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In 2018, the Rural Institute received a five-year, $4.3 million grant to support its Research and Training Center on Disability in Rural Communities (RTC:Rural). The award continues 30 years of RTC:Rural research and training to improve the lives of rural people with disabilities.

RTC:Rural research addresses barriers identified by rural people with disabilities in the areas of health, community living, and employment. These barriers are often related to the limited resources available in rural environments.

The RTC:Rural Director is Catherine Ipsen.

Advancing the understanding about the IPV experiences of people with SCI

This project will include an in-depth interview study with people with SCI who have experienced IPV after sustaining their injury, and a large national survey study of people with SCI throughout the U. S. Together these two studies should advance the understanding about the IPV experiences of people with SCI including the risk factors, the barriers to obtaining help, and the adverse psychological and social effects of interpersonal violence.

Contact:           Rosemary Hughes

Understanding how disability evolves

RTC:Rural’s research has found that people who live in rural areas begin to experience disability as much as 10 years before people in urban areas. There are also higher rates of disability in rural areas across all age groups. RTC:Rural has also found that racial and ethnic minorities experience the highest disability rates as well as the greatest urban/rural differences.

This study will use data to explore the following questions:

• How does disability evolve and vary between urban and rural areas?
• What are the common precursors of disability in urban and rural areas?
• How does migration from an urban area to a rural one (or vice versa) affect disability severity?

Contact:     Catherine Ipsen

Answering questions about health care and quality of life

The Collaborative on Health Reform and Independent Living (CHRIL) is conducting a nation-wide survey to understand how changes in health care reimbursement affects working-age people with disabilities. RTC:Rural is partnering with CHRIL to increase the rural representation in the survey and to answer rural-specific questions about health care coverage, availability, and quality of life.

Contact:     Catherine Ipsen

Scaling up Living Well

Living Well in the Community (LWC) is an evidence-based, peer-led self-management program that helps participants to set and reach quality-of-life goals by developing a healthy lifestyle. RTC:Rural provides training and certification for Centers for Independent Living (CILs) to conduct the workshops. Due to COVID-19, we are providing Living Well training and peer support to CIL partners via online workshops.

Contact:     Catherine Ipsen

Exploring and addressing rural PAS outcomes

Approximately 2.3 million people with disabilities receive paid personal assistance services (PAS) in the United States. For many, these services are critical for social and community participation. However, little is known about rural-urban differences in PAS delivery, and how these services influence community participation and health. This RTC:Rural project explores and develops models address rural PAS delivery.

Contact:     Rayna Sage

Exploring accessible transportation in rural communities

The lack of accessible public transportation is still a major barrier to employment, healthcare access, and community participation for people with disabilities. Though public transportation barriers exist in both urban and rural places, there is a lack of knowledge about how people with disabilities access and use transportation in their rural communities. This RTC:Rural project will begin to compile an evidence-base to better understand the value and importance of rural public transit.

Contact:     Andrew Myers

Developing and evaluating online toolkits for state & tribal Vocational Rehabilitation

Self-employment is an important option for people with disabilities, especially in rural areas where job opportunities are limited. To expand access to self-employment, this RTC:Rural project will create, pilot, and evaluate two self-employment resources for state and tribal Vocational Rehabilitation programs.  Through community-engaged product development, the project has developed the and . The project is now focusing on outreach and evaluation of the guide and toolkit.

Contact:            Catherine Ipsen

Promoting positive outcomes for people with disabilities 

The overarching goal of our center is to conduct research and knowledge translation (KT) activities across health, employment, and community living domains to improve the quality of life of rural people with disabilities. To achieve this, we will (a) fully engage people with disabilities and other relevant stakeholders in all aspects of research and KT activities, (b) utilize national service systems as research and KT partners to improve the reach and uptake of effective solutions, and (c) evaluate community and service system contexts to understand how strategies and available community resources align for impact. Together, our projects promote rural disability community capacity building by providing stakeholders with the data needed to advocate for their interests and goals and developing and sharing interventions appropriate for delivery through existing rural service systems. 

