Community and social participation among adults with mobility impairments: A mixed methods study.
Vidya Sundar, Debra L Brucker, Megan A Pollack and 1 others
PMID 27387816WHAT IT FOUND
For adults with mobility impairments, pain, fatigue, and limited function were the clearest barriers to community and social life.
In 462 survey participants, better health and function were strongly linked to more participation; neighborhood factors and personal confidence were not.
Key findings
01Interviews with 13 adults with mobility impairments identified four themes: health and function, neighborhood and social environment, sense of mastery or self-efficacy, and participation in employment, leisure, social, and volunteering activities.
02In 462 survey participants with difficulty walking, climbing stairs, or using a mobility device, higher health and function was associated with higher community and social participation (total effect beta = .39, p < .01).
03Neighborhood factors and self-efficacy did not have significant direct effects on community and social participation, although health and function and neighborhood environment were associated with self-efficacy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The qualitative phase included only 13 adults, recruited by word of mouth and local agencies, and excluded people with primary or co-existing cognitive impairments, so the themes may not represent all adults with mobility impairments. The quantitative phase used existing survey data from 462 adults aged 50 and over, which the authors called a relatively small sample for the model, and the survey constructs may not match the concepts from the interviews. The study did not test an intervention, so associations cannot show that changing function, confidence, or neighborhood conditions would increase participation. The self-efficacy measure was general and may not be sensitive to changes in community and social participation.
Declared interests
The supplied text does not include an author conflict-of-interest statement. The publication types list research support from the National Institutes of Health and the U.S. Public Health Service.
The easy way to misread this
Do not conclude that improving confidence or neighborhood conditions will increase community participation. In the survey model, self-efficacy and neighborhood factors did not show significant direct effects on participation, while health and function showed a significant direct effect.