Original researchEnvironmental Barriers and Supports to Everyday Participation: A Qualitative Insider Perspective From People With Disabilities
Section snippets
Methods
This study involved secondary analysis of qualitative data from 5 projects,7, 13, 14, 15, 16, 17, 18, 19, 20 with people with diverse disabilities across different regions in the United States.14, 15, 16, 21, 22 The data served as the foundation for the development of new measures of participation: Community Participation Indicators,13, 14, 15 Participation Survey—Mobility,18 health-related quality of life (Spinal Cord Injury Quality of Life and Traumatic Brain Injury Qualitaty of Life),17, 22
Results
We identified 8 major categories of environmental factors that influence participation: built, natural, transportation, assistive technology, information and technology access, social support and societal attitudes, systems and policies, and economic environment (see fig 1). Participants described these environmental factors as facilitators and/or barriers, enabling and/or disabling participation in different participation contexts (see table 2). In some of the environmental categories, more
Discussion
This project fills a knowledge gap by providing a large-scale, multisite, qualitative examination of environmental barriers and supports that affect home, community, work, and economic participation, as assessed by participants with TBI, SCI, and stroke. Use of qualitative methods across studies allowed us to triangulate findings across samples and projects. These qualitative data set the groundwork for the development of items to assess environmental factors on participation and quality of life
Conclusions
This study highlights immediate, community, social, and societal environmental features that influence individual participation and societal enfranchisement of people with disabilities. Identification of these factors allows the development of a comprehensive, consumer-focused assessment of the environment that measures the impact of environment barriers and supports on participation and also could be used to then evaluate the effectiveness of environmental interventions and policies designed
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Supported by the National Institute on Disability through a Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes grant (grant no. H133B090024); Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness (award no. H133B040032); National Institute on Disability and Rehabilitation Research (NIDRR) (Spinal Cord Injury-Quality of Life National Institute of Health R-01 [award no. 5R01HD054659; cofunded by the National Institute of Child Health and Human Development and National Institute of Neurological Disorders and Stroke]; Traumatic Brain Injury Quality of Life NIDRR Field-initiated grant [grant no. H133G070138]; Mobility Impaired Individuals with Secondary Conditions: Health, Participation and Environments [award no. R04/CCR714134]); Centers for Disease Control and Prevention; and the National Center for Complementary and Alternative Medicine and the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (award no. U54AR057951).
Disclosures: none.