legal staff; consequences of failure to address accommodations on an explicit level; need for better understanding of the availability and use of outside resources for achieving accommodation; and improvement of self-advocacy and disclosure by the employees with disabilities. ^

*Postsecondary access for individuals with psychological disabilities: An analysis of federal rulings and institutional philosophies, *policies, and practices

This study was a qualitative investigation, with demographic quantitative features, of post-secondary educational access and legal guidelines for individuals with psychological disabilities. Although disability laws have positively influenced post-secondary educational attitudes and practices relative to accommodating many individuals with disabilities, prevailing stigmas regarding mental illness have discouraged the equal access to higher education for individuals with psychological disabilities. Little research concentrating on this area was found.^ Thirty-six relevant legal case decisions, focusing on a variety of realms of higher education, were scrutinized. The policies, procedures, and practices of six Southeastern United States universities were analyzed through official documents and participant responses from disability service providers and other university employees. Comparisons were made between legal cases, and within and between universities. Case findings also provided standards through which participating university practices could be studied.^ The legal analysis revealed that most institutions did not discriminate against individuals with psychological disabilities. Practices of a few of these institutions, however, suggested non-compliance despite favorable decisions on their behalf. Institutions found to have discriminatory practices were cited for inadequate procedures, or for presumptive assessments of the educational functioning levels of individuals with psychological disabilities.^ Participant university practices generally suggested disability law compliance; however, certain campus interventions were determined to be ineffective in identifying, addressing, and communicating about the educational needs of individuals with psychological disabilities. The most effective services for these individuals, who were described as rapidly increasing in number but lagging in self-advocacy and acceptance by others, went beyond legal requirements.^ Recommendations were made for institutional practices concerning disability-related documentation, written standards and operations, and student identification and referral. Directions for future research focused on study skills training for students; exposure of mental health professionals to client educational needs; and expansion of the current research, on a nationwide collegiate level, and a parallel analysis focusing on business and industry. ^

The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility.

AIMS AND OBJECTIVES: To obtain an understanding of how health professionals support the kidney transplant patient to take their medications as prescribed long term. BACKGROUND: Kidney transplantation requires stringent adherence to complex medication regimens to prevent graft rejection and to maintain general well-being. Medication nonadherence is common in kidney transplantation, emerging in the first few months post-transplantation, leading to poor patient outcomes. DESIGN: Exploratory qualitative design. METHODS: Five focus groups were conducted with a total of seven renal nurse transplant coordinators, two renal transplant nurse unit managers, seven nephrologists, seven pharmacists, four social workers, and one consumer representative representing all five hospitals offering adult kidney transplantation in Victoria, Australia in 2014. The views of two general practitioners who were unable to attend the focus groups were incorporated into the data set. All data underwent thematic analysis. RESULTS: Analysis revealed that adherence was a collective responsibility involving the whole of the transplant team and the patient via education blitz in hospital, identifying and managing nonadherence, promotion of self-advocacy, and the partnership between the patient and health professional. Patients were directed how to take their complex medications to be self-empowered, yet the partnership between the patient and health professional limited the patient's voice. CONCLUSION: Although medication adherence was a collective responsibility, communication was often one-way chiefly as a result of staffing and time constraints, hindering effective partnerships necessary for medication adherence. Expert skills in communication and adherence counselling are necessary to identify barriers affecting medication adherence. Patients need to be systematically screened, prepared and supported long-term within an accommodating healthcare system for the reality of caring for their transplanted kidney. RELEVANCE TO CLINICAL PRACTICE: Kidney transplant recipients require systematic preparation and quality long-term follow-up to adhere to their prescribed medications.