Attitudinal and perceptual correlates of employment status among African Americans with disabilities.

Introduction

Persons with disabilities differ in a number of ways. Among these are differences in level of self esteem, feelings about participation in rehabilitation, and willingness to function in and contribute to society. In addition, considerable evidence has been put forth which suggests that among minority persons with disabilities, the level of utilization of rehabilitation services is often associated with factors such as attitude toward the disability, attitude toward self, perceptions and expectations of the rehabilitation process, and attitudes toward service providers (Atkins, 1980; Belgrave and Walker, 1991a; 1991b). The influence of these variables on adjustment to disability, effectiveness of rehabilitation, and employment of persons with disabilities should be considered by service providers, advocates and policy makers.

There has been a recent increase in the public's awareness of problems faced by persons with disabilities and the difficulties they encounter in attempting to gain equal access to employment. There is a need, however, to further increase the understanding of factors which influence the employment status of African Americans with disabilities. Demographic data suggest that minorities will comprise much of the workforce of the future. It is in this labor force that African Americans with disabilities will have to compete but currently these persons are disproportionaly unemployed as well as underemployed (Campbell, 1991). Bowe (1985) reported that one in seven working aged African American adults has a disability and nearly half of all working age African American adults with disabilities have incomes below the poverty level. The average African American adult with a disability is 42 years old, has less than a high school education, is not working and is not actively seeking employment (Bowe, 1985).

There is general agreement that employment and other problems of individuals with disabilities are not solely physical, but social, emotional and psychological as well. A number of authors have suggested that persons with disabilities face an array of psychosocial and environmental barriers which may negatively impact successful adjustment (Barnes, 1952; Cowen, 1960; Fine and Asch, 1988; Fisher, 1958).

Wright (1978) suggested that interactive personality factors and self esteem play a major role in how people with disabilities perceive and respond to their impairment. Belgrave (1991) found in a study of African Americans with disabilities that personality factors such as high self-esteem and environmental factors such as the availability of social support significantly correlated with successful adjustment. Lipp, Kolstoe, James and Randall (1968) concluded that the psychological problems of persons with disabilities is often based in the perception held by themselves and others that they are different. This perception may be a threat to the integrity of the self concept. Attitudes and perceptions held by persons with disabilities may impact on functional abilities (Fine and Asch, 1988) which have implications for employment. The perception that an individual holds about his/her ability to function on a day to day basis also influences his/her perceptions regarding obtaining and maintaining employment. In an examination of factors involved in the employment success of African Americans with disabilities, Wilson (1988) conducted a case study of seven persons who were successfully employed. He identified nine critical factors which significantly contributed to success in both the attainment and maintenance of employment. Among the factors were positive self-concept, realistic self-appraisal, and availability of strong outside support. Wilson concluded that these critical factors need to be taken into consideration in the rehabilitation process (at both policy and service levels) to ensure that agencies have staff who are sensitive to the needs of African Americans and other minorities with disabilities.

Employment goals and opportunities of African Americans with disabilities may also be limited by African Americans' lack of familiarity with rehabilitation agencies and services and their skepticism of these agencies (Ayers, 1977). Among those African Americans who do avail themselves of services, impressions such as those reported by Jenkins and Amos (1983) are sometimes found. Jenkins and Amos reported that less than half of the respondents in their study had experienced positive interactions with service providers, or had received all the services for which they were eligible. In a study of rehabilitation utilization differences between African Americans and White Americans with disabilities, Belgrave and Walker (1991) found several differences in rehabilitation service utilization with African Americans at a disadvantage.

In conclusion, Craig and Huffine (1976) stated that African Americans will remain in treatment as long as it meets their needs and expectations. It should be a matter of policy that once engaged in the system, clients' needs, perceptions and expectations are assessed and programs are designed that are responsive to these factors. The current emphasis on consumer empowerment accentuates our responsibility to investigate all aspects of client participation and design services that have maximum functional and cultural relevance (Soloman, 1988).

The present study was designed to explore attitudinal influences and related factors which may have implications for efficacious African American participation in the rehabilitation process. This study was undertaken as an examination of the extent to which these factors are related to employment status. Specific questions addressed were as follows:

1. Is there a relationship between employment status group membership and selected attitudes and perceptions held by African Americans with disabilities?

2. To what extent do these selected attitudes and perceptions effectively discriminate among three employment status groups?

3. What is the relative importance of specific attitudinal and perceptual variables on employment status group membership?

The three types of employment status groups were (a) employed, (b) unemployed-not looking for work, and (c) unemployed-looking for work.