Contact:            Catherine Ipsen

Providing supports and services in the community

House Bill 922 passed through the Montana legislature in 2023 and was signed into law by Governor Gianforte. The bill requires the Department of Public Health and Human Services (DPHHS) to develop and implement a current Olmstead Plan. DPHHS is contracting with the Rural Institute for Inclusive Communities (RIIC) to conduct this work over the period of 21 months starting April 1, 2024. The plan will ensure that state-funded services and supports for Montanans with disabilities are, to the greatest extent possible, provided in the community rather than in an institutional setting. The work will include an overview of the Olmstead decision, an analysis of the department's current efforts to integrate people with disabilities into the community, the department-funded services and supports available to people with disabilities, an assessment of the strengths and weaknesses of the system, recommendations for increasing the availability of and access to community-based services and supports, and the incorporation of quality assurance activities to ensure compliance with the principles of Olmstead. This will be completed by an interdisciplinary group of RIIC staff composed of researchers, evaluators, knowledge translation specialists, direct service staff, and staff with lived experience of disability, along with input from the Statewide Independent Living Council. Work will include a data-driven systems overview of state-funded services, accessible language materials throughout all steps of the process, engagement and feedback from consumers, stakeholders, and partners statewide, production of both a comprehensive Olmstead Plan and an evaluation plan, and broad dissemination across Montana.

Contact:            Molly Kimmel

Using data to understand how COVID-19 impacts rural and urban people

The COVID-19 pandemic has changed how we live. People with disabilities have been impacted by increased health risks, service disruptions, and stay-at-home orders. People with disabilities are at higher risk during crises than those without. RTC:Rural COVID-19 research provides timely answers to this evolving crisis. We have explored COVID prevention practices, vaccine hesitancy, county-level risk factors, economic and health impacts, and community response strategies.

Contact:     Andrew Myers

Interventions to increase community participation

The Rural Institute is partnering with the Center to study two ways to increase community participation: the Home Usability Program and Out and Ñý¼§Ö±²¥. The project is partnering with four Centers for Independent Living.

The Home Usability Program works with individuals with disabilities to self-assess and improve the usability of their homes. Previous research shows that people with disabilities who have more usable homes (accessible bathrooms, for example) are more likely to participate in their communities because they expend less energy in daily self-care, thus freeing up more time for other activities.

Out and Ñý¼§Ö±²¥ works with participants to set goals for community participation and solve problems related to barriers in the community, such as inaccessible transportation or lack of access to health care. Out and Ñý¼§Ö±²¥ also builds social networks by using peer support in the pursuit of participants’ goals.

Contact:     Lillie Greiman

Healthy Community Living programs support people with disabilities to live and participate fully in their communities

The (HCL) program trains organizations and individuals to facilitate curriculum-based workshops with community members with disabilities. HCL workshops explore how health, wellness, and community participation goals can enhance quality of life. Workshop participants learn skills and receive support to put their goals into action.

Contact:     Rayna Sage

Building an app using Living Well with a Disability program content

Living Well in the Community (LWC) is a health promotion program developed by RTC:Rural. The LWC program is taught online with groups or in person using multimedia content. We are using funding from an App Factory grant to the Shepherd Center to make LWC program content available with an app. Some people may use the app to support their learning in the LWC class, while others may choose to work through the content on their own.

Contact:     Tannis Hargrove

Developing peer-to-peer training to support independent living in rural areas

The Rural Community Living Development project partners with the to develop and implement peer-to-peer training for Centers for Independent Living (CIL) staff about engaging in community development activities in rural areas to support people with disabilities living independently in their communities. NIDILRR-funded community living resources will be utilized and promoted as well.

Contact:     Rayna Sage

Developing an intervention to improve social connections for disabled people

Project Connect is developing a curriculum to help people with disabilities build social networks. The project aims to reduce social isolation and loneliness. Social isolation increases health risks and has been made more severe by the COVID-19 pandemic. Project Connect is partnering with the and five Centers for Independent Living to create a multi-media curriculum. 

Contact:     Rayna Sage

Examines the impact of stress on negative birth outcomes

Dr. Rosemary Hughes is collaborating with researchers from the University of Virginia on this 5-year project. The study focuses on how interpersonal violence and depression impacts maternal and infant outcomes, such as low birth weight and preterm birth in women with diverse disabilities.

