Transportation Research Part A 107 (2018) 229–245

Contents lists available at ScienceDirect

Transportation Research Part A

journal homepage: www.elsevier.com/locate/tra

On the road again: The barriers and benefits of automobility for

T
people with disability
⁎
Simon Darcy , Paul Francis Burke
UTS Business School, University of Technology Sydney, 1-15 Broadway, Broadway, NSW 2007, Australia

AR TI CLE I NF O AB S T R A CT

Keywords: The UN Convention on the Rights of Persons with Disability (PWD) has been signed by over 160
Private vehicle nations to achieve greater social participation, with public and private transport clearly identi-
Access fied as an area to improve accessibility. Whilst the majority of scholarly work has focused on
Disability public transport needs, less research has examined the barriers or benefits of access to private
Barriers
modified vehicles for PWD. In this exploratory study, a Delphi technique with health experts,
Benefits
Citizenship
researchers, drivers and funding agencies developed an instrument to examine the barriers and
Automobility benefits of access to private modified vehicles for PWD. An online survey was completed by 287
drivers and carers to report on barriers to private modified vehicles, whilst a sub-set of 190
drivers with access to a private modified vehicle reported on experientially derived benefits. A
factor analytic approach identified how financial and informational barriers vary with respect to
several characteristics including disability type and level of support needs. Factors relating to
independence, social and recreational benefits are perceived as more valued experientially de-
rived benefits relative to benefits relating to employability and ability to enjoy downtime.
Benefits in the form of independence are greater among drivers and owners, those with an ac-
quired condition, less complex mobility and everyday support needs, whilst little difference
emerged in terms of the social and downtime benefits. The findings inform policy development
and funding opportunities to provide insight and evidence into the barriers, but also benefits and
variation in private transport needs among PWD.

1. Introduction

Accessibility is a central component to the United Nations’ Convention on the Rights of Persons with Disability including living
independently, community inclusiveness and enabling participation in cultural activities such as those relating to leisure, sport and
tourism (United Nations, 2006, p. np). However, people with disability (PWD) have significantly lower mobility and transport
opportunities available to access spaces and places as compared to the general population (Casas, 2007). The specifics and impact of
difficulties in transport among various disadvantaged groups has been described as “transport disadvantage” (Currie and Delbosc,
2011; Currie et al., 2009; Currie and Stanley, 2007; Denmark, 1998; Hine and Mitchell, 2003). People who are transport dis-
advantaged are affected both socially and psychologically (Delbosc and Currie, 2011b). In a review of the transport disadvantage
literature, Currie and Delbosc (2011) note that among the few studies considering PWD, disadvantage is more pronounced among
them (Currie, 2004; Dodson et al., 2004; Murray and Davis, 2001; Wixey et al., 2005). Such disadvantage compounds the exclusion
PWD face every day (Crow, 1996; Kitchin, 1998), affecting all areas of their lives including employment, health, education, social

⁎
Corresponding author.
E-mail addresses: [email protected] (S. Darcy), [email protected] (P.F. Burke).

https://doi.org/10.1016/j.tra.2017.11.002
Received 12 November 2016; Received in revised form 18 October 2017; Accepted 2 November 2017
Available online 17 November 2017
0965-8564/ © 2017 Elsevier Ltd. All rights reserved.
S. Darcy, P.F. Burke Transportation Research Part A 107 (2018) 229–245

participation and recreation (World Health Organization and World Bank, 2011). The issue speaks to the rights of individuals for
equal access to transportation as part of foundational requirements for social participation and citizenship (Meekosha and Dowse,
1997).
Most research on transport disadvantage among PWD has focused on issues relating to the accessibility and experiences of using
public transport (Casas, 2007; Hine and Scott, 2000; Jensen et al., 2002; Lindqvist and Lundälv, 2012; Risser et al., 2015). These
difficulties are associated with physical accessibility, malfunctioning equipment (e.g. lifts to platforms), lack of audible signalling and
changed or cancelled services (Australian Human Rights Commission, 2015; Currie and Stanley, 2007; Delbosc and Currie, 2011a).
This situation can be further compounded for PWD residing in outer-urban, rural, and remote areas with poor or non-existent
accessible public transport infrastructure, the need to travel further distances to access employment, services and to participate in
activities (Kamruzzaman and Hine, 2012; Rosier and McDonald, 2011).
Many PWD have sought alternative options, including paratransit systems, which are point-to-point systems provided free or
subsidised by government to assist PWD. While less flexible than private modified vehicle (PMV) use, such systems offer in-
dependence for PWD to travel to places of their choosing, thereby successfully facilitating social participation to employment, health,
voluntary, education, social and community engagement activities (Deka and Gonzales, 2014; Fei and Chen, 2015; Nguyen-Hoang
and Yeung, 2010). However, there have been multiple problems with these systems depending on the geographic location, gov-
ernance, delays, effectiveness, efficiency and costs to individuals and to government (Bazaras et al., 2013; Fitzgerald et al., 2000; Fu,
2002).
For some PWD, public and para transport options are not available, with Rosenbloom (2007) suggesting that this is the case for
one-third of Americans. A 2002 study by the U.S. Bureau of Transportation Statistics (BTS) found that that less than one in five used
public transport whilst less than 10 per cent had engaged specialised and ADA paratransit modes (Sweeney, 2004). On the other
hand, 78% of PWD aged 25–64 had used a private vehicle with 69% doing so as drivers. The dependence on cars among older persons
was found to be even higher (Rosenbloom, 2007).
In Australia, in the context of the current study, rates of access to public and private transport among PWD appear higher. One
study in Western Australia indicated 96% had access to public transport with 68% making use of it, whilst 92% of those PWD
surveyed were a passenger or driver of a private vehicle at least once per month (Haning et al., 2012). More broadly, the Australian
Bureau of Statistics (ABS, 2009) reported that 80% of PWD had either driven or been a passenger in a car upon their last trip, with less
than 10% suggesting private transport was sought because of a lack of public transport or preclusions due to their health or disability.
However, another variable in the disability ageing and carers survey specifically examines those who use a modified car or car aids in
Australia. This equated to 0.4% of people with disability or some 15,600 people (ABS, 2009).
The use of a modified car or car aid varies considerably by impairment type. An analysis of data from ABS (2009) highlights these
differences. Amongst those who use modified vehicles or car aids with lower levels of modified vehicle adoption include those with
breathing difficulties (8%), nervous or emotional conditions (10%), loss of hearing (20%) or have a mental illness (24%). Groups with
a higher proportion of PMV adoption include those with incomplete use of their feet or legs (91%), restricted in their physical
activities or work (84%), those with chronic recurring pain (67%) or have difficulty gripping or holding (56%). However, such data
does not identify how many of these people would seek the use of a modified vehicle if they had the need and the means. Further,
these statistics overshadow the reported difficulties among those with greater severity, who are more likely to encounter a wider
range of problems including getting to and navigating transport hubs or getting in and out of vehicles/carriages (Haning et al., 2012).
For these reasons, it is important to understand the benefits and barriers to transportation, but also account for differences in how
such outcomes are realised at different levels across the population of PWD. Identifying potentially marginalised groups and high-
lighting which PWD groups can benefit most and on which dimensions informs the design of policies that support the utilisation of
transport with respect to various factors such as disability type and level of support. The objective of the current research is to
undertake such an investigation in the context of understanding the perceived benefits and barriers of automobility for PWD in
Australia, and how differences in perceptions vary to see whether benefits are uniform or provide greater opportunities to groups
within the PWD community in terms of disability type, level of support need and sociodemographics.

