Download A Critical Review of Assessments of Environmental Factors

A Critical Review of Assessments of Environmental Factors Influencing
Activity and Participation
O.Craciunoiu, MScOT (Candidate), D. Baxter, MScOT (Candidate) & P. Rigby, PhD
Department of Occupational Science and Occupational Therapy,
University of Toronto, Toronto, Ontario.
Introduction: The influence of the environment on activity and participation has gained wide
spread acceptance in occupational therapy and rehabilitation in general. To characterize the
role of the environment on activity and participation, researchers have developed a variety of
assessments and models that researchers and clinicians can use to consider the personenvironment relationship. Although clinicians recognize that the environment affects activity and
participation, approaching clinical practice from a person-environment perspective has been
challenged by clinicians' limited awareness of the spectrum of environment assessments, their
clinical utility, and measurement properties.
Objective: This study identified and critiqued a broad range of environmental assessment tools
across various practice settings. Those designed to assess children’s home, community and
school settings were also included.
Methods: This study expanded on a landmark review of environmental assessments conducted
by Letts et al. in 1994, to critique newly developed tools and examine additional research
conducted with previously reviewed assessments. The Outcomes Measures Rating Form (Law,
2004) was used to evaluate the measurement properties and clinical utility of each assessment.
Results: Of the 88 environmental assessments that were critiqued only 44 were found to have
good measurement properties and clinical utility. The tools were grouped according to place
(e.g., Home, community, school-setting), and focus (e.g., physical, social, institutional aspects of
the environment).
Conclusions: This critique will enable clinicians and researchers to easily identify useful
environmental measures to suit their purposes.