Theoretical foundations for the measurement of environmental factors and their impact on participation among people with disabilities

Susan Magasi; Alex Wong; David B Gray; Joy Hammel; Carolyn Baum; Chia-Chiang Wang; Allen W Heinemann

doi:10.1016/j.apmr.2014.12.002

Theoretical foundations for the measurement of environmental factors and their impact on participation among people with disabilities

Arch Phys Med Rehabil. 2015 Apr;96(4):569-77. doi: 10.1016/j.apmr.2014.12.002.

Authors

Susan Magasi¹, Alex Wong², David B Gray³, Joy Hammel⁴, Carolyn Baum⁵, Chia-Chiang Wang⁶, Allen W Heinemann⁷

Affiliations

¹ Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: smagas1@uic.edu.
² Department of Occupational Therapy, Washington University, St. Louis, MO.
³ Department of Occupational Therapy, Washington University, St. Louis, MO; Department of Neurology, Washington University, St. Louis, MO.
⁴ Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL; Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL.
⁵ Department of Occupational Therapy, Washington University, St. Louis, MO; Department of Neurology, Washington University, St. Louis, MO; Department of Social Work, University of Illinois at Chicago, Chicago, IL.
⁶ Department of Counseling, School, and Educational Psychology, University at Buffalo, The State University of New York, Buffalo, NY.
⁷ Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL; Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.

PMID: 25813889
DOI: 10.1016/j.apmr.2014.12.002

Abstract

The ascendance of the World Health Organization's International Classification of Functioning, Disability and Heath (ICF) as the global standard for describing and characterizing aspects of disability has refocused attention on the role that environmental factors (EFs) have on the health and participation of people with disabilities, both as individuals and as a group. There has been a rise in the development of instruments designed to measure EFs alone and in relation to participation. Some instrument developers have used the ICF as a theoretical base for instrument development and to substantiate content validity claims. We contend that this is a misapplication of the ICF. There is a need to step back and reexamine the role that environmental theories can play in developing a conceptually driven approach to measuring the interaction between EFs and participation. For this review, we draw on the fields of social, community, and developmental psychology; disability studies; gerontology; public health; and rehabilitation. We discuss different approaches to the measurement of EFs. We suggest that given the complex nature of EFs and their influence on participation, there is a need for a fresh approach to EF measurement. The thoughtful application of theories and the use of advanced psychometric, measurement, and e-technologies and data visualization methods may enable researchers and clinicians to better quantify, document, and communicate the dynamic interrelationship between EFs and participation and health outcomes for people with disabilities at the individual, group, and population levels.

Keywords: Environment; Patient-centered outcomes; Psychometrics; Rehabilitation; Research; Social participation; Social theory.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Disability Evaluation*
Disabled Persons / psychology*
Disabled Persons / rehabilitation*
Environment*
Geographic Information Systems
Health Status
Humans
International Classification of Functioning, Disability and Health
Physical Therapy Specialty / organization & administration*
Psychometrics
Social Capital
Social Determinants of Health
Social Participation*