Expanding Access to Recreation in Maine
for People with Disabilities:
A Report of Findings from a Focus Group with Fitness Facilities
by Elise Scala and Mark Richards, Edmund S. Muskie School of Public Service
(February 2003)
Introduction
This report summarizes the findings of a focus
group session with non-profit fitness facilities in the greater Portland, Maine
area. The purpose of
the session was to collect information from a representative group of facilities
regarding the utilization of fitness facilities by people with disabilities;
and to determine facilities’ interests in expanding disability access;
their resource needs to support expansion; and the preferred methodology
for staff to access resource information. The results of the session will
inform the development of resource materials for fitness facilities to expand
opportunities for people with disabilities.
The focus group participants represented a very positive response from the
non-profit facilities that were invited to the session. It was noted by
participants that the session provided an occasion for them to be together,
and that this had not happened before. It should also be noted that work
was done to organize a second focus group session of private/for-profit fitness
facilities. While the telephone contact identified people for a small
focus group session, most did not attend on the scheduled day. The one
Southern Maine fitness business that did attend was interviewed and the results
were as favorable and informative as the full group session with non-profits. Additional
interviews may be conducted in the future to survey this sector to get feedback
on draft materials and to inform them of the resources.
The primary findings of the session were that facilities have experience working
with people with disabilities and all have priorities to provide services to
meet the needs of a diverse population of members and the public that include
people with different types of disabilities, adults and seniors. Attending
municipal recreation programs serve children too, and rely on their individual
staff, family members and affiliated schools to accommodate special needs. The
willingness of all facilities to be responsive to individual requests and needs
for accommodation coexists with limited resources (staff, time, money, equipment,
space and information). This confirmed for the project staff that facilities
need resources to meet current needs and to expand opportunities for people
with disabilities. While resources like buildings, equipment and staffing
are beyond the scope of this project the session helped to identify what information
resources and technical assistance would support facilities’ current
programs and staff to be responsive to requests/needs for accommodation. The
findings are organized in this summary report and will be used to inform the
development of a web-based and print-available format for facility staff. Completion
of this project will support a concurrent initiative to inform people with
disabilities, and the individuals and agencies that provide support services
for them, about fitness facilities as a means to building and sustaining an
active and healthy life.
Acknowledgements
While confidentiality keeps us from naming
the focus group participants we would like to thank them for taking the time
to respond to our calls, attend the session and to give us feedback.
This project is part of the Quality Choices for Maine, Real Choices Systems
Change Grant funded through by the federal Centers for Medicare & Medicaid
Services in partnership with the Maine Department of Human Services.
Focus Group Description and Responses
Fitness Facility Focus Group: Non-Profit Sector
Format: Eight facilities were represented and
the session was facilitated by a Paul Saucier, Director of the Chronic Illness,
Disability and Aging Center at the Muskie School. Project staff, Mark Richards
and Elise Scala recorded the comments. Procedures for informing the participants
and organizing the session were pre-approved by the University Office of Research
Compliance in accordance with laws and policies regarding human subject research. Consent
and confidentiality agreement statements were obtained. The session was
two hours long and the facilitator used key questions and an organized process
to ensure full participation to guide the discussion. The responses are
listed below.
Participants: The non-profit facility group represented area Y’s, Municipal
recreation and University based programs with fitness facilities.
What motivated you to attend today's program?
- Expect to expand (building, program, members) and know that access is needed.
- Aware
of increased number of elderly and people with disability, looking for
ways to accommodate.
- Experience with having participants with disabilities (children
in summer camp programs, elderly patrons, specific requests/needs of spouse
with Alzheimer’s
disease, patron with MS) and want to provide programs for them.
- Want to integrate
people with disabilities into general programs.
- Participating in a Universal
Access Feasibility study.
- Need for resources for equipment and training.
- Want to learn more about interests/needs
of people with disabilitiesLooking for training and research opportunities.
- To
share experience.
- We’ve been approached and want to learn more.
Defining Disability: What does it include?
List: Physical, Mental, Visual, Hearing, Developmental, Chronic illness, age-related
Participants agreed with the comprehensive definition. Their experience was
not limited to physical disabilities, and they provided examples that illustrated
a range of disability by type, age and support needs.
Who are you seeing in your facilities?
