title: Community and social participation among adults with mobility impairments: A mixed methods study.
abstract: Community and social participation is a complex phenomenon that is influenced by personal and environmental factors and is linked to a good quality of life and well-being. Individuals with mobility impairments are at risk of experiencing limitations in participating in community activities due to a wide range of factors.
  
  
  
  To understand community participation as defined by adults with mobility impairments and to examine relationships among factors that influence community participation.
  
  
  
  A mixed-methods study design was used. In-depth interviews of 13 adults with mobility impairments were conducted and themes related to community participation were identified. Data from the Americans' Changing Lives Survey were used to construct variables that mimic the themes from the qualitative phase and structural equation modeling was used to examine the relationships among those variables including community participation.
  
  
  
  Individuals with mobility impairments identified health and function, neighborhood factors and self-efficacy as possible factors influencing participation in community activities. Findings from the SEM suggest a strong causal pathway between health and function and community and social participation. Neighborhood factors and health and function had a significant impact on self-efficacy, and a possible indirect effect through self-efficacy on community and social participation.
  
  
  
  Our study provides new empirical evidence that health and function have a significant impact on community and social participation. Our quantitative findings did not support the direct influence of neighborhood factors in community and social participation, yet these factors may have an indirect role by influencing the self-efficacy of individuals with mobility impairments.
authors.affiliation: Occupational Therapy Department, College of Health and Human Services, University of New Hampshire, Rm 115 Hewitt Hall, 4 Library Way, Durham, NH 03824, USA. Electronic address: vidya.sundar@unh.edu.
authors.forename: Vidya
authors.initials: V
authors.lastname: Sundar
authors.affiliation: Institute on Disability University of New Hampshire, College of Health and Human Services, Durham, NH, USA.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Brucker
authors.affiliation: Hartford Hospital, 80 Seymour Street, P.O. Box 5037, Hartford, CT 06102-5037, USA.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Pollack
authors.affiliation: Tufts Medical Center, Institute for Clinical Care Research and Health Policy Studies, Boston, MA, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001290:Attitude; D006233:Persons with Disabilities; D004777:Environment; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011788:Quality of Life; D012111:Residence Characteristics; D020377:Self Efficacy; D058992:Social Participation; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Community participation; Functional limitation; Mobility impairments; Neighborhood factors; Self-efficacy