2. Automobility for PWD

To date, research in transportation on private transport options using automobiles for PWD has received less attention relative to
issues of transport disadvantage in public transport and alternatives such as paratransit options. This is surprising given the con-
siderable opportunities that exist for PWD given the right support, assistive technology and engineering modifications to motor
vehicles. In contrast, the medical and allied health research literature explores at length the assessment and interventions for assisting
people with impairments to drive (e.g. Legh-Smith et al., 1986). Not surprisingly, both areas of study of PWD consistently highlight
costs as a barrier to PMV (Woodbury, 2013, p. ii). However, not all PWD are transport disadvantaged to PMVs, with the variation in
costs affected by a person’s disability type and their level of support needs (Australian Bureau of Statistics, 2009). For example, vision
impaired requires no modifications to PMVs whereas wheelchair users require significant modification for independent access.
Few production vehicles are made for people with mobility disability. Instead, standard production vehicles must be specially
modified to cater for drivers and passengers with disability. Modifications can range from simple additions (e.g., steering wheel
spinner knob) to more complex modifications to the vehicle body structure, such as extending a vehicle’s length or altering its roof
line (Roads and Traffic Authority, 2007; van Roosmalen et al., 2010). The cost of such modifications varies from a median as low as
$US50 for a steering wheel spinner knob, $US2600 for a roof mounted hoist, to $US25000 for body modifications. In the case of
wheelchair users with the highest support needs, the combined cost of lowering a vehicle’s floor or raising its roof to allow a

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wheelchair user to drive from their wheelchair together with electronic driving aids may cost as much as $US190,000 (Bourke-Taylor
et al., 2014; Darcy and Eley, 2014; Denmark, 1998; Eley, 2016). Among families with children with cerebral palsy, it was identified
over half spent $US22,000 on vehicle modification (Bourke-Taylor et al., 2014). Hence, household income can also affect transport
disadvantage since PMV ownership is restricted through the cost of purchasing modified vehicles as well as maintaining PMVs such as
the cost of petrol, registration, insurance, servicing and repairs of vehicles. This can lead to “transport poverty” among those with
lower rates of disposable income and employment such that ongoing costs of car ownership create financial stress (Gleeson and
Randolph, 2002).
In general, government approaches to PMV ownership have been ad hoc at best with few countries offering schemes to redress the
inequity of PMV ownership for PWD including UK, Germany and Australia (Darcy and Eley, 2014; Layton and Wilson, 2009). Most
schemes offering assistance to PWD to drive or gain access to a modified vehicle are only available to those who were eligible for
compensation via workplace or motor vehicle accident. Government programs vary by country (the vast majority having no assis-
tance programs), whilst approaches to modification approval, assistance, assessment and licensing of drivers with disability further
vary by jurisdiction or by regional government. For example, in Australia, State and Commonwealth government programs give not
only money but also support including occupational therapist and workplace assistance (National Disability Insurance Scheme,
2015b; NSW Lifetime Care and Support Authority, 2016). These resources are both information and assessment based and com-
plement an eligible person’s access to financial resources. In other schemes, access is dependent on the individual being employed.
The neoliberal agenda of employment and citizenship being closely aligned flows through to PMVs, whereas access to automobility
for PWD without employment can increase employment prospects by extending their opportunities for social participation. These
opportunities include volunteering where PWD are exposed to human capital development that are critical to, and transferable, to
employment (Bates and Davis, 2004; Lindsay, 2016).
For those without a motor vehicle license living in a car culture, such as the US, Australia and Canada (Flink, 1975), significant
social disadvantages occur (Featherstone et al., 2005; Hendricks, 2014; Lucas et al., 2011). Critiques of automobility identify that
whilst PWD are able to access the benefits of automobility (e.g., mobility, status, independence, employment and pleasure), society
accrues the costs (e.g. negative externalities of pollution, crowding etc.) and how through new notions of transport sustainability
there is an increased emphasis on social sustainability (Wells and Xenias, 2015).
Consideration of transport disadvantage, however, must move beyond a simplistic understanding that it affects PWD stemming
from being “unable to drive” (cited in Currie and Delbosc, 2011; Murray and Davis, 2001). Study of opportunities for PWD must
recognise the social structure to which they are embedded. For example, PWD are presented many opportunities by the household or
family to which they belong. As such, studying barriers and benefits of private transport must recognise that where PWD are unable
to drive there is an increased role of household members in transporting individuals with disability that creates a dependency and
extra hidden cost of disability to the household through either lost to the cost (lost paid employment through a voluntary transporting
of PWD) and lost independence of PWD that affects social participation (Deka, 2014).
In conceptualising transport disadvantage, Currie and Delbosc (2011, p. 21) identifies that there are three major considerations:
urban form; transport options; and, types of people. As such, it is important to consider that the travel chain is made up of all elements
of a journey including pedestrian access, the vehicles themselves and transfer points, and if any link is inaccessible the entire trip
becomes difficult (World Health Organization and World Bank, 2011, p. 179). These elements of the urban environment further
create barriers for all transport options, including those using PMVs. The personal mobility of the individual, their access to or
limitations with assistive technology may further affect their local mobility. This may occur through: lack of curb cuts, continuous
part of travel, ramps, lifts, tactile ground surface indicators, clear signage, the type surface, the gradient, cross camber, inclement
weather, parking, accessible toilets and a myriad of other access considerations (Bromley et al., 2007; Meyers et al., 2002).
With respect to benefits derived from personal transportation, some studies have linked mobility among PWD to a range of
improvements including quality of life stemming from a sense of freedom, and the control over their participation in the community
(van Roosmalen et al., 2010). Among drivers, Ellaway et al. (2003) found higher levels of benefits relating to perceptions of pro-
tection, autonomy and prestige in their mobility over those who were passengers or public transport users; a link between PMV
ownership, longevity of life and better health was also found (Ellaway et al., 2003).
Freund (2001) discusses the social organisation of space-time practices that create significant disadvantage for PWD requiring
accessible transport options. Drawing on sociology and disability studies connections are made between the social organisation of
space and time in society, the embodied ontology of PWD and the notion of embodied agency. This theoretical examination has
significant implications for transport (public and private) that have been structured without consideration of disability. The social
construction of the transport environment creates a series of “disabling barriers” imposed on top of a person’s impairment that results
in transport disadvantage (Aldred and Woodcock, 2008; Barnes et al., 2010). While public transport and para-transport options have
been examined through social constructionism, there has been a dearth of studies examining automobility and access to private
modified vehicles. This paper will seek to address this gap in the literature by applying a social constructionist and socio-ecological
model to the barriers and benefits of automobility (Devereux et al., 2015; Simplican et al., 2015).

2.1. Summary

Social exclusion from transport can be discussed in terms of the social and human capital an individual is able to develop to
challenge their disadvantage or if unable to challenge their disadvantage how it perpetuates the inequality and discrimination that
they face (Schwanen et al., 2015). As the aforementioned studies have noted, the link between social participation and the devel-
opment of social and human capital for PWD has been shown to be closely connected. Schwanen et al. (2015) notes the embodied

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process for PWD where dependency in transport becomes an internalised dependency for all areas of social participation. In doing so,
those experiencing transport disadvantage (in this case, PWD) are socially excluded beyond just social participation to those areas
that manifestly develop in social capital through bridging (current relationships) and networking (beyond their current social circles)
that provide opportunities for volunteering and employment. To date, the few that consider PWD in terms of PMV suggest a range of
barriers, but also benefits that can be realised, but these may vary across different groups. However, implicit to social capital is an
understanding of the social constructionism and the social ecological model that categorises the dimension of barriers/benefits across
the following levels: individual; interpersonal; organisational; community; and the sociopolitical. In the next section, the research
approach is described in more detail that was used to explore these questions.