- “We see them all.”
- Seeing more individuals with all types of disabilities
- Attention Deficit (ADHD)
- Individuals, some family requests, some group homes
- Parents wanting child to have integrated, group experience
- “Now... we have the community center groups... coming in.”
- Challenge of individuals needing more one-on-one assistance
- Walk-ins that need support.
- Seeing an increase in older women coming in to use the facility.
- Seeing a lot of seniors being referred by health care providers.
- People attending programs with a care-giver. Some programs/facilities can
offer caregiver brief respite during a program, and they can participate
in their own program.
- Sometimes we don’t know a person has a disability until they begin
their class.
- Municipal recreation programs may have seniors attending the fitness programs
and children with disabilities in their summer and after school programs
- Facilities with swimming pools may have a different clientele and ages
with a range of disabilities (compared to a specialized rehab/fitness program
where people are referred by physicians-cardiac/pulmonary rehab and they
don’t
have walk-ins)
- Increased popularity of free in-door track facility (concern that many
coming from other towns and may be limiting access for locals)
What needs have you identified in responding to these requests/needs?
- A medical director has been helpful for working with the chronic illness
programs and serves as a referral for responding to medical questions
- Medical director
serves as link to the medical community
- Need for guidelines on how to accommodate
for different disabilities
- (Children) Need to connect and maintain connection with school nurse and
guidance counselors
- Private changing areas for accommodating families and male/female partners
or client/caregiver pairs
- Assistance in knowing ‘how far to go to accommodate a person’
- Experience of feeling pushed by a person who needed a lift for the
pool and requested one for the hot tub too. Facility purchased 2nd lift
and the person stopped attending
- Resource information/program listing so people can be referred to appropriate
programs and facilities with the access and programs they need
- “Do we have to serve anyone that walks in because we’re a public
service? If you don’t have the staff/expertise/accommodations
do you refer them to other places? (Yes, the Y)”
- “We don’t have all the answers. They come to us to find
out where they can go”
- “Should one place serve lots, and be the specialist?” “Is
this too much?” (One person said it’s self-limiting with location/cost…)
- Need for resources for public recreation for increased summer activity
- Want resource information on specific types of disabilities. (“average
recreation facility doesn’t have the resources, like a medical director”
- Need to go to public school system and experts to get information
- People, and sometimes even their doctors, need assistance to assess and
prescribe exercise restrictions/options
- Concern for liability
- More equipment, space for providing access, money, staff, grants
- Customized, accessible equipment and more space
- Transportation resources/options to get people to and from programs. Need
drivers and the resources to pay them
- Some programs do not need much: Open track sessions with no assigned staff
for guidance and assistance is very popular and people may come in pairs
Staffing Needs
- Hard to keep staff, jobs are part time, low paying, no benefits, can’t
compete with private sector wages
- Hard to find and keep qualified staff
- “If they’re good, they’re gone”
- Need to connect with Therapeutic Recreation students
- Need drivers and the resources to pay them
- Need a list of agencies with expertise in particular areas to get technical
assistance from
- Hard to evaluate staff skills for working with disability (they may be
qualified for teaching fitness or aquatics, be a PT or Recreation instructor,
but did their training include how to work with people with disabilities?
Note: Physical education majors are required to take 2 courses on disability/adapted
PE.
Governance Levels: Amount of input/recommendation for serving people with
disabilities?
- Municipal Recreation: Chain of command from Director is to City Counselor
and City Manager. Program request do not come from above. More bottom
up, responsive.
- Budget allows for hiring aides for children in the summer.
- Board pushes to provide increased level of services, hired a Development
Director to find the resources.
- Main mission of the organization states that it is open to all, irregardless
of ability to pay. So, impetus to accommodate is 2 way, top down and bottom
up.
Finances: How do people pay for programs/services?
- Membership fees and United Way funds
- Scholarships are offered by most facilities. “Don’t want
the money to be the barrier” (i.e., “ask and you shall receive”).
- Free programs do not get regular attendance/commitment so include some
charges.
- Caregivers and Personal Services Assistants who accompany individuals are
not charged.
- Rec programs budget for summer aides for children with disabilities.
- Municipal program: change from general membership fee to program fees for
passes to each facility, pool, fitness center.
