A Formative Assessment of Disability Inclusion in Public Health Pedagogy and Practice Open Access

Abstract

Although inclusion of disability in the learning environment has shown significant benefits for both disabled and non-disabled students (Capp, 2017), current evidence suggests that disabled students face significant barriers to inclusion in the classroom environment (Lindsay et al., 2018). Furthermore, only 14.3% of Master of Public Health (MPH) programs offer courses focused on disability as compared to the 84% of disability-centered courses offered by the same schools in non-MPH graduate programs (Akakpo et al., 2020). Finally, little research focused specifically on graduate and professional students with disabilities currently exists. This special studies project sought first to understand the current state of disability inclusion at the Rollins School of Public Health and then to identify community-centered, evidence-based recommendations for change using a mixed-methods design which included surveys for students (N=57) and faculty and staff (N=40), key informant interviews with RSPH faculty, staff and leadership (N=5), and focus group discussions with disabled students (N=8). Low response rate and small sample size on quantitative measures limited further statistical analysis. Rapid qualitative analysis was used to identify themes, codes and subcodes related to disability and inclusion. Notable qualitative findings from this research include newly identified barriers for graduate students seeking accommodations, the role of “non-mandatory culture” in disability inclusion efforts, and community-driven, evidence-supported recommendations for future improvement. Recommendations include: increased institutional support for faculty and students; formal support networks for disabled students; and community-building professional development for all RSPH community members.

Table of Contents

Chapter 1: Introduction 1

Rationale 1

Problem Statement 1

Purpose 2

Research Question 2

Significance 2

Definition of Terms 2

A Note on Language 3

Positionality Statement 5

Chapter 2: Literature Review 6

Defining Disability 6

Domestic and International Human Rights Policies Relevant to Students with Disabilities 9

Disability in Public Health Ethics, Pedagogy, and Practice 11

Community Based Participatory Research, Intersectionality, and Positionality 12

Disability, Stigma, and DEI in Higher Education 15

Disability in Post-Secondary Classrooms and Curricula 17

Chapter 3: Methodology 19

Study Population and Sample 19

Quantitative Research Design 20

Qualitative Design 21

Data Collection Procedures 24

Quantitative Procedures 24

Qualitative Procedures 24

Instruments Design 25

Faculty and Staff Survey 25

Attitudes Toward Teaching All Students (ATTAS-mm) Scale 25

Student Survey 26

WP-SS Enhanced 26

Student Perceptions of Classroom Support (SPCS) Scale 27

Quantitative Analysis 28

Qualitative Analysis 28

Ethical Considerations 29

Chapter 4: Results 32

Quantitative Results 32

Faculty and Staff Survey Results 32

Figure 4.1: Faculty and Staff Demographic Data 32

Student Survey Results 34

Figure 4.2: Student Demographic Data 34

Figure 4.3: Student Responses to WP-SS Extended 36

Qualitative Results 38

Figure 4.4: Demographic Data Key Informants 38

Figure 4.5: Relevant Data on Student Focus Group Participants 39

Theme I: Public Health & Pedagogy 39

Code: Curriculum Development 40

Subcode: Tools and Guidelines 41

Code: Training 42

Theme 2: Culture of Inclusion at RSPH 43

Code: Dimensions of Disability 43

Subcode: Spectrum of Disability 43

Subcode: Dichotomy of Disability 44

Code: Professional Experience with Disability 44

Subcode: Navigating Formal Accommodations 45

Subcode: Unofficial Accommodations 47

Subcode: Other Professional Experience 48

Code: Personal Experience with Disability 49

Code: DEI 50

Subcode: Cancel Culture 51

Subcode: Performative Activism and Co-Opting Language 52

Subcode: Disability in DEI 53

Code: Emory and RSPH Policies and Programs 54

Subcode: Department of Accessibility Services (DAS) 54

Subcode: Supportive Services and Physical Accessibility 56

Code: Barriers and Facilitators of Disability Inclusion 57

Subcode: Effective Communication 57

Subcode: Contextual Factors 58

Subcode: (Lack of) Knowledge About and Comfort With Disability 59

Subcode: (Lack of) Institutional Support for Faculty and Staff Development 60

Subcode: “Non-Mandatory” Faculty and Staff Culture 61

Subcode: Challenges in the Accommodations Process 62

Subcode: Student-Focused Recommendations for Change 63

Subcode: Faculty and Staff-Focused Recommendations 66

SUBCODE: Administrative and Environmental Recommendations 68

Chapter 5: Discussion 72

Duality of Intent to Include and Ability to Include 72

The Role of the Medical Model of Disability in Public Health Curricula and Practice 75

Student Perspectives on Disability and Accommodations 76

Curriculum Approval and Disability Inclusion 78

Accessibility Checklists and “Checking Boxes” 79

Universal Design for Learning (UDL) as an Effective Intervention 80

Limitations and Delimitations 81

Chapter 6: Conclusion 83

Implications for Public Health Curricula and Practice 83

Recommendations for Change 84

Appendix A: Recruitment Materials 98

Figure A.1: Recruitment Graphic for Faculty & Staff Survey 98

Figure A.2: Recruitment Graphic for Student Survey 99

Appendix B: Key Informant Interview Guide 100

Appendix C: Focus Group Discussion Guide & Visual Aids 105

Figure C.1: Participant Introductions 109

Figure C.2: Problem Tree for Activity 109

Appendix D: Attitudes Toward Teaching All Students Scale (ATTAS-mm) – modified for survey use 111

Figure D.1: Attitudes Toward Teaching All Students (ATTAS-mm) - modified 111

Figure E.1: Washington Group Short Set – Extended 113

Appendix F: Student Perceptions of Classroom Support Scale – as modified for survey 115

Appendix G: Codebook 119

Appendix H: Rapid Analysis Summary Form 124

Appendix I: Full Results – Modified Attitudes Toward Teaching All Students Scale (ATTAS-mm) 126

Figure I.1: Modified ATTAS-mm – Faculty Results 126

Figure I.2: Modified ATTAS-MM – Staff Results 127

Appendix J: Full Results – Modified Student Perceptions of Classroom Support (SPCS) Scale 128

Figure J.1: SPCS Results – Physical Environment Subscale 128

Figure J.2: SPCS Results – Instruction Subscale 128

Figure J.3: SPCS Results – Peer Support Subscale 129

Figure J.4: SPCS Results – Curriculum Subscale 129

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Public Health Education
Keyword	disability
Committee Chair / Thesis Advisor	Ordonez, Claudia, Emory University
Committee Members	Butler, Allison, Emory University

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