3. Research design

The background literature and UN human rights social model theory guided the research design generally and the survey in-
strument design specifically to examine the benefits and barriers in PMV access and to explore disparity across PWD on various
dimensions of disability, support needs and demographics. A social model of disability approach focuses on the lived experience of
PWD, the barriers they face and the transformative solutions to creating enabling environments and attitudes (Oliver, 1990). The
results and discussion draw upon a social constructionist approach to understanding disability in the PMV context. Further, to assist
in analysing the results and discussion, a social ecological model (individual/intrapersonal; interpersonal; organisational; commu-
nity; and, sociopolitical and public policy) is utilised to better understand the PMV ecosystem (Simplican et al., 2015).

3.1. Instrument development

As no previous quantitative studies had been developed to examine the benefits of ownership of a PMV, this exploratory study also
used a Delphi technique to assist with questionnaire development (Hasson et al., 2000; Linstone and Turoff, 1975). The Delphi group
consisted of 15 expert advisers from across government, not-for-profit and commercial suppliers, chosen for their relative expertise in
disability, industry knowledge, access, occupational therapy, policy or advocacy. Nine of the group had lived experience of driving
with disability across the all levels of support needs from relatively independent with low-tech driving requirements (e.g. spinner
knob) through to the highest level quadriplegic drivers using specialist electronic equipment. Two were also passengers with dis-
ability. All members were involved in initial conversations about the project and the series of four rounds of questionnaire instrument
development and pilot testing that occurred over a six-week period. The questionnaire instrument changed over this time period as
did the wording of individual items. Once the questionnaire testing was complete, the Delphi group remained involved and received a
draft report for comment. The pilot examined: survey completion time; identifying duplication; typographical errors; establishing
clarity and validity of questions and items; and obtaining suggestions for additional questions or omitted areas that would add value
to understanding the issues.
The finalised 12 items referring to barriers to ownership, accessing and modifying PMVs were evaluated by respondents on a five
point scale with respect to how strongly a subject agreed with whether each was perceived to impede PMV access (“strongly disagree”
to “strongly agree”). The finalised 22 items to measure for benefits of having access to PMVs were presented on a 5-point scale of
importance (“not at all important” to “very important”). The items cover a broad spectrum of aspects relating to barriers and benefits
of PMV. As outlined in the next section, this motivated the reduction of variables to a smaller number of common factors to aid
comparisons with respect to a number of underlying enabling and inhibiting factors and to understand whether these loomed sig-
nificantly larger for one PWD group over another. The patterns of responses on the items were considered in terms of how the data
could be categorised into various unknown, but underlying themes. Specifically, exploratory factor analytic (EFA) approach was used
to uncover any complex factors in the data followed by confirmatory factor analysis (CFA) (Anderson and Gerbing, 1988; Hair et al.,
2010) using Mplus version 7.3 (Muthén and Muthén, 1998-2012) to make comparisons of groups of PWD on these underlying
dimensions.

3.2. Survey participants and procedure

As there is no complete Census list of PWD in Australia, an electronic snowballing technique was used to contact a radiating
sample based on organisational member lists to contact PWD and family members (Veal and Darcy, 2014), a technique successfully
used in previous studies of PWD [references withheld]. A database of over 100 disability organisations was used to contact PWD
across Australia from April 2014 through to August 2014. The organisations communicated information about the research with a
link to the questionnaire to members on their websites, by direct e-mail or within electronic or hard-copy newsletters, and sup-
plemented using social media and blog posts. Qualtrics online survey platform was utilised for its accessibility features including for
people with vision impairment and its robustness in previous studies (Darcy, 2010; Darcy et al., 2017).
Qualifying subjects were those who were either a PWD, their family or carers who owned or would like to own a modified vehicle
for the purposes of providing private transport for a PWD. A total of 413 persons commenced the survey with 86 subjects being
screened out or terminating the survey themselves. Out of this, 87.8% of respondents responded to the questions relating to the issues
and barriers that were critical of them owning, accessing or modifying a PMV. A further 58% qualified and responded to questions
relating to the experientially derived benefits of owning or having access to a PMV. Among this group, 28% were family or carers who
owned the vehicle with modifications to cater for the needs of another PWD. Among PWD undertaking the survey, 56% were those
who were also able to drive. Other sociodemographic characteristics are presented in Table 1.

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Table 1
Characteristics of respondents completing survey.

Entire sample (n = 287) Owner drivers (n = 190)

Respondent Characteristic n % n %

Driver-Owner of private motor vehicle with modifications

PWD owner of a private motor vehicle with modifications 153 53.3 121 63.7
Family/carer owner for other PWD 60 20.9 56 29.5
Non-owner 74 25.8 – –
Congenital or acquired condition
A congenital condition (from birth) 124 43.2 83 43.7
An acquired condition (a result of trauma/illness) 163 56.8 107 56.3
Mobility based classification of disability
Mobility-requiring the use of a Power Wheelchair 118 41.1 86 45.3
Mobility-requiring the use of a Manual Wheelchair 78 27.2 55 28.9
Mobility-use of other mobility aids (e.g., scooter) 64 22.3 30 15.8
Others (include limited mobility no aid required) 27 9.4 19 10.0
Identify as having multiple disabilities
Yes – person has multiple disabilities 121 42.2 70 36.8
No 166 57.8 120 63.2
Level of support needs in everyday living
None (Independent) 27 9.4 19 10.0
Low 57 19.9 38 20.0
Medium 56 19.5 32 16.8
High (twice daily) 61 21.3 41 21.6
Very High (requires full-time assistance/attendance) 86 30.0 60 31.6
Eligibility for compensation
Yes (for motor vehicle purchase/modification) 57 19.9 42 22.2
No 229 80.1 147 77.8
PWD who drives
Yes 107 56.3 106 56.1
No 83 43.7 83 43.9
Gender
Malea 144 50.2 84 47.7
Female 111 38.7 92 52.3

a
One respondent identified themselves as transgender; no significant differences between two samples were identified (p > .05).

4. Results

4.1. Measure of barriers

The first analysis focused on issues that all survey participants regarded as critical to gaining ownership, access and modification
to private vehicles, with 287 providing data for analysis. The distribution of ratings and summary statistics for each of the 12 items
are presented in Appendix A. EFA performed on these barriers showed the presence of three underlying components; one construct,
however, was described by a single item. Subsequently, the CFA was performed in Mplus for two remaining latent constructs, namely,
financial barriers and information barriers. Items that dropped from the analysis were a measure relating to the costs of lessons being
prohibitive and another difficulty in locating information about an appropriate vehicle for a person’s access needs. Both had low
correlations with other items.
The model fit of the final CFA is acceptable (CFI = 0.947 > 0.9), along with both the SRMR of 0.042 and the RMSEA of 0.098
below 0.10 as required (Steiger, 1989; Browne and Cudeck, 1993). With respect to internal consistency reliability of the reflective

Table 2
CFA Results Examining Barriers in Modified vehicle ownership.

Barriers Est CA CR AVE

Financial Barriers
Owning a private motor vehicle is a financial burden 0.472 0.635 0.725 0.597
The cost of vehicle modifications for my disability is too expensive 0.986
Information Barriers
Information about vehicle modifications schemes is non-existent 0.616 0.881 0.716 0.556
I don’t know where to find information about reputable vehicle modification suppliers 0.787
I don’t know who to go to get assistance and advice on vehicle modification 0.846
I cannot locate information about modifications most appropriate for my access needs 0.859
Up-to-date information about new driving technology is difficult to find 0.695
Information about an appropriate vehicle for my access needs is difficult to locate 0.634

CA = Cronbach alpha (α); CR = composite reliability; AVE = average variance extracted.

