Personal and environmental influences on the community participation by people with mobility, visual and hearing impairments and limitations

Full participation by people with disabilities is recognized as a civil right (Americans with Disabilities Act) and a contributor to good health. Community participation by people with disabilities is limited. Accounting for factors influencing community participation required adding personal and environmental features into a single survey of those with different types of impairments. This goal was accomplished by creating the Survey of Participation and Receptivity in Communities (SPARC). This survey of 17 different community sites provides information on several components of participation by people with mobility, visual or hearing limitations. The components include frequency, personal evaluation, health conditions, interpersonal communications and physical features that facilitate their participation. An online web based computer assisted version of the SPARC was completed by a convenience sample of 692 people with mobility, visual or hearing limitations. The internal consistency and stability of the SPARC varies by the type of community site but are moderate to good. Structural equation modeling determined differential contributions of the components of community participation. For example, the perceived treatment of survey respondents at their physician's office contributed to how these visits were evaluated. Problem resolution without the survey respondent's input was valued at physician office visits but not at grocery stores. The influence of physical features of the community sites was different for each group. Participation at community sites was influenced by pain and fatigue differently by each group.