ERIC EJ1142802: Stress Associated with Transportation: A Survey of Persons with Visual Impairments

2017·0.09 MB·English

by  ERIC

CE Article
Stress Associated with Trans-
portation: A Survey of Persons
with Visual Impairments
Adele Crudden, Jennifer L. Cmar, and Michele C. McDonnall
Structuredabstract:Introduction:Thisstudyevaluatedtransportation-relatedstress
and factors predicting stress among persons with visual impairments. Methods:
Participantswithvisualimpairmentscompletedelectronicsurveysratingtheirstress
levelsexperiencedwhencompletingvariouswalkingandpublictransportationtasks.
They also indicated activities they avoided due to transportation stress. Results:
Higher stress was reported for navigating unfamiliar bus routes, walking in urban
areas without sidewalks, and walking in unfamiliar places. Significant predictors of
walkingstresswereage,yearssincevisionloss,dogguideuse,physicallimitations,
and frequency of public transportation use. Significant predictors of public trans-
portation stress were age, orientation and mobility (O&M) training, physical limi-
tations, and frequency of public transportation use. Most-avoided activities due to
transportation-related stress were entertainment or leisure activities and visiting
family and friends. Discussion: Unfamiliar situations and unpredictable environ-
ments were associated with higher stress. Frequent public transportation use and
longer time since vision loss predicted lower stress, which indicates that increased
and varied experiences may affect transportation-related stress. Older persons and
persons with physical limitations had more transportation-related stress. Social
activities,whichareimportantinmanagingstress,weremostfrequentlyavoideddue
totransportationstress.Implicationsforpractitioners:O&Minstructorsshouldkeep
inmindthatprovidingvariedexperiencesandlongertrainingisindicatedforpersons
with high stress, particularly for older persons, and those with recent vision loss or
physicallimitations.Everyoneinvolvedintherehabilitationprocessshouldremem-
ber that building relationships with consumers, encouraging public transportation
use, participating in support groups, and overcoming travel barriers for social
activities may help reduce transportation stress.
T
he ability to travel independently is vocational and community activities, par-
an important component of success in ticularly for persons with disabilities
(National Council on Disability, 2005).
Thecontentsofthisreportweredevelopedunder
a grant from the U.S. Department of Health and representthepolicyoftheDepartmentofHealth
HumanServices,NIDILRRgrant90RT5011-01- andHumanServicesandshouldnotindicateen-
00. However, these contents do not necessarily dorsementbythefederalgovernment.
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©2017AFB,AllRightsReserved JournalofVisualImpairment&Blindness,May-June2017
CE Article
Orientation and mobility (O&M) training little stress negatively affects perfor-
facilitates the ability of persons with vi- mance (Lindau, Almkvist, & Moham-
sual impairments to perform independent med, 2000).
travel on foot and through the use of Various factors influence how people
transportation systems. However, per- experience stress. Skills learned through
forming these skills and the resultant participation in higher education, such as
travel activities may be stressful. Al- problem solving and how to use informa-
though stress can be a positive factor in tion, are helpful in confronting stressful
enhancing motivation and alertness, it situations(Ranchor&Sanderman,2000).
maycauseavoidanceandirritability.This Older persons report less stress than
national survey of adults with visual im- younger persons, but that could be due to
pairments (that is, those who are blind or
maturation, generational effects, or other
have low vision) gathered information
variables (Avison, 2000).
about self-reported stress levels associ-
Coping mechanisms are behaviors
ated with various O&M skills and trans-
that limit or remove stress and may in-
portation activities. This information will
clude confronting stressors or avoiding
be helpful to service providers, adminis-
them. People may engage in avoidance
trators, and individuals with visual im-
coping when they predict that their ac-
pairments in receiving, planning, or pro-
tions will not generate a positive out-
viding O&M services.