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Table 3
Differences in perceived barriers.

Financial Information

Respondent characteristic n Mean (Stdev) F-stat (p-value) Mean (Stdev) F-stat (p-value)

Driver-Owner
PWD who own a private motor vehicle with modifications 153 3.85 (0.95)ab 14.32 (.000)** 3.16 (0.95)a 5.58 (.004)**
Family/carer owning PMV for other PWD 60 4.34 (0.83) 3.39 (0.89)
PWD or family/carer who would like a PMV 74 4.44 (0.68) 3.59 (0.93)

Congenital or acquired condition

A congenital condition (from birth) 124 4.21 (0.85) 2.77 (.097)* 3.40 (0.94) 1.52 (.219)
An acquired condition (a result of trauma/illness) 163 4.03 (0.94)a 3.26 (0.96)

Main disability
Mobility-requiring the use of a Power Wheelchair 118 4.42 (0.71) 11.35 (.000)** 3.43 (0.87) 4.14 (.007)**
Mobility-requiring the use of a Manual Wheelchair 78 4.07 (0.88)a 3.17 (0.95)a
Mobility-other mobility aids (including scooter) 64 3.67 (1.06)a 3.10 (1.03)a
Others (include limited mobility no aid required) 27 3.88 (0.86)a 3.73 (0.85)

Identify as having multiple disabilities

Yes – person has multiple disabilities 121 4.31 (0.77) 11.13 (.001)** 3.37 (0.93) .66 (.418)
No 166 3.96 (0.96)a 3.28 (0.96)

Level of support needs in everyday living

None (Independent) 27 3.52 (0.99)ab 9.64 (.000)** 2.7(.98) abcd 2.84 (.025)*
Low 57 3.84 (0.98)ab 3.36 (0.95)
Medium 56 3.95 (0.96)a 3.34 (0.95)
High (twice daily) 61 4.22 (0.76)a 3.43 (0.88)
Very High (requires full-time assistance/attendance) 86 4.49 (0.68) 3.37 (0.94)

Eligibility for compensation

Yes – for purchase/modification 57 3.85 (0.95)a 6.26 (.013)** 2.96 (0.92)a 10.43 (.001)**
No 229 4.18 (0.87) 3.41 (0.94)

PWD who drives

Yes 107 3.88 (1.00)a 14.80 (.000)** 3.14 (0.98) 1.57 (.211)
No 83 4.36 (0.66) 3.32 (0.89)
Gender
Male 144 4.11 (0.88) .53 (.466) 3.49 (0.91) 7.62 (.006)**
Female 111 4.03 (0.94) 3.17 (0.94)a

Significance level at **p < .01 and *p < .05.

a
Denotes significantly different to group with highest mean.
b
Significant difference compared to next highest mean (Tukey HSD); p < .05.

multi-item constructs, the composite reliability (CR) (Werts et al., 1974) exceeds 0.7 for both constructs were thereby considered
satisfactory (see Table 2). The loading of one item for financial barrier construct was 0.472, thereby affecting internal consistency in
the form of Cronbach Alpha (Cronbach, 1951). However, this item was retained in the model as it improved overall model fit, offered
suitable internal consistency based on composite reliability, and improved discriminant validity from the financial barrier construct.
The average variance extracted (AVE) is often used as a common measure of convergent validity at the construct level and should
be greater than 0.50 in this regard (Hair et al., 2010); as such, the measures of both constructs relating to barriers achieve high levels
of convergent validity. Discriminant validity, the extent to which each construct is sufficiently different from other constructs, is
established by confirming the correlation between the two constructs is lower than the square root of the AVE of the two constructs
(Fornell and Bookstein, 1981; Fornell and Larcker, 1981). In the current instance, this is established (0.773 for financial; 0.750 for
information; correlation, r = 0.319).
Overall, the results show financial factors present more as a significant barrier to PMV when compared to barriers relating to
information requirements (Mfin = 4.12; Minfo = 3.31; t = 11.44; p < .0001). The result is as expected; particularly when 80% of
respondents do not qualify for compensation for vehicle modification, more than 51% have high or very high levels of support needs
in their everyday living and living costs often loom larger among PWD and their carers relative to people without a disability
(Australian Bureau of Statistics, 2012; Cullinan et al., 2011). Whether these and other differences are significant to how perceived
barriers to PMV modification vary across respondents with respect to several indicators including their level of support needs, type of
disability, and other sociodemographic characteristics were formally tested using ANOVA. In the case of significant differences, a
post-hoc tests using Tukey-Kramer honest significant difference (HSD) were performed (Tukey, 1949) with the results presented in
Table 3.
In summary, the perception that financial and information were barriers was found to be more significant amongst: (a) PWD or
carers who currently do not own a modified vehicle; (b) people with a congenital disability (i.e., from birth); (c) have higher levels of
support needs in everyday living; (d) those not eligible for compensation with motor vehicle purchase modification or purchase; (e)

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Table 4
CFA results for perceived benefits of access to a private modified vehicle.

Perceived Benefits Est. CA CR AVE

Social and Recreational Benefits

Keeps me connected to family and friends 0.795 0.825 0.827 0.616
Opportunities to socialise with others 0.849
Provides access to leisure and recreation activities 0.704

Employability
Gives access to employment 0.746 0.833 0.845 0.735
Allows me to do my job better 0.956

Downtime
Get away from daily life 0.797 0.862 0.868 0.769
Provide opportunities to unwind 0.950

Independence
Experience freedom to go anywhere at any time 0.791 0.843 0.843 0.576
Increases independence 0.842
Not dependent on others 0.717
Have control over my life 0.674

CA = Cronbach alpha (α); CR = composite reliability; AVE = average variance extracted.

those PWD who do not currently drive. In addition, information barriers were significantly higher among females, whilst those with
multiple disabilities were significantly more likely to have financial considerations as a barrier to PMVs.

4.2. Measure of benefits

The distribution of ratings and summary statistics for responses to each of the 22 benefits are presented in Appendix B. Focusing
on the experience of owners and benefits they have derived through their direct experiences as an experiential measurement was
thought to be more valid and reliable rather than considering the anticipated benefits of non-owners meant that the analysis focused
on a subset of the sample, namely 190 respondents. Once again a combination of EFA and CFA was used to identify underlying
themes in the data and to provide parsimony in exploring differences across the sample. EFA indicated the presence of six factors,
however, two of these factors were dropped on the basis that they were constructed as single-item measures and found to have high
cross-factor loadings with other constructs. As such, the final CFA reported upon consists of the four remaining latent constructs.
Other items were dropped on the basis of low factor loadings.
The CFA shows an acceptable model fit (RMSEA = 0.059 < 0.1; CFI = 0.956 > 0.9) (Browne and Cudeck, 1993; Steiger, 1989).
The four constructs recognised were ‘social and recreational benefits’, ‘employability benefits’, ‘downtime’ and ‘independence’. These
constructs had acceptable values of Cronbach’s Alpha, Composite Reliability (CR) and Average Variance Extracted (AVE) as seen in
Table 4. Discriminant validity is also established with the inter-correlation between any two latent factors less than the square root
AVE of the individual constructs (Fornell and Bookstein, 1981; Fornell and Larcker, 1981) as seen in Table 5.
At an aggregate level, the mean estimates of each latent construct, show the perceived benefits are all extremely valued; however,
benefits relating to independence and improving access to social and recreational activities are significantly higher relative to the
other benefits of downtime and employability derived from PMV ownership (see Fig. 1).
These identified constructs were further considered in terms of mean differences with respect to the characteristics of the re-
spondents (see Table 6). The results show independence and social and recreation were important benefits of access to PMV, con-
sidered highly by all the groups in question. In summary, there were no significant differences across the various individual measures
considered with respect to social benefits that are associated with access to a modified private vehicle for PWD. In contrast, benefits
relating to independence and employment were more significant amongst owners who: (a) are PWD as compared to family or carers;
(b) have lower levels of support needs in their everyday living; and, (c) are PWD who are drivers themselves rather than passengers.
The perceived benefits arising from access to a modified vehicle in the form of independence, but not those relating to social,
employment, or downtime, was perceived to be a more significant benefit among those with an acquired condition (i.e., a disability as
a result of trauma or illness as opposed to congenital condition), but significantly less among those requiring the use of a power

Table 5
Correlations between perceived benefits construct.

