Article

OBJECTIVE: To describe environmental factors that influence participation of
people with disabilities. DESIGN: Constant comparative, qualitative analyses of
transcripts from 36 focus groups across 5 research projects. SETTING: Home,
community, work, and social participation settings. PARTICIPANTS:
Community-dwelling people (N=201) with diverse disabilities (primarily spinal
cord injury, traumatic brain injury, and stroke) from 8 states. INTERVENTIONS: None.
MAIN OUTCOME MEASURES: Environmental barriers and supports to
participation. RESULTS: We developed a conceptual framework to describe how
environmental factors influence the participation of people with disabilities,
highlighting 8 domains of environmental facilitators and barriers (built,
natural, assistive technology, transportation, information and technology access,
social support and attitudes, systems and policies, economics) and a
transactional model showing the influence of environmental factors on
participation at the micro (individual), mesa (community), and macro (societal)
levels. Focus group data validated some International Classification of
Functioning, Disability and Health environmental categories while also bringing
unique factors (eg, information and technology access, economic quality of life)
to the fore. Data were used to construct items to enable people with disabilities
to assess the impact of environmental factors on everyday participation from
their firsthand experience. CONCLUSIONS: Participants with disabilities voiced
the need to evaluate the impact of the environment on their participation at the
immediate, community, and societal levels. The results have implications for
assessing environmental facilitators and barriers to participation within
rehabilitation and community settings, evaluating outcomes of environmental
interventions, and effecting system and policy changes to target environmental
barriers that may result in societal participation disparities versus
opportunities.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS