BACKGROUND
Persons with physical disabilities are more likely to be sedentary than the general population. One plausible explanation for this lower involvement in physical activity is that persons with physical disabilities have an accrued sensitivity to environmental features that might hinder involvement in physical activity.
OBJECTIVES
The main goal of this presentation is to describe the relationship between neighborhood-level determinants of active living (i.e., activity friendliness, density of destinations, safety, quality of the walking surface, adaptation of crossings and adaptation of surroundings) and the active living practices (e.g., performing active transport, participation in leisure-time physical activity) of persons with physical disabilities living in a large metropolitan area.
METHODS
A sample of 206 persons with physical disabilities were recruited via a local rehabilitation and adapted fitness centre. In-depth telephone interviews were administered by third-year occupational therapy students. The interview guide included a modified version of the PADS (Physical Activity and Disability Survey; Rimmer et al) which contains questions on physical activity, active living and other activities of daily living. Individuals were geocoded within their neighborhood of residence (n=114 census tracts) using their postal codes. Data on neighborhood active living potential were collected in the context of a larger project. Eighteen items relating to general aspects of neighborhood active living potential were scored on a ten-point scale and grouped into the three summary items of: density of destinations, activity friendliness, and safety. Following an extensive review of literature, three further items relating specifically to the needs of persons with physical disabilities were developed and coded on the same 10-point scale. These items were: accessibility of the sidewalk/walking surface (i.e., smoothness of walking surface, seamlessness between sidewalk and street), adaptation of the crossing signals and other signage (i.e., auditory signals for crossing, sufficient time to cross, large lettering on street signs), and adaptation of the surroundings (i.e., access ramps for stores, interconnections with adapted transportation).
RESULTS
The final sample of participants in the telephone interview portion of the study included 95 males and 111 females. Average age was 41 yrs (SD: 11.4). Primary disabilities were self-reported and categorized as mobility (46.3%) neuro-muscular disease (23.3%), balance/agility (13.6%) sensory (4.7%) and other (12.1%). For the neighborhood observation portion of the study, the three summary items measuring active living potential for the general population as well as the three individual items pertaining specifically to persons with physical disabilities all showed normal distributions and significant variations across census tracts (mean: 4.55/10; SD: 0.92 ). Cross-tab analyses were performed and showed that current involvement in physical activity was significantly related to the quality of walking surfaces (Chi2 = 25.9, p = 0.001) and to the adaptation of surroundings (Chi2 = 15.2, p = 0.019). Active transport was significantly related to lesser density of destinations in the neighborhood (Chi2 = 6.0, p = 0.05) as well as to the quality of the walking surface (Chi2 = 14.2, p = 0.019).
CONCLUSIONS
Unlike in the general population (Gauvin et al, 2005) persons with physical disabilities who live in neighborhoods with a high density of destinations are less likely to engage in active transport. Furthermore, this active transport is also influenced by the quality of the walking surface, which can present a distinct set of obstacles to persons with physical disabilities. In terms of leisure-time physical activity participation, we observe that persons with physical disabilities who live in neighborhoods with more adapted destinations and transport, as well as a more conducive walking surface, tend to be more active. These results underscore the importance of addressing the needs of persons with physical disabilities when considering built-environment influences on active living.