come (Bohus, 2000). Avoidance coping
Stress can be effective in the short term, but it
is typically not effective when stressors
Stress encompasses various psychologi-
arepresentonanongoingbasis(Carver,
calorphysicalresponses,positiveorneg-
2011). Social support, another factor in
ative, to demands (Pandey, Quick, Rossi,
reducing stress, promotesfeelingsofcon-
Nelson, & Martin, 2011) or a sense of
uncertainty in response to unexpected trol and increases self-esteem (Urchino &
events(Finan,Zautra,&Wershba,2011). Birmingham,2011).Tangibleorinforma-
Psychological stress occurs when people tionalsocialsupportismosthelpfulwhen
perceiveenvironmentaldemandsasbeing facingcontrolledevents,suchassecuring
beyond their resources and thus threaten- transportationtowork,butemotionalsup-
ing or harmful (Smith & Kirby, 2011) as port and fostering a sense of belonging
opposedtochallengesthataredemanding are more helpful for uncontrolled events
butachievablewitheffort(Carver,2011). (Urchino & Birmingham, 2011), such as
Stress can positively impact performance losingone’sdriver’slicenseduetovision
at its optimum level, but too much or too loss. When encountering stressors, people
must consider their individual situations
and make judgments regarding whether
EARN CES ONLINE
they possess the resources to confront the
by answering questions on this article.
stressor and whether this expenditure of
For more information,
visit: http://jvib.org/CEs. resources is worth the outcome (Aldwin
& Yancura, 2011).
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JournalofVisualImpairment&Blindness,May-June2017 ©2017AFB,AllRightsReserved
CE Article
STRESSANDTRAVELFORPERSONS 2011; Tanaka, Murakami, & Shimuzi,
WITHVISUALIMPAIRMENTS 1982).Urbanareasareparticularlystress-
Existing literature about how people with ful,especiallyforolderpeople,duetothe
visual impairments experience transpor- overwhelming stimuli and constant
tation-relatedstressisscantanddated,yet changes in the environment (Rutberg,
it remains an important topic. The travel 1976).
behavior and lifestyles of persons with Incremental exposure to increasingly
visual impairments could be affected by stressful activities, or “desensitization”
personal (for example, physical or psy- (Rutberg,1976),anddiscussiongroupsof
chosocial) variables (Corn & Sacks, O&M recipients (Rutberg, 1976; Sey-
1994; Gillman & Simon, 1980) and envi- bold, 1993) may be effective in easing
ronmental factors (Marston & Golledge, stress associated with O&M instruction.
2003). For visually impaired persons, in- Other suggestions to reduce stress in-
dependent travel demands concentration, cluded expanding the time frame for
effort, and attention: learning new routes O&M training, fostering close relation-
or environments is demanding and can ships between the person with the visual
lead to “tension, anxiety and feelings of impairmentandtheO&Mspecialist(Rut-
insecurity” (Passini, Dupre, & Langlois, berg, 1976), using wayfinding devices
1986, p. 906). The prospect of receiving (LaGrow et al., 2009), and using virtual
O&M training can cause emotional stress training techniques (Seki & Sato, 2011).
when persons with visual impairments This research evaluates walking stress,
lack information about the nature of publictransportationstress,activitieslim-
O&M and its training methods, and po- itedbystress,andfactorspredictingstress
tential recipients may anticipate needing among adults with visual impairments.
to concentrate to the point of exhaustion Our research questions were:
(Seybold, 1993). Although we might ex-
pect feedback from an O&M specialist to 1. Which transportation tasks are most
be reassuring to visually impaired per- stressful?
sons, instructor intervention and contact 2. Which activities are limited due to
withunexpectedobjectsresultedinahigh transportation stress?
stress response among persons with some 3. Whatfactorspredictwalkingandpub-
experience in cane travel (Ponchillia, lic transportation stress?
1984).