Method

Subjects. Subjects were recruited from participating rehabilitation agencies and facilities as follows: a) Harlem Hospital, and Queens Independent Living Center, New York City, New York; b) Michigan Department of Rehabilitation, Detroit, Michigan; c) California Department of Rehabilitation, Los Angeles, California; d) Atlanta Independent Living Center, Atlanta, Georgia; Georgia Department of Rehabilitation, Atlanta, Georgia and; e) the D.C. Rehabilitation Services Administration, Washington, D.C. All agencies had participated in prior research projects with the Howard University Research and Training Center.

The sample consisted of 186 African Americans with disabilities. Of these, 114 had a physical disability, nine had a cognitive disability, 35 had an emotional disability, and 17 had a sensory disability. Type of disability could not be determined for 11 persons. There were 80 females and 105 males. One subject did not report gender. Age of the subjects ranged from 18 to 64.

Instrumentation. Data were collected using the Walker/Asbury Structured Interview schedule. Constructed by the authors, the instrument was designed to (a) gather bio/demographic data, (b) explore problems associated with accessibility of services, and to (c) measure attitudinal, perceptual and related variables. The attitudinal and perceptual variables were measured using likert-type scales. These are briefly described below.

The Attitude toward Seeking and Receiving Services Scale assesses whether or not the client feels comfortable asking for and receiving rehabilitation services. The internal reliability of this ten item scale was .62. The seven item Attitude Toward Service Provider Climate Scale was developed to assess how the client perceived the rehabilitation climate including his/her perceptions regarding level of comfort with the service provider. The internal reliability of this scale was .85 for the study sample. The Attitude toward Service Provider Capability scale provided an assessment of how confident the client felt about the service provider's ability to understand and help him/her. The internal consistency of this seven item scale was .82 for the study sample.

The ten-item Rosenberg (1965) Self-esteem Scale was used to measure self-esteem. This scale has been used in numerous studies and has acceptable reliability and validity. The internal reliability for the study sample was .78.

Perception and beliefs about the disability were assessed by an 18 item Attitude Toward Disability Scale. These items were written to assess how a person feels about having a disability and the extent to which the disability is perceived both positively and negatively. The conceptualization of some of the scale items was based on Linkowski's (1983) attitude toward disability scale. The internal consistency of this scale was .83 for the study sample.

The eight item Attitude Toward Employment Scale measured the extent to which a person values employment and feels that employment is important. The internal reliability coefficient was .78 for this sample.

The 10 item Perception of Emotional Support Sub-scale and the nine item Perception of Tangible Support Sub-scale assessed the extent to which the respondent perceived that emotional and tangible support was available. These support items were written based on the Social Support Index which assesses the availability of emotional, tangible, and cognitive support (Wilcox, 1981). The internal reliabilities for this sample were .73 for the emotional support scale and .84 for the tangible support scale.

Client Expectations of the Rehabilitation Process Scale was written to assess clients' expectations regarding positive and negative aspects of the rehabilitation process. This seven item scale had an internal reliability coefficient of .77. The seven item Client Perceptions of the Rehabilitation Process scale measured whether or not clients' perceptions of the outcomes of the rehabilitation process were positive or negative. The internal reliability of this scale was .82.

For all scales, a higher mean rating represented a more positive attitude. In addition to the attitudinal and perceptual measures, respondents were also asked to provide detailed information regarding their employment status.

Content validity of the scales written by the authors was established using the following methods.

a. A panel of rehabilitation experts systematically constructed, examined and revised the items.

b. Professionals in the field and members of an advisory board served as judges for determination of content coverage and item domain sampling.

c. Items were administered in a field pilot study. Items were then revised based on feedback from pilot study respondents.

Procedures. As noted previously, rehabilitation agencies and organizations were chosen based on prior research with the Howard University Research and Training Center. The agencies and organizations are all located in cities where there is a sizable ethnic minority population. These agencies and organizations used lists of clients to randomly select individuals of various ethnic/racial backgrounds for study participation. Results in this paper pertain only to those subjects who were African American.

All subjects were assured of confidentiality and were asked to sign a Participant Consent Form, which explained the purpose of the study. In instances where participants were limited in physical or reading ability, staff members read each question TABULAR DATA OMITTED aloud and recorded their responses. Appropriate steps were taken to ensure confidentiality and consistency in recording. Orientation and training sessions were held for interviewers. The investigators are cognizant of the fact that a considerable percentage of individuals in the population of persons with disabilities had no opportunity to be chosen for this study due to their being outside of the rehabilitation services delivery system. Thus the study results are generalizable only to those African Americans with disabilities who are system participants or are otherwise in contact with rehabilitation agencies.

Results

Complete data across all study variables were available for 169 subjects. Table 1 shows the means and standard deviations for the 10 altitudinal and perceptual variables for each of the three employment status groups.

