title: Impact of environmental factors on community participation of persons with an intellectual disability: a systematic review.
abstract: METHODS
  A systematic review of the literature.
  
  
  OBJECTIVE
  To describe which environmental factors have an impact on community participation of persons with an intellectual disability.
  
  
  METHODS
  A systematic literature search was conducted for the period of 1996-2006 in Pubmed, CINAHL and PSYCINFO. Search terms were derived from the International Classification of Functioning, Disability and Health. Three investigators assessed the relevance of the studies identified using predefined selection criteria. Aspects of community participation included were: domestic life; interpersonal interactions and relationships; major life areas; community, civic and social life. Environmental factors included were: products and technology; natural environment and human-made changes to environment; support and relationships; attitudes; services, systems and policies.
  
  
  RESULTS
  Out of 236 initial hits, 9 quantitative studies and 2 qualitative studies met the predefined selection criteria and were included in the study. Various research instruments were used in the studies and only one study used a conceptual framework. The review allowed the identification of a number of environmental factors positively affecting participation: opportunities to make choices; variety and stimulation of the environment of facilities; opportunities for resident involvement in policy making; small residential facilities; opportunities for autonomy; vocational services; social support; family involvement; assistive technology; and positive staff attitudes. A number of identified environmental factors negatively affecting participation are: lack of transport and not feeling accepted.
  
  
  CONCLUSIONS
  It can be concluded that little has been published about the impact of environmental factors on community participation. Many studies do not clearly define the concept of community participation. Research on the impact of environmental factors on community participation so far seems not to be based on a theoretical framework. Most studies focused on the impact of services on community participation in general.
authors.affiliation: Vilans, Hoensbroek/Governor Kremers Centre, Maastricht, The Netherlands. m.verdonschot@vilans.nl
authors.forename: M M L
authors.initials: MM
authors.lastname: Verdonschot
authors.forename: L P
authors.initials: LP
authors.lastname: de Witte
authors.forename: E
authors.initials: E
authors.lastname: Reichrath
authors.forename: W H E
authors.initials: WH
authors.lastname: Buntinx
authors.forename: L M G
authors.initials: LM
authors.lastname: Curfs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology* / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D012111:Residence Characteristics; D012919:Social Behavior; D012931:Social Environment; D012944:Social Support; D055815:Young Adult