title: Association of environmental factors with levels of home and community participation in an adult rehabilitation cohort.
abstract: OBJECTIVE
  To examine whether home and community environmental barriers and facilitators are predictors of social and home participation and community participation at 1 and 6 months after discharge from an acute care or inpatient rehabilitation hospital.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Postacute care.
  
  
  METHODS
  Adults (N=342) age 18 years or older with a diagnosis of complex medical, orthopedic, or neurologic condition recruited from acute care and inpatient rehabilitation facilities. The mean age +/- standard deviation of participants was 68+/-14 years; 49% were women and 92% were white.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participation in social, home and community affairs as assessed with the Participation Measure for Post-Acute Care.
  
  
  RESULTS
  Adjusting for covariates, 1 month after discharge a greater presence of home mobility barriers (P<.01) was associated with less social and home participation; whereas greater community mobility barriers (P<.01) and more social support (P<.001) were associated with greater participation. At 6 months, social support was the only environmental factor associated with participation after adjusting for covariates.
  
  
  CONCLUSIONS
  This study provides new empirical evidence that environmental barriers and facilitators do influence participation in a general rehabilitation cohort, at least in the short term.
authors.affiliation: Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA. jkeysor@bu.edu
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Keysor
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
authors.forename: Wendy
authors.initials: W
authors.lastname: Coster
authors.forename: Janet Prvu
authors.initials: JP
authors.lastname: Bettger
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Haley
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001107:Architectural Accessibility; D001900:Boston; D015331:Cohort Studies; D003256:Community Participation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009983:Orthopedic Equipment; D010351:Patient Discharge; D012047:Rehabilitation Centers; D012656:Self-Help Devices; D012944:Social Support