Social Employment Downtime Independence

Social 0.785
Employment 0.350 0.857
Downtime 0.489 0.399 0.877
Independence 0.686 0.458 0.544 0.759

Note: Diagonal entries represent sqrt (AVE); off-diagonal elements represent correlations.

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5.0

4.5

4.0

3.5

3.0

2.5

2.0

1.5

1.0
Social and Employability Downtime Independence
Recreational

Fig. 1. Mean estimates of four benefit measures.

Table 6
Differences in measures of perceived benefits.

Variable Social Independence Downtime Employment

n Est. (SD) F (p-value) Est. (SD) F (p-value) Est. (SD) F (p-value) Est. (SD) F (p-value)

Modified vehicle owner with a disability or owner-driver-carer

Owner with a disability 121 4.68 (0.44) 1.6 (.214) 4.70 (0.47) 13.7** (.000) 3.94 (0.94) 0.4 (.536) 4.06 (1.09) 7.2** (.008)
Family or carer owning vehicle 56 4.57 (0.73) 4.36a (0.74) 4.04 (0.88) 3.60a (1.04)

Condition of person with a disability

A congenital condition 83 4.59 (0.65) 1.2 (.28) 4.46a (0.70) 7.5** (.007) 3.97 (0.95) 0.0 (.957) 3.89 (1.04) 0.1 (.804)
An acquired condition 107 4.67 (0.46) 4.69 (0.46) 3.98 (0.90) 3.93 (1.11)

Mobility based classification

Mobility- Power Wheelchair 86 4.61 (0.50) 0.4 (.725) 4.45ab (0.58) 3.3 (.021)* 3.98 (0.93) 0.7 (.575) 3.90 (1.06) 0.5 (.657)
Mobility- Manual Wheelchair 55 4.67 (0.44) 4.70 (0.45) 3.92 (0.84) 4.02 (1.03
Mobility- other mobility aids 30 4.70 (0.56) 4.78 (0.44) 3.89 (0.91) 3.72 (1.10)
Others (limited; no aid) 19 4.54 (0.94) 4.59 (0.96) 4.23 (1.11) 3.97 (1.31)

Identify as having multiple disabilities

Yes – multiple disabilities 70 4.61 (0.64) 0.2 (.619) 4.53 (0.68) 1.0 (.313) 3.96 (0.94) 0.0 (.923) 3.62a (1.15) 8.7 (.004)**
No 120 4.65 (0.50) 4.62 (0.53) 3.98 (0.91) 4.09 (1.00)

Level of support needs

None (Independent) 19 4.67 (0.58) 0.4 (.825) 4.80 (0.50) 3.7 (.006)** 4.22 (0.84) 1.6 (.166) 4.36 (0.97) 2.5 (.041)*
Low 38 4.68 (0.43) 4.82 (0.32) 3.84 (0.92) 4.10 (1.09)
Medium 32 4.59 (0.53) 4.62 (0.48) 3.74 (0.88) 4.06 (0.99)
High (twice daily) 41 4.56 (0.50) 4.47ab (0.58) 3.91 (0.88) 3.86 (0.90)
Very High (full time assistance) 60 4.67 (0.65) 4.43ab (0.74) 4.14 (0.97) 3.61ab (1.2)

Person with disability who drives themselves?

Drive themselves 106 4.67 (0.49) 0.3 (.603) 4.77 (0.39) 25.1 (.000)** 4.01 (0.90) 0.1 (.767) 4.24 (0.97) 22.6 (.000)**
Passenger 83 4.63 (0.48) 4.40a (0.61) 3.97 (0.90) 3.54a (1.04)

Highest educational qualification completed

University 71 4.56 (0.66) 1.2 (.330) 4.48 (0.75) 1.9 (.137) 3.78a (1.06) 2.5 (.062)* 3.93 (1.18) 0.5 (.681)
Diploma(undergraduate/associate) 21 4.51 (0.55) 4.46 (0.63) 3.81 (0.88) 4.17 (0.91)
Trade qualification/apprenticeship 40 4.70 (0.48) 4.73 (0.43) 4.22 (0.75) 3.85 (1.11)
Other (including school) 45 4.70 (0.46) 4.65 (0.42) 4.10 (0.84) 3.85 (0.98)

Current employment status?

Employed 89 4.58 (0.53) 0.9 (.345) 4.54 (0.58) 0.8 (.373) 3.89 (0.96) 1.0 (.324) 4.17 (0.95) 10.2 (.002)**
Not currently working 87 4.66 (0.60) 4.62 (0.63) 4.03 (0.92) 3.67a (1.15)

Total income of person with a disability

Refused to answer 31 4.82 (0.39) 1.9 (.133) 4.75 (0.50) 1.4 (.237) 4.51 (0.55) 4.8 (.003)** 4.31 (0.88) 1.6 (.193)
Under $21,000 per year 42 4.64 (0.47) 4.63 (0.51) 3.95a (1.06) 3.87 (1.19)
$21,000–$52,000 per year 52 4.62 (0.53) 4.59 (0.54) 3.84a (0.93) 3.82 (1.07)
More than $52,000 per year 50 4.55 (0.53) 4.50 (0.59) 3.81a (0.84) 3.89 (1.03)

** p < .01.
* p < .05.
a
Denoting significantly different to group with highest mean.
b
Significant different compared to next highest mean, etc. (Tukey HSD; p < .05).

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Fig. 2. Perceived benefits by level of everyday support required.

wheelchair. Perceived benefits relating to employment were found to be more significantly lower for those with multiple disabilities
and those currently employed. Finally, those who perceived access to a modified vehicle had provided greater benefits relating to the
ability to experience downtime (i.e., escapism) were more significant amongst those with a trade qualification or apprenticeship as
compared to those who had completed University study.
The benefit of escapism was also found to be significantly higher amongst those who did not provide information about their
household income as compared to those respondents who did. Finally, benefits from PMV varied with respect to required levels of
support in everyday living; whilst all PWD perceived high levels of social benefit, those with very high levels of support were
significantly less likely to nominate value with respect to independence and employment. These effects are illustrated in Fig. 2. Since
a person in this group required assistance throughout the day, this indicated that owning a modified vehicle would not provide
similar value of independence benefits as compared to that of a person with lower support needs who may be able to drive. In
addition to that, a person with high and very high support needs is also less likely to travel to work and therefore will not gain
benefits in terms of employment when it comes to having access to a PMV (Australian Bureau of Statistics, 2009).

5. Discussion

The results of the exploratory study provide important insights into barriers and benefits of automobility for PWD who require
PMV ownership. The results provide understanding based on social constructionist and socio-ecological approaches to the issue. The
results highlight considerations with respect to groups of PWD and policy implications, as are now discussed.