Methods
Persons who are visually impaired find
that open areas such as lobbies and park- TRANSPORTATIONSURVEY
inglotsaredifficulttonavigate(Passiniet Acomprehensivesurveytoassesstranspor-
al., 1986), presumably because these ar- tation issues experienced by people with
eas lack spatial and directional informa- visual impairments was developed with in-
tion (Marston & Golledge, 2003). An in- putfromtheNationalResearchandTrain-
creased stress response is associated with ing Center (NRTC) on Blindness and
unfamiliarity with an area, lack of travel Low Vision’s national advisory council
skills,androutecomplexity(Seki&Sato, that included individuals with visual
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impairments and O&M specialists. Na- items were eliminated and a few items
tional transportation surveys, such as added. The second round of data collec-
those conducted by the U.S. Census Bu- tion occurred in January and February
reau and the U.S. Department of Trans- 2014, and the survey was open to all
portation (McKenzie & Rapino, 2011; persons with visual impairments, aged 18
Santos, McGuckin, Nakamoto, Gray, & to 65 years. A survey link was posted on
Liss, 2011), were reviewed and a few theNRTCwebsiteandane-mailwiththe
pertinent items were included on this sur- survey link was sent to major consumer
vey, along with items related to O&M, groups, members of the NRTC national
transportation methods, and transporta- advisory council, and personal contacts
tion challenges. The survey was pilot with requests to forward the link to eligi-
tested with 10 people with visual impair- ble individuals. Participants could be en-
ments using various assistive technolo-
tered in a drawing for a $100 gift card by
giesandbrowsers;theirfeedbackresulted
providing their contact information. The
inmodificationstocontentandformatting
second administration produced 353 sur-
tofacilitateaccessibility.Pilottestingand
veys,althoughonepersoncompletedboth
subsequent survey administration were
versions, resulting in 492 usable surveys
conducted using an electronic platform.
from the two administrations. Only items
Our university’s Institutional Review
foundonbothversionsofthesurveywere
Board for the Protection of Human Sub-
used for data analysis.
jectsapprovedthisstudy.Formoreinfor-
mation about the survey and its develop-
SAMPLE
ment, see Crudden, McDonnall, and
Forthisstudy,thesamplewaslimitedto
Hierholzer (2015).
nondrivers who had access to public
transportation in their local areas, re-
PROCEDURE
sulting in 368 surveys, since missing
Two administrations of the survey were
data for some key variables reduced the
conducted.Thefirstadministrationwasto
sample size. To maximize power, the
people in the NRTC’s participant registry
largest sample available was used for
between ages 18 and 65 years. The reg-
each analysis, resulting in sample sizes
istryisalistofpeoplewithvisualimpair-
ranging from 259 to 364. Demographics
ments who volunteered to be contacted
presented in the Results section are for
about participation in research. Surveys
the largest possible sample of 368
were completed between September and
(when data were available), since data
November 2013. Approximately 255 per-
from all respondents were used for one
sons were sent the survey link and were
or more analyses.
asked to participate. A $25 gift card in-
centive was offered to respondents who
completed all items; 140 usable surveys VARIABLES,MEASURES,
were generated. ANDSTATISTICALANALYSES
Based on feedback from the first ad- The variables of interest in the study pre-
ministration, the survey and some of its sented here were related to participants’
formatting were revised. Some redundant self-reported transportation stress and
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variablespredictingthisstress.Onesetof frequency per month of public transpor-
questions measured the level of stress tation use (numerical value based on re-
experienced, on a 0 to 10 scale, for items spondent’s rating on a 7-point scale from
related to mobility with walking in spe- “Never” to “Six or more times per
cific situations, asking for assistance, ar- week”).
ranging transportation, and using public Descriptivestatisticswereusedtopres-
transportation. Respondents also indi- ent information about stress levels expe-
catedwhetherstressassociatedwithusing rienced with different transportation
transportation for eight activities limited and mobility activities. Multiple regres-
their participation in those activities. sion was used to determine which vari-
The first set of stress questions (see ables were associated with walking and
Table 2) was evaluated with Cronbach’s public transportation stress. Two models
alpha and exploratory factor analysis to
predicting these stress measures were de-
determine the appropriateness of using
veloped. SAS 9.4 was used to conduct
the items as a combined scale. We antic-
statistical analyses.
