Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 12 , Pages 1566-1575, December 2006

Association of Environmental Factors With Levels of Home and Community Participation in an Adult Rehabilitation Cohort

Presented in part to the American Congress of Rehabilitation Medicine, September 28−October 2, 2005, Chicago, IL.

  • Julie J. Keysor, PhD, PT

      Affiliations

    • Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA
    • Corresponding Author InformationReprint requests to Julie J. Keysor, PhD, PT, Sargent College of Health and Rehabilitation Services, Boston University, 635 Commonwealth Ave, Rm 521, Boston, MA 02215.
    • ,
  • Alan M. Jette, PhD, PT

      Affiliations

    • Health and Disability Research Institute, Boston University School of Public Health, Boston, MA.
    • ,
  • Wendy Coster, PhD, OTR

      Affiliations

    • Department of Occupational Therapy and Rehabilitation Counseling, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA
    • ,
  • Janet Prvu Bettger, ScD, TRS

      Affiliations

    • ScD Program in Rehabilitation Science, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA
    • ,
  • Stephen M. Haley, PhD, PT

      Affiliations

    • Health and Disability Research Institute, Boston University School of Public Health, Boston, MA.

Abstract 

Keysor JJ, Jette AM, Coster W, Bettger JP, Haley SM. Association of environmental factors with levels of home and community participation in an adult rehabilitation cohort.

Objective

To examine whether home and community environmental barriers and facilitators are predictors of social and home participation and community participation at 1 and 6 months after discharge from an acute care or inpatient rehabilitation hospital.

Design

Cohort study.

Setting

Postacute care.

Participants

Adults (N=342) age 18 years or older with a diagnosis of complex medical, orthopedic, or neurologic condition recruited from acute care and inpatient rehabilitation facilities. The mean age ± standard deviation of participants was 68±14 years; 49% were women and 92% were white.

Interventions

Not applicable.

Main Outcome Measures

Participation in social, home and community affairs as assessed with the Participation Measure for Post-Acute Care.

Results

Adjusting for covariates, 1 month after discharge a greater presence of home mobility barriers (P<.01) was associated with less social and home participation; whereas greater community mobility barriers (P<.01) and more social support (P<.001) were associated with greater participation. At 6 months, social support was the only environmental factor associated with participation after adjusting for covariates.

Conclusions

This study provides new empirical evidence that environmental barriers and facilitators do influence participation in a general rehabilitation cohort, at least in the short term.

Key Words: Disabled persons, Environment, Outcome assessment (health care), Rehabilitation

 

 Supported by the National Institute of Disability and Rehabilitation Research, U.S. Department of Education (grant no. H133B990005), the National Institute of Child Health and Human Development (grant no. 5 K12 HD043444-02), and the Arthritis Foundation (arthritis investigator award).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(06)01335-9

doi:10.1016/j.apmr.2006.08.347

Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 12 , Pages 1566-1575, December 2006

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