5.1. Barriers

The findings identified two key components to barriers of ownership to PMV, namely financial considerations and information
provision. The significance of financial issues associated with PMV modifications confirms the qualitative work by Woodbury (2013)
that identified the initial purchase cost of a car and modification, along with ongoing costs of petrol, vehicle maintenance, insurance
and breakdowns, as substantial barriers. Quantitatively this work is also supported by the equipment and costing outlined in other
studies (Bourke-Taylor et al., 2014). Not surprisingly, this study supports the finding that the cost of vehicle modification was the
most significant barrier. The component explores the notion of “owning a private motor vehicle is a financial burden”. This reinforces
work on transport disadvantage and subsequent transport poverty where people are forced to own a car for social participation and
are then burdened by the ongoing financial and other costs associated with car ownership in a disability and PMV context (Currie,
2004; Gleeson and Randolph, 2002). Given that PWD have lower levels of employment and income than the general population (ABS,
2009), this could explain the disabling nature of car ownership on the financial position of PWD. Whilst financial barriers were also
evident among those who wanted to own a PMV but were unable to, this was also particularly significant among those with con-
genital disability, power wheelchair users, those with multiple disabilities, higher support needs, those without compensation, and
those who don’t drive themselves. As such, these individuals experiencing cumulative disadvantages face significantly higher im-
pediments to owning PMVs. Such groups already experience additional costs of care, which often fall upon families over and above
the standard costs of living (Baldwin, 2015) and linked to a lower levels of employment and, hence, incomes (ABS, 2009). The
inhibiting costs of PMV transport are not only higher, but sit alongside ongoing costs including disability specific equipment, medical
support, care, in-home support, education and therapy.
This study has contributed a new component of information provision as a major barrier to private vehicle modification.
Reviewing the items under this component examined how information about PMV modification is non-existent in relation to schemes,
reputable suppliers, assistance and advice and generally difficult to locate up-to-date information for their access needs. This suggests
that knowledge management systems about PMV modifications leave a lot to be desired by the group. In particular the combination
of being a person who wanted to own a modified vehicle, those who did not own a modified vehicle, power wheelchair users, those
with multiple disabilities and males regarded the lack of information as more critical to their situation. This component suggests that
authorities need to improve knowledge management systems to lower the barriers for PMV access.

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5.2. Benefits

The benefits of automobility for PWD have been identified in the findings as a significant outcome and quantitatively builds on
the qualitative work of Woodbury (2013). The components of social and recreational, independence, downtime and employability
were all valued highly by PWD. However, it was benefits relating to social and recreational outcomes, and increased independence
that were most highly valued. This suggests that while policy considerations favour employment as an area that current funding
support programs are targeted at, our study highlights the personal benefit for PWD in increasing independence, and the general
social and recreational participation. As outlined in the background literature, this can contribute towards social and human capital
development including volunteering, which in turn may provide employment opportunities for PWD (Bates and Davis, 2004; Lindsay,
2016; Schwanen et al., 2015). By not providing financial support for PMV outside of the strict neoliberal employment policy criteria,
governments may be foregoing medium and long-term benefits of social and human capital development, which may include em-
ployment. Even without employment, PWD who are more socially and recreationally connected by levels of social and human capital,
and much higher levels of quality of life (Chenoweth and Stehlik, 2004; Helliwell and Putnam, 2004).
While the study did not examine the emotions arising from automobility, the items associated with independence as an indicator
of transport disadvantage affecting an individual’s freedom, their dependence on others and a loss of control in their lives suggest
associated emotional outcomes. Their improved automobility gave them an increased sense of agency over all areas of their life. This
is directly connected to their social and recreation activities, opportunities to escape from everyday life and unwind (downtime), and
increased employment opportunities. Quite simply, automobility provides the participants of this study with an increased disability,
citizenship in all areas of their life (Meekosha and Dowse, 1997).
As noted in the results, employment and those with higher education levels perceived less benefits in downtime, and social and
recreation participation. Whilst counter intuitive, Guryan et al. (2008) found that time allocated to leisure falls sharply as education
and income rises whilst higher-educated parents spend more time with their children. One explanation is that those with education
qualifications utilise their PMVs to undertake an array of social, educational and related activities at the expense of those activities
they perceive as enabling them to provide opportunities to unwind.

5.3. Individual differences in perceived benefits and barriers of PMV

Differences in the perceived benefits and barriers of ownership and access to PMVs were identified across a wide array of variables
including: congenital/traumatic disability; whether they had multiple disabilities; compensatable/non-compensatable; owners/did
not own; drivers/non-drivers; education; employment; income; and gender. This social milieu adds a further complexity to under-
standing an individual’s intrapersonal, interpersonal and social context. The lived experience of the group, the barriers that they face
and the transformative solutions to assist with automobility can be best understood through a combination of the social construc-
tionist approach and the social ecological model. In understanding social constructionist approaches through a disability studies, a
person’s impairment becomes a socially constructed “disability” (see Oliver, 1990) through the disabling environment, discourses and
hostile attitudes within the private vehicle access and modification ecosystem. The opportunities that individuals have within their
socially constructed environment, requires an understanding of the “embodied ontology” (Shakespeare and Watson, 2001). The
matrix of disadvantage requires enabling practices to assist individual’s in human capital development to overcome their lack of
knowledge or skills that people without disability develop as a natural part of their life course. Unless somebody knows which PMV
modifications are available how can they even imagine driving? Without access to a vehicle with the requisite modifications, how can
they or their support network provide them with the same opportunities as their nondisabled peers? Unless government policy
programs are in place then how can the extra costs of disabilities be moderated for equity considerations?
While PWD have been recognised as a group experiencing transport disadvantage (Currie, 2004; Dodson et al., 2004; Murray and
Davis, 2001; Wixey et al., 2005), there has been no exploration of the individual differences of the group’s complexity as a multi-
layered construct. This study extends Currie and Delbosc (2011) understanding of the importance of the urban form, transport forms
and types of people by providing a richer understanding of the complexities of PMV access and modification. With respect to types of
people, the research indicates how the type of disability and their support needs affect the barriers they face and the benefits they
receive from access to a PMV. Others have called the impact of these variables on participation of the group as creating an “inherent
complexity” (Darcy, 2010). This study has reinforced previous findings that identified the importance of both disability and support
needs as key constructs for understanding access to PMV ownership and modification, while others examined other forms of social
participation (Darcy et al., 2017). When considered with the noted problems in accessing public transport and travel more generally
due to the urban form and transport types, this “complex interplay” (Packer et al., 2007) between PWD and the contextual en-
vironment of transport disadvantage, the reasons for the potential benefits become more pronounced.
One important variation among PWD with respect to experientially derived benefits from PMV was found in relation to in-
dependence, which was significantly higher among PWD who were owners as compared to their carers, family members or atten-
dants. Perceived benefits relating to independence were also significantly lower among those who required the use of a power
wheelchair as opposed to other forms of mobility classification, lower among those with higher levels of support required in everyday
living and lower among those PWD who are passengers rather than drivers. In contrast, people using manual wheelchair or require no
aid can easily be accommodated in a vehicle by folding the chair or with less assistance from others in a standard vehicle that does not
require a high level of modifications. Therefore this group requires lower financial resources and information on schemes to access
PMV. As such, one important takeaway from the research is recognise that access to PMV provides greater forms of independence, but
the realisation of this depends on the individual circumstances for the PWD to realise such benefits. That is, in many cases power

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wheelchair owners, passengers, and those with high levels of support are often still reliant on another person to drive the vehicle; on a
positive note, other differences relating to social benefit and escapism were less varied across these same individuals.
In Australia, about two thirds of people are born with their disability and one third acquired their disability such as through illness
or accident (ABS, 2009), with the latter in this study reporting significantly higher perceived benefits relating to independence. One
explanation is that those who acquire disability at a later stage in life are familiar with the independence they had when living
without a disability. Indeed, Bogart (2014) finds that social group identity and development of self-identity among those acquiring
their disability result in differences in the development of self-concept and satisfaction for life.