- Variety of payment options, multi-month plans
- Group rates negotiated for group home residents
- Off-site programs at nursing homes offered and will train nursing home
personnel.
Individual stories that describe how a person with disabilities has been served
at your facility
- Person with brain injury in a nursing home: Staff member initiated services,
arranged transportation by town ambulance, set up individualized strengthening
program. Person has developed mobility and strength and has increased his program
involvement. Staff took initiative to get him independent living skills training
from another agency, adapted equipment (tennis wheel chair via the US Tennis
Association), and he has set a goal to play tennis
- Parent request to enroll child with Asperger’s for summer camp. “I
called the school and the teacher and guidance counselor gave us information
we needed to learn more” Recreation director could then train/prepare
staff and the child had a good experience. Knowing there is a disability,
gathering information, training staff, communication with the mother = success.
- Example of lack of disclosure and communication: Child enrolled in camp
without disability information disclosed. Child was disruptive and when director
talked to the mother she mentioned that he was hearing impaired. Counselors
were informed, changes were made, and the experience improved for everyone.
- College students assist with senior programs. Supplements staff.
- Many clients who use a personal trainer have a disability. Facility operates
in a fairly affluent area where most can afford to pay for the personal
trainer.
- Small facility with only one staff on duty almost always recommends a personal
trainer to individuals that need one-on-one assistance.
- Elderly couple; man with Alzheimer’s disease, wife needed assistance. While
staff levels make it difficult to give the man one-on-one assistance while
covering the program it gave the wife some much needed respite time. ”Elderly
patrons may have the money for services/assistance, but they don’t
know who to call or what to do” We called the Alzheimer’s Association
and linked her to programs that could assist her.
- Recreation program and child with autism. Information from mother and opportunity
to visit the child’s school program provided information for knowing
how to accommodate the child’s needs.
- Helping a morbidly obese woman with a developmental disability meet her
weight loss goals. Requires one-on-one assistance a lots of encouragement.
Training
- Municipal program provides 2 days of training prior to summer camp. The
information is based on the what they know about the children’s needs.
- Worked with the parents and observed the child in another setting to prepare.
- Utilize contacts at Spurwink school to get information or to provide training.
- Recreation program has 4 day training before summer camp. Bring in nurses
and counselors from the school to train for bee stings and other procedures.
- Facility is an ACSM (American College of Sports Medicine) member and follows
best practice guidelines/standards. These guide staff qualifications
and training. Challenge is that it’s not clear how much prior training
or experience the staff have had pertaining to disability.
- “How much experience do our instructors have with disability? If
the instructor says “I’m comfortable” this means they have
enough training”.
- Focus on fitness training resources available through the Sports Medicine
program?
- Member of SMART: Southern Maine Area Recreation Tech group has monthly
meetings. It’s a support group where disability concerns can be discussed.
Issues
- Physical access requires space for proper layout of equipment and building
changes.
- Parking: more people are using handicapped stickers/placards
- Electric doors weren’t installed when the building was constructed
- Elevator had to be installed
- Lack of space in fitness facility to accommodate wheelchair mobility
- Pool: Need lifting device and temperature control
- Bathroom and shower facilities: One recreation/community facility has 4
family locker rooms, separate from the common area, with showers and bathrooms
that offer privacy and accommodates mixed genders
- Communications: No TDD (telephone device for the deaf) necessitated “use
of the fax to communicate with a customer. It was a hassle and he didn’t
come back”
- Some facilities use e-mail
- Written materials: limited acknowledgment on the cognitive/literacy concerns
What resources would be helpful and what format would be useful for you?
- Web-based information would be good, but also want hard copy that can be
handed out to board members
- List of available resources, “places I can call to gather information,
someplace to go to look up information on disabilities”
- Links to Alpha One, Maine Handicapped Skiing
- Resources for adapted equipment
- Social services support program resources to information on how to make
referrals
- “Agencies should be informed of what we do and what resources are
available”
- Information on codes on physical access, simplified
- Training opportunities for staff (“I attended a training program
with Maine Handicapped Skiing. It included experiential learning (ski blind-folded)
- Legal information
- Emergency response protocols
- Information and opportunities to network (municipal groups use local schools)
(SMART: Southern Maine Area Recreation Techs)
- Funding sources
- Grant information
- Self Assessment survey tool to evaluate access
- Hire staff with disabilities to increase your information
- Specific information on the various conditions and illnesses
- How to retain people in programs? (Comment: Patrons with chronic illness
will cycle in and out due to health problems)
Summary of Findings
The recorded comments from the focus group
can be organized into key areas according to the purposes of the session; to
identify
- facilities’ interests in and needs to provide accommodation for people
with disabilities;
- their resource needs for responding to accommodation needs and to expand
access; and
- the format /method of delivery of the resources that would be utilized
by their staff.
