Date of Graduation


Document Type


Degree Type



Davis College of Agriculture, Natural Resources and Design


Design Studies

Committee Chair

J. Chris Haddox

Committee Co-Chair

Shan Jiang

Committee Member

Shan Jiang

Committee Member

Lesley Cottrell


The Americans with Disabilities Act (ADA) became law in 1990. Since then, research has shown that people with disabilities continue to experience environmental, systematic, and structural barriers to health care. The purpose of this research is to explore the prevalence of barriers in rural West Virginia health facilities and the relationship between building characteristics (like age and purpose) and accessibility. The researcher evaluated ten rural outpatient member-sites of the West Virginia Practice-Based Research Network using a survey to understand building characteristics and a tool to measure essential features for a facility to be considered ‘usable’. Findings included a negative correlation between building age and accessibility score. The results showed that once adjusted for items that did not apply to specific clinics, surveyed clinics scored an average of 73% in overall accessibility. Counters, restrooms, and exam rooms were the lowest scoring categories. The study also found a moderate negative correlation (Spearman p -.6274) between the age of the building and overall score and a strong negative correlation (Spearman -.71) between the age of building and Mobility score. In addition, this research found a moderate statistical difference mean in usability score of buildings retrofitted to house medical offices. This research supports the notion that physical and environmental barriers to health care access still exists and that older clinical buildings run a higher risk of being non-compliant with essential ADA items and thus, contribute to barrier creation.