5.4. Implications for policy and Practice, and disability citizenship

The implications for policy and practice are threefold: in car-dependent societies access to PMVs for PWD should be regarded as a
need not a want; policy must recognise that for this group PMV ownership is more than employment and is an important contributor
to quality of life; targeted policy solutions need to recognise both the costs associated with the purchase of a vehicle and the cost of
access modifications. Each of these considerations is now discussed.
In car dependent societies access to PMVs should be regarded as a need not a want as all areas of social organisation are affected
by “car culture” (Flink, 1975; Hendricks, 2014). This is accentuated for PWD who face a double whammy of transport disadvantage
through public transport as well as PMVs. As Hendricks (2014) notes this can have a detrimental effect in neoliberal societies where
those with transport disadvantage are less likely to be employed, are restricted socially and are less independent. As noted in Article 9
of the UN CRPWD access to public and private transport including modifications is regarded as a right. Yet, very few countries have
policy to assist PWD to overcome their higher likelihood of living in poverty and purchase a PMV (Currie and Stanley, 2007; Darcy
and Eley, 2014).
The findings on barriers clearly indicate that policy needs to address information issues to do with the provision and location
across all aspects of driver assessment, licensing, suppliers, comparative consumer information and financial assistance. The pro-
vision of this information as a public good in one consolidated location would assist not just PWD, but allied health professionals,
driving assessors and the modification suppliers market. Indeed, evaluation of individual transportation needs can be complex and
often requires a team of qualified professionals with the necessary medical background and specialty experience to adequately
address the needs of passengers or drivers (Pierce, 1997).
Foremost, information must be readily available and easily accessible so that consumers can make an informed choice as to
whether they have an option to drive, understand what types of vehicles are appropriate (drivers and passengers) and how to go
about locating options to make assessments. There are a variety of possible outcomes with respect to information provision: tradi-
tional media, online information, social media and the use of specialist forums. While formal production of knowledge and in-
formation has been the tradition in medical, allied health and rehabilitation, consumer to consumer tacit knowledge has been
growing in the disability space with the sharing of information first on older style forums, and now newer social media platforms
(Goggin and Newell, 2003; Ellis and Goggin, 2015).
In neoliberal states, financial assistance with vehicle purchase and modification has been heavily linked to employment. While
from a policy perspective this may be regarded as an important consideration for rationing expenditure, it belies a social under-
standing of disability citizenship (Darcy and Taylor, 2009; Meekosha and Dowse, 1997). As this paper has shown, people have rated
the benefits of PMV ownership more highly for social and recreation, and independence over employment. While employment has
been shown to be an important outcome for many, those without employment can contribute in many other ways to society and
provide a higher quality of life (van Roosmalen et al., 2010; Park et al., 2002; Petry et al., 2005). For example, within a social and
recreational context recognising the importance of creating social capital through their social engagements can be a starting point to
leading onto other opportunities (Schwanen et al., 2015). For example, volunteering is a valuable social activity, important avenue
for people to develop their social and human capital, and as a first step for increased social participation. From these beginnings,
people may go onto employment as an outcome of these other avenues of social participation that they would not otherwise be able to
undertake without access to a PMV.
Transport poverty (Currie, 2004; Gleeson and Randolph, 2002) combined with the extra costs of vehicle purchase and the cost of
modifications (Park et al., 2002) create a vicious cycle for individuals and families of children with disabilities. As was shown by Park
et al. (2002), this impacts heavily on the developmental aspects of children with disability and can become a lifelong issue. As such,
finance was identified as a significant barrier to PMV access and modification, but its consideration varies by individual require-
ments. For example, those with multiple disabilities often face a more complex set of circumstances with respect to meeting a range of
needs and the involvement of families, carers and support services (Petry et al., 2005). For this reason, this criteria is often reflected
in funding (e.g. National Disability Insurance Scheme, 2015a), compensation and other settings such as meeting teaching and
learning requirements in schools (Turnbull, 1995). Similarly, the current research supports such considerations in funding for PMV
access.
The results and discussion can be understood when considered in terms of the social ecological model offered by Simplican et al.
(2015). This application is summarised in Fig. 3. Social constructivists approach discusses in terms of aggregation of barriers and
enablers, whereas social ecological approach breaks this further down in terms of individual, interpersonal, organizational, com-
munity and macro-policy level. As such, when considering the results and discussion using in the social ecological model, a more
nuanced understanding of barriers and enablers of the PMV ecosystem emerges.

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Fig. 3. Social ecological model of private motor vehicle access and modification.

At the individual level, apart from standard sociodemographic characteristics (age, gender, employment status, etc.), a person’s
disability type and level of support needs are important considerations for the type of PMV. At the interpersonal level, where an
individual’s ability to communicate with others is important so is the type of communication required beyond processes including
alternative information provision (e.g. Braille or screen readers for blind/vision impaired) together with the attitudes of others
towards PWD. At the organisational level, individual organisations play their role to identify the relative attitudes and approaches to
PWD within the identified stakeholder groups. Are they reflective of a culture of inclusion through a whole of organisation approach
together with other factors such as individual access practices (e.g. inclusive information provision)? At the community level, do
stakeholders come together as an identifiable community for PMV? Further at this level, do advocacy and information providers exist
that have the requisite knowledge in relatively specialised area, together with geographic and virtual connection, and access to
transportation services in the broader sense? The advocacy and information organisations provide a coordinating role for the other
stakeholder groups to act as an intermediary between suppliers and consumers. Finally, at the socio political and public policy levels
does government have programs that recognise transport disadvantage for PWD? This includes the existence and enforcement of
overall legal frameworks, ideology of government (e.g. neoliberalism), and whether there is a history of service delivery in PMV.
Together these five levels provide a social ecological model of private motor vehicle access and modification.

6. Conclusions

Transport disadvantage and transport poverty resulting from disadvantage are serious social issues for PWD, reflected in the UN
Convention on the Rights of Persons with Disabilities that specifically identifies access to public and private transport as essential for
disability citizenship. Yet, for PWD who require the use of PMVs, their transport disadvantage and poverty is compounded by the
significant barriers to ownership. This study has found that across all groups financial barriers were the most significant of the
barriers. Whilst varying in its impact across groups of PWD, access to information about the supply chain of the private vehicle
modification market and services created further barriers to ownership.
While policy in neoliberal states is focused on benefits of access to PMV in terms of employment, this study has determined PWD
valued the social and recreational benefits, and the independence auto mobility creates above the instrumentality of employment.
Quite simply, automobility gives back what many PWD have lost: an active life that is independent and socially fulfilling, which

