The (Sometimes Not So) Great Outdoors: Perspectives on Greenspace Accessibility Among People Living With Chronic Spinal Cord Injury

Research Objectives: To investigate 1) types of greenspace that people with spinal cord injury (SCI) report accessing in their daily lives, 2) specific features they describe as important for maintaining accessible greenspaces, and 3) the impact of greenspace accessibility on their quality of life.

Design: Analysis of qualitative and quantitative data from a mixed methods study (2018-2022). Participants recorded their community activities for seven days using smartphones and discussed their geolocated activity data in semi-structured interviews.

Setting: Community.

Participants: Thirty adults with chronic impairment from SCI living in New Jersey. Eligible participants were community-living for at least two years.

Interventions: Not applicable.

Main Outcome Measures: "Types of Greenspace" includes categories identified by participants. "Important Features" include factors that improve the accessibility of greenspace. "Consequences" summarize the meanings of greenspace accessibility for participants’ daily lives. "Valence" denotes participants’ descriptions as either positive or negative.

Results: 80% of participants described greenspace as part of their community activity, including parks, beaches, recreational areas, and farms, but only 63% reported a positive experience. Beaches were frequently identified as inaccessible due to the limitations of mobility mats and beach wheelchairs. Parks used by participants were described as fully accessible if paved pathways, flat terrain, and accessible amenities (e.g., restrooms) were present. Inaccessible greenspaces were described as contributing to social exclusion (e.g., remaining on the boardwalk during a family beach day) and feelings of dependency. Accessible greenspaces were described as contributing to well-being and the continuation of pre-injury social roles and activities (e.g., independently taking children to the park).

Conclusions: Exposure to greenspace is uniformly associated with mental health benefits in the general population, but recent prior evidence suggests a mixed relationship for people living with SCI. To further investigate, we explored perspectives among people with lived SCI experience. The findings provide targeted information about improving the accessibility of specific outdoor recreation spaces for people with mobility disabilities and indicate that the mental health benefits of greenspace extend only as far as their accessibility to all community members.

Author(s) Disclosures: None.