Transportation Barriers to Vision Care for the Visually Impaired

Concerns about or problems with transportation acutely affect the large and growing population of people in the US living with visual impairments, who have been shown in previous studies to lack adequate transportation which keeps them from receiving low vision rehabilitation and other specialized care. This research will take a multi-fold approach to understanding safety concerns that pose transportation barriers to health care among Nebraska residents with visual impairments, focusing on those living in rural areas. For one research thrust, the project team will conduct in-depth, semi-structured interviews with patients seeking care at the University of Nebraska Medical Center’s Weigel Williamson Center for Visual Rehabilitation, which operates a main clinic in Omaha and satellite clinics in Lincoln and Hastings—the latter intended to serve people living in rural and small urban areas in central and western Nebraska. Interview data will shed light on transportation safety and access concerns facing patients as well as on the prevalence and nature of transport barriers to low vision care. For another research thrust, the project team, working with UNL and UNMC partners, will explore potential strategies for addressing transportation barriers, such as deploying innovative, integrated non-emergency medical transportation services; coordinating patient transportation; providing travel training or information on alternative transportation services at points of care; and offering telerehabilitation. This cross-cutting research, with implications for policymaking and practice in transportation and medicine, will advance understanding of transportation barriers facing rural residents with visual impairments and assess strategies to address these barriers.

"Tasks and expected task deliverables associated with each primary research question/activity are listed and described following: 1. How do transportation-related barriers pose obstacles to seeking low vision rehabilitation services among rural residents with visual impairments in Nebraska? Expected deliverables associated with relevant research activities to question (1)—i.e., collecting and analyzing interview data with low vision care patients or caregivers—include one or more academic abstract(s) for submission to conferences and a manuscript to be submitted for eventual publication on the topic of transportation barriers to low vision care for rural residents. These deliverables will be coordinated among the UNL research team and UNMC partners, but primarily produced by PI Dr. Cochran and UNL student research assistants. 2. What potential strategies might address transportation barriers to low vison care facing the visually impaired in Nebraska? The primary deliverables of research activity (2) will include, again, one or more academic abstracts for submission to conferences and a 1–2-page brief written for an audience of physicians and care coordinators on how to address or alleviate common transportation barriers facing patients seeking low vision rehabilitation services. 3. What is the demand for non-emergency medical transportation (NEMT) in rural Nebraska, and where are existing and potential locations for rural transit services to participate in NEMT? Deliverables associated with research activity (3) include data sets and demand analyses for medical trips and/or non-emergency medical transportation services in Nebraska, focusing on rural regions of the state. It is possible that data sets, derived from several potential sources, such as the 2017 National Household Travel Survey and NDHHS NEMT data, may be integrated into a single data set that could be more easily accessed by other researchers and practitioners seeking to quantify NEMT demand in the state. This research activity will also result in the production of maps showing and quantifying NEMT demand across the state. Results of this research activity will also likely be used for one or more academic abstract(s) for conferences, and potentially, eventual production of a manuscript for publication in a relevant peer-reviewed journal."

It is expected that this research will, overall, result in more advanced understanding of transportation barriers facing rural residents with visual impairments as well as demand for non-emergency medical transportation in Nebraska. Expected research products, or proposed deliverables, include academic abstracts for submission to conferences; one or more manuscripts for eventual publication in relevant peer-reviewed journals; a 1–2-page brief for physicians and care coordinators on how to address or alleviate common transportation barriers facing patients seeking low vision rehabilitation services; and data sets and maps quantifying NEMT demand across the state.

This project will contribute to planning and operating a more equitable, inclusive transportation system by identifying and seeking to address the transportation needs of rural residents with visual impairments. This work will have broad implications for improving access to transportation and health care among transportation-disadvantaged populations (i.e., the elderly, people with disabilities) in underserved rural communities. This work will also contribute to training future transportation professionals in ways to identify and address the transportation needs of vulnerable road users living in rural communities. Furthermore, this project will train and encourage students to participate in interprofessional collaborations with planners, engineers, and medical professionals to promote transportation equity and safety.