Social Participation of Adults Aging with Long-Term Physical Disabilities: A Cross-Sectional Investigation of the Role of Transportation Mode and Urban versus Rural Living

Research Objectives: To explore how the built environment influences the social participation of adults aging with long-term physical disabilities (AAwPD) to inform community-based interventions and service provision. We hypothesized that social participation would be significantly different between AAwPD using private versus public transportation and living in urban versus rural areas.

Design: This cross-sectional study explored relationships among transportation mode, residential location, and social participation for AAwPD. A multivariate analysis of covariance (MANCOVA) was used to investigate differences in social participation across public versus private transportation and urban versus rural residential location. Linear regression examined associations among health and demographic, social, and built environment factors and social participation.

Setting: A comprehensive survey was administered online or via telephone.

Participants: A convenience sample of 331 community-dwelling AAwPD living in Missouri completed the survey.

Interventions: N/A

Main Outcome Measures: Dependent variables included the PROMIS Ability to Participate and Satisfaction with Participation in Social Roles and Activities measures. Residential location was dichotomized as urban or rural, and transportation mode was dichotomized as public or private.

Results: Approximately 40% of participants reported dissatisfaction with their current levels of social participation and wanted to do more. Significant differences in social participation were found across transportation mode and residential location. AAwPD using public transportation (specifically paratransit) and living in urban areas reported significantly higher social participation ability than rural-dwelling private transportation users (p <.001). The linear regression revealed that individual health and demographic factors served a larger role in predicting social participation than built or social environmental factors.

Conclusions: AAwPD experience barriers in the built environment that can hinder their social participation. Our findings suggest that transportation mode plays a significant role in shaping social participation outcomes for AAwPD. However, compared to built and social environmental factors, individual factors (i.e., physical function, pain, fatigue, depression) may restrict social participation more.

Author(s) Disclosures: The authors report no conflicts of interest.