Interests in, and needs to, provide accommodation for
people with disabilities: All participants spoke of their interests in accommodating their members and
the general public when notified of a disability or a request for accommodation. The
basis of this interest varied from being responsive to recent experiences working
with a person with a disability and a recognized increase in the population
of elderly and people with disabilities accessing their programs, to being
pro-active and seeking information for future building and program expansions
and seeking resources for staff training, research, new adaptive equipment
and designs for integrated programs.
Resource needs for responding to peoples’ needs and to expand
access for people with disabilities: Participants talked about a range of resource
needs. These have been organized into groups.
1. Building, program/equipment space, parking facilities:
- Self-assessment survey tool to evaluate facility and program accessibility
2. Equipment:
- Adapted fitness equipment: what’s available, how to customize and/or
purchase it
- Electric doors, elevators and other building/facility access equipment
- Communication devices (TDD/TTY, relay services, interpreter services)
3. Staffing:
- Recruitment and retention of skilled staff
- Listing of schools that train/educate fitness/recreational therapy instructors
and information about how they prepare students to work with people with
disabilities
- Hiring people with disabilities
4. Design tips:
- Changing rooms to accommodate family help and mixed gender with caregivers
- Protocols for inquiring about disability
- Techniques for reducing liability
- Emergency procedures to ensure response to medical and safety needs
- Facility design for universal access
- Program ideas for retaining people in fitness programs
5. Staff training and support:
- Opportunities and resources for training staff about disabilities and accommodations
- Professional networks for sharing and learning about adapted fitness
- Accessing medical expertise (when you don’t have a medical director
- Tools to assess and develop staff knowledge and skills for meeting needs
of people with disabilities
6. Programs and Services
- Information on adapting programs like health assessment procedures, activity
programs/classes and services
7. Information:
- Compliance information: Legal, access codes and ADA guidelines (simplified)
- Disability: Resource information describing disability and accommodation
needs
- Adaptive equipment: Resources for purchase and rental
- Funding resources, grants, tax credits
- Assessment techniques
- Consumer disclosure protocols and etiquette
- Recommendations for working with referral agencies
- Resource links to organizations with expertise in fitness and disability
- Resource links to organizations that provide technical assistance for disability
accommodation
- Referral sources of area agencies, schools, physicians
Format /method of delivery of the resources that would
be utilized by their staff: All participants responded favorably to the idea of a web-based resource
of information and contact sources, but also said that a paper copy would be
useful for sharing information with staff. It is important to note that
the primary method of gathering information described by participants in situations
when disability related information was needed involved contacting others;
agencies, schools, student’s family member, and/or colleagues. The success
of this session, as an opportunity for discussion of a topic of common interest,
also points out that networking with peers is an important method staff can
use to gather information and get support.
Proposed Project Plan
The goal of this project is to utilize
the focus group findings to develop a resource guide for fitness facilities
that will assist them to accommodate the needs, and expand opportunities, for
people with disabilities to access their programs. The project staff will
develop a web-based resource guide that focuses on the categories listed in
the summary of findings on pages 9 and 10 of this report. While providing
funds for buildings, equipment and staffing is beyond the scope of this project
contact information related to these will be included in the resource guide.
The preparation of the resource guide will be the primary work of the project. The
development and design will be done in conjunction with the Information Access
Project, an associated grant project at the Muskie School, that will provide
links to a comprehensive array of resources for disability information and
services. To ensure ease of use, and respond to the request for printed
materials, the website and links can be downloaded and/or printed.
Once the resource guide is completed and the web site is activated printed
materials will be sent to fitness facilities and advertised to notify programs
of the resource. Technical assistance for training fitness facility staff
to use the resource guide will be offered during this time.