ipated that items related to walking mo-
bilitywouldbeassociatedwithonefactor Results
and the remaining items would be asso-
DEMOGRAPHICS
ciated with a second factor. This hypoth-
The mean age of respondents was 47.72
esis was supported by these analyses,
(SD (cid:2) 12.26). Seventy-five percent of
which indicated that two factors provided
respondents were White and 37.7% were
a better fit for the data (based on the
from the South. Just over half of the re-
proportion criteria). The two factors re-
spondents self-reported they were legally
sulted in a 4-item walking stress measure
blind, and 43.94% reported a physical
and a 6-item public transportation stress
limitation that affected their public trans-
measure (see Table 2 for factor loadings
portation use. Years since vision loss
and alpha coefficients). These two com-
ranged from 2.01 to 64.82 (M (cid:2) 36.70,
posite measures were utilized as depen-
SD (cid:2) 17.81). More than one-third of the
dent variables in the regression analyses.
sample (34.5%) were visually impaired
Thesummedscaleswereconvertedtothe
since birth. See Table 1 for additional
original 0 to 10 scale of the individual
demographic information.
items by dividing the summed score by
the number of items, with higher scores
indicating higher stress. MOBILITYANDPUBLIC
Variables expected to predict stress TRANSPORTATIONUSE
wereincludedasindependentvariablesin Most respondents traveled with a white
the regression models. These variables cane and over 25% used dog guides. Fur-
wereage,yearssincevisionloss,yearsof thermore, 85.2% of respondents had re-
education completed, whether totally ceived O&M training. Although more
blind or not, receipt of O&M training, than72.7%ofrespondentsreportedusing
white cane use, dog guide use, presence public transportation more than once per
of a self-identified physical limitation month, the remaining 27.3% used it in-
that affected transportation options, and frequently or never.
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Table1 stresswasreportedforusingtaxis,asking
Demographicinformation.
other pedestrians for assistance, and ask-
Variable n % ing bus drivers for assistance. Respon-
dentsmostfrequentlyindicatedthattrans-
Raceorethnicity
White 276 75.0 portation stress limited their participation
BlackorAfricanAmerican 36 9.8 in entertainment or leisure activities and
Hispanic 21 5.7
visits to friends or family members. The
Asian 12 3.3
least frequently avoided activity was em-
Multiracial 11 3.0
AmericanIndian 3 0.8 ployment (see Table 3).
Unknown 9 2.5
Annualhouseholdincome
(cid:3)$25,000 110 29.9 PREDICTORSOFWALKINGSTRESS
$25,000to$50,000 80 21.7
A multiple regression analysis was con-
$50,000to$75,000 44 12.0
ductedtodetermineifpersonalcharacter-
$75,000to$100,000 35 9.5
(cid:4)$100,000 31 8.4 istics, receipt of O&M training, cane or
Chosenottoanswer 68 18.5 dog guide use, and public transportation
Education
use predicted walking stress. These vari-
Nohighschooldiploma 10 2.8
ables explained 13% of the variance in
Highschoolgraduate 29 8.0
Somecollege 63 17.4 walking stress, F (9, 305) (cid:2) 4.99, p (cid:3)
Associate’sdegree 45 12.4 .0001. Significant predictors included
Bachelor’sdegree 98 27.1
age, years since vision loss, dog guide
Graduateorprofessionaldegree 117 32.3
Notreported 6 use, physical limitations, and public
Region transportation use (see Table 4). Holding
Northeast 101 27.6
other variables constant, walking stress
Midwest 68 18.6
waspredictedtoincreaseby.06forevery
South 138 37.7
West 59 16.1 additional year of age, so that a 10-year
Notreported 2 increase in age is associated with an in-
Vision
crease in walking stress of approximately
Totallyblind 146 39.7
.60. A person with physical limitations
Legallyblind 201 54.6
Lessseverevisualimpairment 21 5.7 was predicted to have higher stress of .79
Travelmethod compared to a person without physical
Whitecane 247 67.1
limitations. Holding other variables con-
Dogguide 101 27.5
stant, walking stress was predicted to de-
Neither 91 24.7
crease by .03 for each year since vision
loss; a dog guide user was predicted to
TRANSPORTATIONSTRESS have .68 lower stress than someone who
Table 2 provides descriptive statistics for doesnotuseadogguide;andforeachuse
the 12 survey items related to stress. of public transportation per month, stress
Respondents reported the highest stress was predicted to decrease by .03. Daily
navigatingunfamiliarbusroutes,walking use of public transportation (assuming 30
in urban areas with no sidewalks, and days per month) would predict lower
walking in unfamiliar places. The lowest walking stress of .90.
