2068. Cultural Barriers to Access of VA Blind Rehabilitation Services
MD Williams, Southern Arizona VA Health Care System; doctoral student, College of Nursing, University of Arizona, CS Wilkinson, Southern Arizona VA Health Care System and College of Nursing, University of Arizona, RA Moreno, Southwestern Blind Rehabilitation Center and Southern Arizona VA Health Care System, J Glittenberg, Colleges of Nursing and Anthropology, University of Arizona

Objectives: Objectives of this research were to describe attitudes and beliefs about blindness and blind rehabilitation among Hispanic and American Indian blind veterans, and to explore relationships between attitudes/beliefs and utilization of blind rehabilitation services.

Methods: The design of this study is a qualitative, ethnographic research approach. Hispanic and American Indian blind veterans in Arizona were recruited through purposive sampling to saturation of attitude and belief domains emerging from the data. Informed consent was obtained, consistent with Human Subjects Committee and tribal processes. Data consists of transcriptions of field notes and 28 audio taped interviews conducted with 15 key cultural informants. Fourteen of the informants are blind, thirteen are veterans, eight are Hispanic, and seven are American Indian. Context data was collected through participant observation, and interviews of key blind rehabilitation service providers. Data analysis included a repetitive cycle of immersion in, and abstraction of, themes from individual cases, synthesis of common themes and patterns, key informant challenge of conceptualizations, and validation through expert panel review

Results: A predominant emergent taxonomy organizes conceptual meanings into layers of connection. Blindness is the most critical group-related connection and is an indicator of service provider credibility. Within blindness, a second taxonomy organizes conceptual meanings into staged processes that influence types of service sought, willingness to openly access services, and means for accessing service. Connecting to the larger veteran brotherhood is represented as figuring more prominently in service access decisions than specific barriers to service access identified by individuals.

Conclusions: Blindness is a significant connection crossing other group identities, and represents credibility in blindness-related service provision. Failure to address disconnectedness with the larger veteran community may contribute to ineffectiveness of interventions to overcome specific barriers to service access.

Impact: The findings of this study provide information useful to the design of services for blind Hispanic and American Indian veterans. Findings from this study also provide insight into strategies designed to reduce barriers to access of services across a diverse population of veterans. This study raises intriguing questions regarding the impact that multiple layers of connection may exert upon attempts to adequately and appropriately address diversity.