title: Which Environmental Factors Have the Highest Impact on the Performance of People Experiencing Difficulties in Capacity?
abstract: Disability is understood by the World Health Organization (WHO) as the outcome of the interaction between a health condition and personal and environmental factors. Comprehensive data about environmental factors is therefore essential to understand and influence disability. We aimed to identify which environmental factors have the highest impact on the performance of people with mild, moderate and severe difficulties in capacity, who are at risk of experiencing disability to different extents, using data from a pilot study of the WHO Model Disability Survey in Cambodia and random forest regression. Hindering or facilitating aspects of places to socialize in community activities, transportation and natural environment as well as use and need of personal assistance and use of medication on a regular basis were the most important environmental factors across groups. Hindering or facilitating aspects of the general environment were the most relevant in persons experiencing mild levels of difficulties in capacity, while social support, attitudes of others and use of medication on a regular basis were highly relevant for the performance of persons experiencing moderate to higher levels of difficulties in capacity. Additionally, we corroborate the high importance of the use and need of assistive devices for people with severe difficulties in capacity.
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology-IBE, Ludwig-Maximilians-University (LMU), Munich 81377, Germany. Loidl_Veren@web.de.
authors.forename: Verena
authors.initials: V
authors.lastname: Loidl
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology-IBE, Ludwig-Maximilians-University (LMU), Munich 81377, Germany. cornelia.oberhauser@med.lmu.de.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Oberhauser
authors.affiliation: Swiss Paraplegic Research, Nottwil 6207, Switzerland. carolina.ballert@paraplegie.ch.
authors.forename: Carolina
authors.initials: C
authors.lastname: Ballert
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology-IBE, Ludwig-Maximilians-University (LMU), Munich 81377, Germany. michaela.coenen@med.lmu.de.
authors.forename: Michaela
authors.initials: M
authors.lastname: Coenen
authors.affiliation: Blindness and Deafness Prevention, Disability and Rehabilitation (BDD), World Health Organization, Geneva 1211, Switzerland. acieza@who.int.
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology-IBE, Ludwig-Maximilians-University (LMU), Munich 81377, Germany. carla.sabariego@med.lmu.de.
authors.forename: Carla
authors.initials: C
authors.lastname: Sabariego
mesh_terms: D000328:Adult; D000368:Aged; D002160:Cambodia; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004777:Environment; D005260:Female; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010865:Pilot Projects; D012111:Residence Characteristics; D058992:Social Participation; D012944:Social Support; D011795:Surveys and Questionnaires; D014186:Transportation; D014944:World Health Organization
keywords: capacity; data collection (MeSH); disability and health; disability evaluation (MeSH); environmental factors; health surveys (MeSH); international classification of functioning; performance; random forest