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Table2
Descriptivestatisticsandfactorloadingsfortransportationstressitems.
Factorloading
Public
Variable n Mean(SD) Walking transportation
Walkingstress(composite)(cid:2)(cid:2).85 336 5.82(2.52)
Walkinginurbanareaswithoutsidewalks* 259 6.61(2.89) — —
Walkinginunfamiliarplaces 363 6.57(2.78) .46 .37
Crossingintersectionswithoutsignals 361 6.22(3.03) .49 .29
Walkingonthesideofruralroads 341 5.40(3.19) .82 (cid:5).02
Walkinginresidentialareaswithoutsidewalks 356 5.26(3.06) .95 (cid:5).05
Publictransportationstress(composite)(cid:2)(cid:2).86 336 4.80(2.34)
Navigatingunfamiliarbusroutes 350 6.80(2.80) .17 .66
Arrangingtransportationinunfamiliarlocations 361 5.36(3.09) .02 .73
Usinglightrail,likeacommutertrainorsubway* 289 5.01(3.41) — —
Usingpublicbuses 359 4.88(3.25) .03 .69
Askingbusdriversforassistance 359 4.31(3.30) .04 .75
Askingpedestriansforassistance 364 4.11(2.98) (cid:5).02 .70
Usingtaxis 360 3.54(2.89) .07 .60
Itemsweremeasuredona0–10scale,wherea10indicatedhigherstress.Therangeforallitemsis0
to10.Theboldfaceincolumns2and3representthenandmeanforthecompositevariables;forcol-
umns4and5,boldfacerepresentsfactorloadingsthatareabove.4.
*Notincludedincompositemeasures.
PREDICTORSOFPUBLIC Resultsindicatedthat16%ofthevariance
TRANSPORTATIONSTRESS in public transportation stress can be at-
A multiple regression analysis was con- tributed to these variables, F (9, 306) (cid:2)
ductedtodetermineifpersonalcharacter- 6.53, p (cid:3) .0001. As shown in Table 4,
istics, receipt of O&M training, cane or significant predictors included age, re-
dog guide use, and public transportation ceipt of O&M training, physical limita-
use predicted public transportation stress. tions,andpublictransportationuse.Hold-
ing the other variables constant, each year
of age was associated with an increase of
Table3
.03inpublictransportationstress,suchthat
Frequencyandpercentageofparticipantswho
limitedactivitiesduetotransportationstress, a 10-year increase in age would predict an
despiteavailabilityoftransportation
(N(cid:2)357). increase in public transportation stress of
approximately .30. A person with physical
Activity n %
limitations was predicted to have higher
Entertainmentorleisure 213 59.7 public transportation stress of .67 com-
Visitingfriendsorfamily 179 50.1 pared to a person without physical lim-
Othershopping 163 45.7
itations. Holding other variables con-
Groceryshopping 128 35.9
stant, receipt of O&M training was
Volunteeractivities 125 35.0
Medicalappointments 117 32.8 associated with a reduction in public
Worshipservices 104 29.1 transportation stress of .78, and public
Employment 84 23.5
transportation stress was predicted to
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Table4
Multipleregressionresultsforwalkingstress(N(cid:2)315)andpublictransportationstress(N(cid:2)316).
