Article

OBJECTIVE: To test the effect of personal and environmental factors on children's
participation across 3 different settings (home, school, community); to ascertain
the interrelations between these factors; and to propose and test 3 models, 1 for
each setting, using structural equation modeling. DESIGN: Survey, cross-sectional
study, and model testing. SETTING: Web-based measures were completed by parents
residing in North America in their home/community. PARTICIPANTS: Parents (N=576)
of children and youth with and without disabilities, (n=282 and n=294,
respectively), ages 5 to 17 years (mean age, 11y 2mo), completed the
Participation and Environment Measure for Children and Youth (PEM-CY).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The PEM-CY measured levels
of participation frequency and involvement, as well as environmental barriers and
supports of participation, in each of the following 3 settings: home, school, and
community. Information about the child's health condition and functional issues
was also collected. RESULTS: All 3 models fit the data well (comparative fit
index, .89-.97) and explained 50% to 64% of the variance of participation
frequency and involvement. Environmental barriers and supports served as
significant mediators between child/personal factors (income, health condition,
functional issues) and participation outcomes, across all models. The effect of
the environment was most pronounced, however, in the community setting.
CONCLUSIONS: Our findings highlight the unique role of the environment in
explaining children's participation across different settings and, therefore,
support the development of interventions targeting modifiable environmental
factors.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS