Dana Anaby1, Mary Law2, Wendy Coster3, Gary Bedell4, Mary Khetani5, Lisa Avery6, Rachel Teplicky7. 1. School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada. Electronic address: dana.anaby@mcgill.ca. 2. School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada. 3. Department of Occupational Therapy, Sargent College of Rehabilitation Sciences, Boston University, Boston, MA. 4. Department of Occupational Therapy, Tufts University, Medford, MA. 5. Department of Occupational Therapy, Colorado State University, Fort Collins, CO. 6. Avery Information Services Ltd, Orilla, Ontario, Canada. 7. CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.
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.
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.
Authors: Jessica M Jarvis; Vera C Kaelin; Dana Anaby; Rachel Teplicky; Mary A Khetani Journal: Dev Med Child Neurol Date: 2020-04-07 Impact factor: 5.449
Authors: Mary A Khetani; James E Graham; Patricia L Davies; Mary C Law; Rune J Simeonsson Journal: Arch Phys Med Rehabil Date: 2014-10-18 Impact factor: 3.966
Authors: Tanya E Benjamin; Rachel G Lucas-Thompson; Lauren M Little; Patricia L Davies; Mary A Khetani Journal: Phys Occup Ther Pediatr Date: 2016-03-01 Impact factor: 2.360
Authors: Vera C Kaelin; Erin R Wallace; Martha M Werler; Brent R Collett; Mary A Khetani Journal: Disabil Rehabil Date: 2020-06-01 Impact factor: 3.033