Walking Public
stress transportationstress
Predictors B SE t B SE t
Intercept 4.26 1.10 3.87** 6.96 1.02 6.80**
Age .06 .01 4.77** .03 .01 2.18*
Yearssincevisionloss (cid:5).03 .01 (cid:5)2.98** (cid:5).02 .01 (cid:5)1.87
Yearsofeducation (cid:5).02 .06 (cid:5).28 (cid:5).10 .06 (cid:5)1.72
Totallyblind (cid:5).003 .31 (cid:5).01 (cid:5).46 .28 (cid:5)1.64
Physicallimitations .79 .28 2.83** .67 .25 2.62**
O&Mtraining (cid:5).01 .43 (cid:5).02 (cid:5).78 .40 (cid:5)1.97*
Caneuse .05 .31 .15 (cid:5).12 .28 (cid:5).42
Dogguideuse (cid:5).68 .31 (cid:5)2.17* (cid:5).44 .28 (cid:5)1.55
Transportationusepermonth (cid:5).03 .01 (cid:5)2.35* (cid:5).05 .01 (cid:5)4.21**
*p(cid:3).05,**p(cid:3).01
decrease by .05 for each use of public increased stress. Less stressful tasks in-
transportation per month. Daily use of cluded using taxis and asking others (pe-
public transportation is associated with a destrians or bus drivers) for assistance.
reduction in public transportation stress Interestingly,askingbusdriversforassis-
of 1.50. tance was slightly more stressful than
asking pedestrians, and both activities
Discussion
wererankedaslessstressfulthanactually
In the study presented here, we investi- using public buses.
gated walking stress and public transpor- Transportationstressmayhaveprompted
tation stress using survey data from 368 some respondents to engage in avoidance
working-age, nondriving adults with vi- coping, since they reported limiting
sual impairments who had access to pub- participation in various activities due to
lictransportation.Themoststressfultasks stress. Respondents most frequently lim-
includedwalkinginunfamiliarplacesand ited participation in entertainment and
in urban areas without sidewalks, navi- leisure activities, which are generally re-
gatingunfamiliarbusroutes,andcrossing garded as enjoyable, stress-reducing ac-
uncontrolledintersections.Thesetasksin- tivities. Visiting family and friends in-
volved unfamiliar or unpredictable travel volves social support, a helpful factor in
environments, which could lead to feel- reducing stress (Urchino & Birmingham,
ings of uncertainty associated with stress 2011), yet respondents frequently re-
(Finan et al., 2011). Many people might ported limiting this activity due to trans-
report feeling some stress in these envi- portation stress. Each person must evalu-
ronments; however, the additional cogni- ate whether performing a stressful activity
tive demands (for example, concentra- isworththeexpenditureofresources(Al-
tion,effort,andattention)onpersonswith dwin & Yancura, 2011), so some persons
visual impairments during independent mayforegoparticipatinginentertainment
travel (Passini et al., 1986) may lead to and leisure activities and visiting friends
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orfamilymembersbecausetheyhaveex- guides alert handlers to surface changes,
hausted their resources performing other help them avoid contact with obstacles,
stressful activities. On a positive note, and assist in maintaining a straight line
less than a quarter of respondents indi- of travel (Franck, Haneline, Brooks, &
cated that transportation stress limited Whitstock, 2010), all of which could mit-
participation in employment. igate stress in these environments. Dog
Older age and self-reported physical guide users typically travel more often
limitations were associated with higher than persons without dog guides and
walking and public transportation stress. more often than before they had a dog
Rutberg (1976) found that urban areas guide (Gillman & Simon, 1982), thus in-
weremorestressfulforolderpersons,and creasing their travel experiences, which
our results indicate that walking in urban may influence how they perceive travel-
areas without sidewalks was the second related stress. Dog guide users report that
most stressful activity. In both regression dogs are helpful in initiating conversa-
models, more frequent transportation use tions (Gitlin, Mount, Lucas, Weirich,
per month was associated with signifi- & Gramberg, 1997), another factor that
cantly lower stress levels, even when might alleviate stress. Another possibility
accounting for personal characteristics, is that individuals who seek training with
O&Mtraining,andcaneordogguideuse. adogguidemightalreadyhavelowstress
Our findings suggest that more time and more sophisticated travel skills.
since vision loss is associated with less O&M training was not associated with
walkingstress.Forpeoplewithvisualim- walkingstress;however,itwasassociated
pairments,learningtheskillsforefficient, with lower public transportation stress.
