Online Program

Built environment predictors of participation for physically disabled adults

Tuesday, November 5, 2013 : 11:00 a.m. - 11:15 a.m.

Amanda L. Botticello, PhD, MPH, Outcomes and Assessment Research, The Kessler Foundation Research Center, West Orange, NJ
Tanya Rohrbach, MA, Raritan Valley Community College, Branchburg, NJ
Nicolette Cobbold, BS, Outcomes and Assessment Laboratory, Kessler Foundation Research Center, West Orange, NJ
This study investigates the influence of the built environment on participation among adults aged 17 and older chronically physically disabled from spinal cord injury (SCI). Data are from participants from the New Jersey site (N=504) of the Spinal Cord Injury Model Systems (SCIMS) database, a longitudinal study of persons with traumatic SCI living in the community, surveyed between 2000 and 2012. Participation is measured across four domains—physical independence, mobility, occupational, and social integration—by the Craig Handicap Assessment and Reporting Technique (CHART). Covariates include impairment-related, health status, and background (i.e., socioeconomic and demographic) characteristics as well as assistive technology use and vehicle access. Geographic information systems (GIS) data was used to construct a measure of the land use mix for a 5-mile buffer of the individual's residential location to assess the built environment. Logistic regression models were analyzed for each functional domain. Contrary to expectations, preliminary analysis indicated that persons living in single use (i.e. predominantly residential) communities reported increased odds of physical independence, mobility, and social participation due in part to contingencies between land use type and individual functional differences. Conversely, persons living in communities characterized by mixed land use reported increased odds of occupational participation. Importantly, all analyses indicate that the built environment predicts participation controlling for a range of individual predictors. Overall, these findings provide support for the role of environment in the disabling process and may be used to help target interventions intended to improve social integration for persons with disabilities.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the findings from this analysis in the context of the growing literature examining the role of the environment in the disabling process. Identify and describe the GIS methods used to construct objective measures of the built environment for this analysis. Discuss the role of communities in shaping differences in the experience of disability based on the interactions presented between individual and community predictors. Discuss the implications of the role of communities in long-term participation for chronically physically disabled adults for future research, clinical practice, and advocacy.

Keyword(s): Disability Studies, Geographic Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a been the principal or co-principal investigator on several federally funded projects related to disablity-outcomes research. My current line of inquiry focuses on conducting social epidemiological investigations of long-term health and well-being following acquired disability in adulthood. I have also conducted several studies of community effects on mental health outcomes among adolescents and older adults.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.