Community Participation and Enfranchisement Among Adults With Mobility Impairments

Abstract

Adults with paralysis often experience restricted community participation, yet less is known about participation enfranchisement, including perceived control and importance. This study aimed to describe patterns of participation enfranchisement and examine associations with demographic and functional factors among adults with mobility impairments. Thirty adults with paralysis using mobility aids completed the Community Participation Indicators (CPI) at an adaptive fitness center. Social and recreational activities were most frequently performed, whereas employment, volunteering, and civic activities were least frequently performed. Adjusted CPI ratios indicated higher meaningful participation in social and household activities (≥.60) and lower meaningful participation in employment, volunteering, and civic roles (≤.36). Independent driving (τ_b = –.490, p =.002) and independent living (τb =.409, p =.009) were associated with greater perceived control. Longer disability duration (r_s = –.573, p <.001) and earlier onset (r_s =.481, p =.007) were associated with lower perceived importance. Findings highlight barriers and opportunities for occupational therapy to enhance participation enfranchisement.

Plain Language Summary

Understanding Community Participation and Meaning for Adults With Mobility Impairments

Adults living with paralysis often face challenges that make it harder to take part in community activities. This study explored how adults who use mobility aids participate in their communities and how meaningful those activities are to them. Thirty adults with paralysis completed a survey at an adaptive fitness center about their involvement in everyday activities. They also rated how important these activities were and how much control they felt they had over their participation. Participants were most involved in social and recreational activities and participated less often in employment, volunteering, and civic roles. The findings showed that participants were generally able to engage in social and household activities in ways that felt meaningful, but they were less able to participate in work, volunteering, and civic activities at levels that matched what they felt was important. Those who could drive or live independently felt a stronger sense of control and meaning in their participation. People who had lived with paralysis longer or since an earlier age viewed participation as less important overall. These findings suggest that community participation is influenced not just by physical ability but also by independence, opportunity, and social support. Occupational therapy can help by reducing barriers and supporting people to engage in activities that bring meaning and connection to their lives.