Navigating a way forward: using focused ethnography and community readiness to study disability issues in Ladakh, India.
OBJECTIVE
This article offers a discussion about the use of focused ethnography and the community readiness model to study disability at the community level in cross-cultural or international settings. It describes lessons learned when applying these methods to inform community-based disability programming in remote, rural villages in Ladakh, India.


METHODS
Data were collected from 30 persons with disabilities, family members and community leaders in four remote villages using interviews and participant observation. All interviews were analysed qualitatively using a mix of inductive and deductive techniques. Community readiness interviews were scored using anchored rating scales to determine level of 'readiness' to take action on meeting the needs of persons with disabilities. Following the initial assessment, community workshops were used to disseminate results and facilitate local engagement in planning and intervention.


RESULTS
There were minor challenges and significant benefit in the application of these two approaches in Ladakh; outcomes included: a known level of community readiness that can be used to improve targeting of appropriate community-based intervention and assess change over time, identification of salient needs, barriers and facilitators for persons with disabilities and their families; and community-level engagement during and following the research.


CONCLUSIONS
Research models with participatory components like focused ethnography and community readiness hold significant promise for planning and evaluating community-based disability programmes.
McElroy
Theresa A
TA
Centre for International Child Health at BC Childrens Hospital, Vancouver, British Columbia, Canada. tree_mcelroy@yahoo.ca
Davis
Alexis
A
Hunt
Cynthia
C
Dadul
Jigmet
J
Stanba
Tsering
T
Larson
Charles
C
D000293:Adolescent; D000328:Adult; D000884:Anthropology, Cultural / Q000295:instrumentation; D002648:Child; D003144:Communication Barriers; D055812:Community-Based Participatory Research; D003695:Delivery of Health Care / Q000208:ethnology; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006379:Helping Behavior; D006801:Humans; D007194:India / Q000208:ethnology; D033181:Information Dissemination; D007407:Interviews as Topic; D007857:Leadership; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D008960:Models, Psychological; D012424:Rural Population; D012944:Social Support