Abstract
Objective
To test the effect of personal and environmental factors on children's participation
across 3 different settings (home, school, community); to ascertain the interrelations
between these factors; and to propose and test 3 models, 1 for each setting, using
structural equation modeling.
Design
Survey, cross-sectional study, and model testing.
Setting
Web-based measures were completed by parents residing in North America in their home/community.
Participants
Parents (N=576) of children and youth with and without disabilities, (n=282 and n=294,
respectively), ages 5 to 17 years (mean age, 11y 2mo), completed the Participation
and Environment Measure for Children and Youth (PEM-CY).
Interventions
Not applicable.
Main Outcome Measures
The PEM-CY measured levels of participation frequency and involvement, as well as
environmental barriers and supports of participation, in each of the following 3 settings:
home, school, and community. Information about the child's health condition and functional
issues was also collected.
Results
All 3 models fit the data well (comparative fit index, .89–.97) and explained 50%
to 64% of the variance of participation frequency and involvement. Environmental barriers
and supports served as significant mediators between child/personal factors (income,
health condition, functional issues) and participation outcomes, across all models.
The effect of the environment was most pronounced, however, in the community setting.
Conclusions
Our findings highlight the unique role of the environment in explaining children's
participation across different settings and, therefore, support the development of
interventions targeting modifiable environmental factors.
Keywords
List of abbreviations:
CFI (comparative fit index), CI (confidence interval), HC (health condition), PEM-CY (Participation and Environment Measure for Children and Youth), RMSEA (root mean square error of approximation), SEM (structural equation modeling)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 27, 2014
Footnotes
Supported by the U.S. Department of Education, National Institute on Disability and Rehabilitation Research (grant no. H133G070140).
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
