A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
People with mobility disabilities have difficulty standing, walking, or climbing stairs. Because of such difficulty, they may have trouble participating in recreational, social, civic, or religious activities in their communities. The participation limitation may stem from physical problems such as pain or fatigue, from environmental barriers like living in areas without public transportation, or both. People with mobility disabilities may have an easier time participating in their communities if they live in safe and well-connected cohesive neighborhoods where neighbors help each other, and if they have high self-efficacy-- a belief in themselves and their ability to manage life’s demands. In a recent NIDILRR-funded study, researchers looked at the connections between health and function, neighborhood supports, self-efficacy, and community participation for people with mobility disabilities. The researchers wanted to find out which types of community activities people with mobility disabilities consider most important, and how their health and function, neighborhood supports, and self-efficacy affect their community participation.
Researchers at the Rehabilitation Research and Training Center on Disability Statistics and Demographics conducted a two-part study to answer these questions. First, they interviewed 13 adults with mobility disabilities who ranged in age from 36-77 years old. All of the interview participants lived in the New England region. During the interviews, the participants were asked which community activities they felt were important to them, what interfered with their participation, and what helped them participate more fully.
Secondly, the researchers looked at data from 462 adults with mobility disabilities who completed a national survey, the Americans’ Changing Lives (ACL) survey, in 2012. On this survey, the participants answered questions about their community participation, such as how often they socialized with friends, volunteered in the community, and attended civic or religious meetings. They also answered questions about their health and function, including cognitive problems and depression; characteristics of their neighborhood such as safety and how much neighbors helped each other; and their self-efficacy, such as how much they agreed with statements like “I am always optimistic about my future.” The researchers looked at the relationship between community participation and these other variables.
From the interviews, the researchers found that paid employment, leisure, social activities, and volunteerism were important community activities for these participants. The participants said that health issues or functional limitations, such as fatigue and trouble standing for long periods, restricted their community participation. Environmental barriers like a lack of public transportation also got in the way of their participation. The participants said that having supportive friends and neighbors to share resources helped them participate in their community. They also said that having a sense of self-efficacy--believing in themselves and having a positive outlook on life--was important in motivating them to participate more fully in their communities.
The researchers found that the ACL survey results showed some similar findings. There was a strong correlation between health and function and community participation. The participants who reported more health problems also reported participating less often in community activities. There was also a small connection between self-efficacy and community participation. The participants who had higher self-efficacy participated more in their communities. The neighborhood characteristics were unrelated to community participation; however, the participants living in safer, more supportive neighborhoods had higher self-efficacy than those with less neighborhood support.
Based on these findings, the authors noted that participating in work, socialization, leisure, and volunteerism are important goals for people with mobility disabilities. However, health problems and functional limitations can interfere with community participation. Rehabilitation providers can help people with mobility disabilities participate in their communities by helping them manage physical symptoms, like pain and fatigue, and optimizing their mobility with appropriate mobility aids. Mental health problems, like depression, are also important to address as they can interfere with community participation. When it comes to getting out and about in the community, people with mobility disabilities may be able to adapt to unsafe or unsupportive neighborhoods, participating in their communities despite neighborhood barriers. However, social support from neighbors and friends may help people with mobility disabilities to build a strong sense of self-efficacy and maintain a positive outlook when tackling challenges.
To Learn More
Identifying and removing physical and environmental barriers can be an important step toward better community participation. The Community Health Environment Checklist (CHEC), a tool developed under the NIDILRR-funded Rehabilitation Research and Training Center (RRTC) on Independent Living, is an objective assessment of physical environmental features and asks the basic question “Can a person with a disability get in, do what they need to do, and get out without much difficulty?” Learn about CHEC, how to use it in your community at http://www.rtcil.org/chec
Staying healthy and positive is crucial to remaining active and engaged in the community. The RRTC on Healthy Aging and Long-Term Physical Disabilities has many excellent resources on ways to maintain physical and mental health for people aging with disabilities that may impact their mobility. Visit them at http://agerrtc.washington.edu
The researchers from this RRTC presented Disability Health and Wellness, a 2-day training for community service providers that examined the multiple aspects of health care, rehabilitation care, legislation, politics, environment, education, society, and attitudes that impact people aging with disabilities. The presentations, developed through a partnership with Senior Services, are available from the RRTC’s website.
To Learn More About this Study
Sundar, V., Brucker, D., Pollack, M.A., and Chang, H. (2016) Community and community participation among adults with mobility impairments: A mixed methods study. Disability and Health Journal, 9, 682-691. This article is available from the NARIC Collection under Accession Number J74550.