independenttraveltakestime.Whencon- O&Mtrainingmightprovidemoreoppor-
sidering the relationship between stress tunitiestopracticeandrefinepublictrans-
and time since vision loss for individuals portationskills.StructuredO&Mlearning
with later-onset visual impairments, we opportunities that promote optimal stress
must also consider the process of adjust- levelscouldpositivelyaffectperformance
ment to vision loss. Persons with newly and use of public transportation.
diagnosed visual impairments who have The regression models did not explain
trouble finding the mailbox or walking to a large degree of the variance in stress,
neighbors’ houses might experience in- indicating that other factors likely con-
surmountablestressattheprospectofrid- tribute to transportation stress. Future
ing a bus. More time since onset of a studies would benefit from inclusion of
visual impairment also implies that a per- additional variables, particularly psycho-
son has more opportunities to practice logical variables (such as personality
using these skills. traits, self-efficacy, and self-esteem) and
Dogguideusepredictedlowerwalking other physical and social factors.
stress, which included situations such as This survey focused on transportation,
crossing uncontrolled intersections and notO&M;thus,thesurveyitemswerenot
walking along streets without sidewalks, designed to capture all possible stress-
environmentsthatoftenhaveinconsistent inducingmobilitysituations.Thewalking
auditory or tactile orientation clues. Dog stress variables were chosen to represent
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situations that persons could encounter portation use, which highlights the need
while using public transportation that for O&M specialists to incorporate many
mightleadtohighstress.Thus,thesurvey opportunities for consumers to use vari-
did not include more routine travel tasks ous transportation methods. This finding
or additional “high stress” items, such as extends beyond O&M instruction, since
walking in malls or parking lots (Passini encouraging regular public transportation
et al., 1986), and respondents were not use in daily life may help individuals ex-
asked for details about their prior O&M periencelesstransportation-relatedstress.
training. To provide a more comprehen- When planning instruction, O&M spe-
sive picture of stressful travel environ- cialists should be sensitive to consumers’
ments, future stress research could in- stress levels and aware of situations that
clude additional O&M training variables could lead to higher stress (for instance,
and the relationship with the O&M when traveling in unfamiliar environ-
provider. ments). Given that emotional support and
a sense of belonging are helpful when
LIMITATIONS confronting uncontrolled events (Urchino
The survey used a nonprobability sam- & Birmingham, 2011), persons who an-
pling method, which limits the generaliz- ticipatefrequenttravelinunfamiliarareas
ability of its findings. Compared to the maybenefitfromdiscussiongrouppartic-
U.S.populationofindividualswithvisual ipation to address concerns and share ef-
impairments, the sample had larger per- fective coping strategies. Incorporating
centages of people who were totally technology such as wayfinding devices
blind, had higher levels of education, and and virtual training into O&M training
used dog guides. Further, because this may impact consumers’ stress and anxi-
survey was administered electronically, ety (LaGrow et al., 2009; Seki & Sato,
respondents were limited to persons with 2011).
access and ability to use computers and O&M specialists should also consider
the Internet. personal factors associated with stress
Measuresusedherewerebasedonself- (for example, age and physical limita-
reports. Although self-report measures of tions) and strategies that are most effec-
psychological stress are common, several tive in reducing stress. Carefully se-
other items were more open to interpre- quenced O&M lessons can help visually
tation. For example, respondents were impaired persons develop various skills
asked about physical limitations that af- that will empower them to face poten-
fected their transportation options. Those tiallystressfulsituationsratherthanavoid
who answered “yes” were asked to spec- them. Conversely, progressing through
ify their physical limitations, and re- instruction too rapidly could have a det-
sponses included a range of disabilities. rimental effect on performance when in-
dividuals experience high stress during
IMPLICATIONSFORPRACTITIONERS lessons (Lindau et al., 2000). Accounting
Many variables that predicted lower for the stress-related factors identified in
stress can be targeted for intervention. this study during O&M training might
Oneexampleisfrequencyofpublictrans- help individuals overcome avoidance
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