A stepwise multiple discriminant analysis was computed in order to determine value and importance of these variables for discriminating among the three employment status groups. Table 2 presents the order of entry at the various steps and the significance level for each of the variables. Significant variables in order of entry were a) attitude toward employment, b) attitude toward seeking and receiving rehabilitation services and 3) self-esteem. The remaining variables did not reach a level of tolerance necessary for entry into a discriminant function. This indicated that these variables would not have significantly reduced Wilk's Lambda any further and they were therefore not continued in the analysis.

The direction of the relationship of significant variables to employment status was as follows: Respondents with more positive attitudes toward employment, more positive attitudes toward seeking and receiving services and higher self-esteem were more likely to be employed or looking for employment versus unemployed and not looking.

Table 2

Multiple Discriminant Analysis Summary

                                                            Equivalent
Step         Variable Entered                  Wilk's Lambda    F        P

1       Attitude Toward Employment                  .86        13.00   .001
2       Attitude Towed Seeking and                  .84         7.42   .001
        Receiving Services
(*) 3   Self-Esteem and Attitude Toward Self        .83         5.28   .001

* No other Variables included after Step 3 due to insufficient tolerance

The standardized discriminant function coefficients revealed that the most important and influential variable influencing employment status was attitude toward employment. This was followed by attitude toward seeking and receiving services and self-esteem.

Discussion

Bowe (1985) has presented evidence that many minorities do not fully utilize available rehabilitation services and benefits. The findings in the present study suggest an explanation for this may be related to the extent to which services are made available and the manner in which these services are offered. The results of this study indicated that African Americans with positive attitudes toward seeking and receiving rehabilitation services were more likely to be employed or looking for work. These findings suggest that services must be available and positively perceived as beneficial in order to be of benefit to African Americans with disabilities. Rehabilitation services that are offered in a culturally sensitive manner which takes into consideration the world-view, values, and lifestyles of African Americans with disabilities are likely to be more acceptable to these clients.

The study results also indicate that attitude toward employment is a critical variable associated with employment status. In fact, it was the strongest predictor of employment status. This finding was expected. If employment of persons with disability is a prominent goal of rehabilitation, then the attitude of clients toward this goal must be factored into the rehabilitation services equation. The rehabilitation system must examine the meaning and significance of work in the individual's life. Activities and exercises aimed at promoting positive work attitudes may be beneficial in changing negative attitudes toward work.

The findings on the importance of self-esteem to employment status is consistent with other studies which have shown it to be a contributor to positive outcomes among African Americans with disabilities (Wilson, 1988; Belgrave, 1991; Belgrave and Walker, 1991). However, the relative strength of this variable compared to the other variables was somewhat lower than expected. This conjecture was predicated mainly on the importance placed on self-esteem in the literature devoted to other aspects of African-American life and culture.

The fact of its being a significant influence in terms of employment reaffirms the importance of self-esteem in yet another critical area. Employed persons with disabilities had a more positive attitude toward employment than persons who appeared to have dropped out of the labor force. The self-esteem of those who were unemployed but looking for work, was also higher than that of those who were unemployed and no longer looking. Perhaps, a high level of self-esteem is necessary for those who face employment rejection but continue to look for work.

There was some degree of uncertainty regarding the directionality of the study findings pertaining to employment attitudes, and self-esteem attitudes. Being employed may in fact increase positive attitudes toward work and self-esteem rather than positive attitudes toward work and self esteem leading to employment. Likewise, there is ambiguity regarding whether or not the respondents' perceptions were more positive because they had actually benefitted from the rehabilitation process or whether their perceptions were influenced by the favorable circumstances of their having a job. Moreover, in the degree to which employment is perceived as a positive ingredient in daily functioning, it seems that attitude toward seeking and receiving services may be influenced by being employed.

The study results have implications for service providers who are trying to involve more African Americans in rehabilitation. It might be useful to routinely assess the self-esteem, attitude toward employment, and attitudes toward seeking and receiving rehabilitation services of these clients as a part of the rehabilitation process. Where these affective aspects are found to be low, it might be appropriate to apply interventions and to take positive steps leading to their elevation.

Acknowledgements

This study was supported by a Research and Training Center grant from the National Institute of Disability and Rehabilitation Research to Howard University. The following agencies were participating data collection sites: Harlem Hospital, Queens Independent Living Center, Michigan Department of Rehabilitation, California Department of Rehabilitation, Atlanta Independent Living Center, Georgia Department of Rehabilitation, and the D.C. Rehabilitation Services Administration. The authors would like to thank all of the rehabilitation professionals at these agencies who coordinated activities and conducted interviews.

This study was part of a larger study of attitudinal and perceptual variables and their impact on the rehabilitation process among ethnic minorities.

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Charles A. Asbury, Center for Disability and Socioeconomic Policy Studies, Howard University, Research and Training Center, 2900 Van Ness Street, NW, Washington, DC 20008.