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ultimately improve quality of life outcomes as other studies have shown. Those who participated in the study nominated the em-
ployment benefits stemming from automobility, which provides a way to challenge the ‘poverty cycle’ given PWD have lower income
and less access to employment opportunities. However, while policy supporting access to private vehicles has focused on those in the
employment, policy makers could learn a lot from social and human capital where people who are socially engaged, undertaking
volunteer roles or other community works are in a much better position to gain human capital which could be translated into
employment.
Macro policy in this area needs to recognise the broader social outcomes of having an active disability citizenship whether
employed or not. The policy implications need to go beyond assisting those who are employed already because it is those who are not
in employment who are at a double transport disadvantage through the lack of financial ability to purchase or modify a vehicle or for
the modifications. Policy development must in the first instance offer direct and indirect financial assistance to PWD, their family,
attendants and their carers to assist them in purchasing and modifying private vehicles so that there is a more level playing field with
accessing the benefits of automobility. In recognising this point, there is also a major public policy concern that even with financial
support transport provision becomes privatised for those PWD who can afford the extra costs. Whereas efficient and accessible public
transport options provide an affordable solution for all people.
Secondly, as a public good to alleviate problems of fragmentation in information provision and access, the whole supply chain of
driver assessment, training, licensing, supplier information and other contributing knowledge systems needs to be centrally located
into a continually updated repository. These two simple policy development strategies would address the findings and discussion
presented in this study. While the findings of this study supported previous research related to public transport access, this study has
extended the knowledge of automobility to understanding that once barriers are removed, the benefits are valued through the re-
creation of their independence, their social and recreational lives, and the instrumentality that employment brings to the individuals
and to the community at large.
As an exploratory study, there are a series of improvements to be made in future work to address various study limitations. One
improvement relates to the measures themselves. Specifically, in the case of financial barriers a two-item measure was employed as
opposed to a three-or-more multi-item measure; as such some criticism regarding an accurate assessment of reliability is appropriate
(Eisinga et al., 2013). In relation to financial barriers, distinguishing between entry-costs associated with modifications relative to
ongoing costs of ownership may address concerns regarding face-validity and reliability. In addition, the snowballing sampling
technique and online survey method lends itself to obvious criticisms in terms of representativeness. Whilst the online survey method
was employed to minimise costs, maintain respondent anonymity and reduce the burden on respondents relative to a paper-based
survey, it raises questions of sample representativeness despite allowing carers to complete the survey and utilising survey software
that met with industry and international best practice for W3C compliance for inclusive online interactions with PWD. As such, to
assess the generalizability of the findings, the research would benefit from additional studies that involve a larger sample size and
consider other populations. This includes investigating potential variation in the effect of government policies across countries, which
vary greatly in terms of the eligible items that are subsidised with respect to assistive devices relating to vehicle modifications (Layton
and Wilson, 2009).
Finally, it is important to recognise that the landscape for PMVs is also subject to continual innovation, presenting opportunities
for further research to better understand the barriers and benefits for PWD. For example, it will be increasingly important to ac-
knowledge the use of automobiles within the framework of a shared economy, such as ride sharing/car sharing, and in terms of the
introduction of autonomous vehicles (Ronald et al., 2017). Whilst some authors have begun asking questions about the impact on
social and behavioural outcomes of these innovations (e.g. Janasz and Schneidewind, 2017), our study further supports the need to
account for the experiences of PWD in these evaluations. Some authors have begun to do so; for example, Cavoli et al. (2017) notes
that PWD can experience delays in realising the benefits of new technologies alongside other minority groups, and in the case of
autonomous vehicles, costs may be prohibitive (Thomopoulos & Givoni, 2015). Consistent with our research, the benefits of shared
mobility could be greater flexibility and independence (Bohm, 2015; Begg, 2014). However, as our research suggests, PWD are likely
to have varied experiences with respect to a range of factors affecting their ability to realise the benefits in the advent of such
innovations in transport.

Acknowledgements

The authors would like to thank the people with disability who responded to the survey for without their support this research
would not be possible. We would like to acknowledge that the study was conducted with the technical assistance of Tom Eley of OT
Solutions. We would also like to acknowledge our colleagues Dr. Graham Massey for his assistance with approaching the analysis and
Srishti Sethi for her involvement as a research assistant.Funding disclosure

The authors would like to acknowledge funding assistance of the New South Wales Department of Family and Community
Services and the Australian Research Council (DE130101463) that supported elements of the research.

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Appendix A

Ratings of all barriers relating to private modified vehicles

Evaluation of Barrier Strongly disagree Disagree Neutral Agree Strongly Agree Mean SD

The cost of vehicle modifications for my disability is too expensive 3% 5% 17% 23% 52% 4.17 1.12
The process to obtain assistance for private vehicle modifications is too complex 4% 9% 28% 23% 36% 3.77 1.32
Owning a private motor vehicle is a financial burden 5% 11% 22% 30% 32% 3.73 1.37
Up-to-date information about new driving technology is difficult to find 3% 16% 26% 33% 22% 3.57 1.16
Information about an appropriate vehicle for my access needs is difficult to locate 5% 18% 21% 32% 24% 3.53 1.37

242
Cost of lessons is prohibitive 2% 7% 52% 17% 23% 3.52 0.94
Information about vehicle modification schemes is non-existent 5% 21% 20% 25% 28% 3.49 1.55
Locating driving instructors with disability expertise is difficult 3% 6% 53% 19% 20% 3.47 0.92
I don’t know where to find information about reputable vehicle modification suppliers 8% 28% 21% 21% 21% 3.19 1.64
I don't know who to go to, to get assistance and advice on vehicle modification 6% 28% 23% 26% 17% 3.19 1.43
I cannot locate information about modifications most appropriate for my access needs 7% 26% 33% 17% 17% 3.10 1.39
There is plenty of information on government assistance schemes for private vehicle modifications (R) 11% 8% 19% 26% 36% 2.34 1.79
R = results following reverse coding are presented.
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 S. Darcy, P.F. Burke

Appendix B

Ratings of all benefits relating to private modified vehicles

Benefit Not at all important Not important Neutral Important Very important Mean SD

Experience freedom to go anywhere at any time 1% 0% 5% 20% 75% 4.67 0.41

Increases independence 1% 0% 7% 20% 72% 4.63 0.46
Opportunities to socialise with others 1% 0% 4% 27% 68% 4.61 0.41
Keeps me connected to family and friends 1% 0% 7% 24% 69% 4.60 0.46
Not reliant on public transport 2% 0% 7% 18% 73% 4.60 0.64
Provides access to leisure and recreation activities 1% 0% 7% 26% 66% 4.57 0.47
Feel less tension and stress in relation to other transport options 1% 2% 7% 23% 68% 4.55 0.57
Not dependent on others 1% 0% 12% 19% 68% 4.53 0.58
Provides opportunities to experience new things 2% 0% 10% 32% 57% 4.43 0.61

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Have control over my life 1% 0% 17% 26% 57% 4.38 0.66
Provide opportunities for me to contribute to society 2% 2% 18% 26% 53% 4.26 0.86
Improved self-esteem 4% 4% 11% 27% 54% 4.23 1.09
Allows me to do things for others 1% 0% 23% 29% 47% 4.23 0.71
Much cheaper than wheelchair accessible taxi 2% 5% 20% 21% 53% 4.18 1.03
Have a sense of the future 2% 2% 22% 27% 47% 4.14 0.95
Achievement 2% 1% 24% 28% 45% 4.13 0.90
Gives access to employment 7% 2% 23% 20% 49% 4.02 1.40
Provide opportunities to unwind 2% 2% 26% 32% 37% 4.00 0.92
Gives access to education 3% 4% 26% 33% 35% 3.93 1.01
Allows me to do my job better 4% 4% 33% 18% 41% 3.88 1.26
To feel like I belong 4% 2% 33% 28% 34% 3.85 1.06
Get away from daily life 2% 7% 37% 25% 31% 3.77 1.02
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S. Darcy, P.F. Burke Transportation Research Part A 107 (2018) 229–245

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