A tale of two countries: environmental impacts on social participation after spinal cord injury.
METHODS
Comparative analysis of survey data produced in two countries.


OBJECTIVE
To assess the degree to which environmental barriers impact social participation, and to identify the aspects of participation most affected.


METHODS
Community-dwelling individuals with spinal cord injury in the USA and Turkey.


METHODS
Subjects completed the Functional Independence Measure (FIM) motor score, the Craig Hospital Inventory of Environmental Factors (CHIEF), and the Craig Handicap Assessment and Reporting Technique (CHART). Analysis of co-variance was used to analyze CHIEF and CHART differences within and between country.


RESULTS
US subjects reported higher participation scores (CHART) and lower barriers (CHIEF), however, when controls for age, gender, time since injury and motor ability (FIM) were applied, country differences in reports of barriers were limited. Motor ability was the major predictor of participation, which was minimally affected by barriers.


CONCLUSIONS
Conceptualization and measurement issues may have been the reason for the minimal support for the hypothesis that environment affects participation. Suggestions for future research are made.


BACKGROUND
National Institute on Disability and Rehabilitation Research, Centers for Disease Control and Prevention.
Dijkers
M P J M
MP
Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
Yavuzer
G
G
Ergin
S
S
Weitzenkamp
D
D
Whiteneck
G G
GG
D000203:Activities of Daily Living; D001107:Architectural Accessibility / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D003466:Cultural Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012931:Social Environment; D012944:Social Support; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D014421:Turkey / Q000453:epidemiology; D014481:United States / Q000453:epidemiology