This project will:

• Analyzes data across women with and without disabilities
• Interview pregnant and new mothers with disabilities
• Conduct focus groups with perinatal health providers

Contact:     Rosemary Hughes

Evaluates ways to improve the health of people with spinal cord injury

Dr. Rosemary Hughes of the Rural Institute is partnering with researchers with the Texas Model Spinal Cord Injury (SCI) Program at TIRR-Memorial Hermann. This project collects data that are added to the National SCI Database and Registry and used by researchers to improve services and outcomes for people with SCI. A primary aim is to evaluate an online psychological health intervention for women with SCI.

Contact:     Rosemary Hughes

Making rural data more accessible

In order to create policies and programs that serve the needs of people with disabilities in rural communities, it is important to know things about them, such as demographic information and location. The federal government maintains several large data sets that collect this information. These include the American Community Survey, the Current Population Survey, the Behavioral Risk Factor Surveillance System, and the Survey on Health Reform and Disability. However, it can be difficult to access rural disability data from these data sets (see Data Limitations in the American Community Survey: The Impact on Rural Disability Research).

To address these issues, RTC:Rural is partnering with the Disability Statistics and Demographics Rehabilitation and Research Training Center (StatsRRTC) to conduct rural analyses of existing large data sets. These rural analyses will help describe the experiences of rural people with disabilities, and can be used to inform advocates, service providers, researchers and policymakers about emerging trends, hypotheses and policy impacts.

Contact:     Catherine Ipsen

Promoting apprenticeship opportunities in rural communities 

Rural Institute staff member Catherine Ipsen provides technical assistance to the Rural Youth Apprenticeship Development Project (RYAD) housed at the Institute for Community Inclusion at the University of Massachusetts Boston. 

RYAD partners with State and American Indian Vocational Rehabilitation agencies to create apprenticeship programs for youth with disabilities in underserved rural communities. RYAD will document the implementation of the apprenticeship model and create a toolkit with rural-specific apprenticeship tools and resources.

Contact:     Catherine Ipsen

Explores how loneliness impacts the health of men and women with spinal cord injury

2019 - 2022

Dr. Rosemary Hughes of the Rural Institute is partnering with researchers from Baylor College of Medicine to understand the impact of loneliness on veterans and other adults with Spinal Cord Injury (SCI).

The project involves national surveys administered at baseline and 12 months later.  This study is the first comprehensive investigation of the impact of loneliness and how it affects the health of men and women with SCI.

Contact:     Rosemary Hughes

Using data to improve maternal and infant healthcare in Montana

2021 - 2022

The Rural Institute is partnering with the program and the Centers for Disease Control & Prevention (CDC) to implement the Levels of Care Assessment Tool (LOCATe) in Montana.

LOCATe is a tool that collects information about levels of maternal and neonatal care. Facilities are classified into levels based on equipment, staff, and volume of services. The LOCATe assessment will provide facilities with information on their own resources and capacity. The State of Montana will use LOCATe to guide investments in maternal and infant healthcare.

Contact:     Carly Holman

Creates an online health information resource for women

2018 – 2021

Dr. Rosemary Hughes of the Rural Institute is collaborated with researchers from Baylor College of Medicine’s Center for Research on Women with Disabilities (CROWD) to expand health information on the CROWD website.

This project partnered with a Community Advisory Board, clinicians, researchers, and librarians to improve health literacy and reproductive, pelvic, and sexual health outcomes among women with disabilities. A national survey and a focus group study examined the health information seeking trends of women with physical disabilities.

Contact:     Rosemary Hughes

Investigates the link between energy exertion and quality of life

2016 - 2020

Participating in the community requires effort, and people vary in how much they spend before needing rest. As a result, everyone must make choices about what activities they spend their effort on. This project studied two interventions that looked at the relationship between personal effort and community participation.

This project was a collaboration between at the Rural Institute for Inclusive Communities, the Ñý¼§Ö±²¥’s  Bureau of Business and Economic Research, and the New Directions Wellness Center within the Department of Physical Therapy and Rehabilitation.

Contact: Andrew Myers