A subjective measure of environmental facilitators and barriers to participation for people with mobility limitations

Purpose. The aim of this paper is to describe the development and psychometric properties of a self-report survey of environmental facilitators and barriers to participation by people with mobility impairments. Method. A measure called the Facilitators And Barriers Survey of environmental influences on participation among people with lower limb Mobility impairments and limitations (FABS/M) was developed using items based on focus groups to ensure content validity. Discriminant validity was assessed on 604 individuals who completed the FABS/M once. Internal consistency and test-retest reliabilities were based on 371 individuals who completed two surveys. Results. The FABS/M includes 61 questions, 133 items and six domains including the type of primary mobility device; built features of homes; built and natural features in the community; community destination access; community facilities access; community support network. Environmental items are scored for the frequency of encounter and the magnitude of influence on their participation. The internal consistencies and the test-retest reliabilities of the domains of the FABS/M ranged from low to moderate. The discriminant validity of domains differed for device and diagnostic groups. Conclusion. The FABS/M joins the MQE and the CHIEF as another subjective measure for use in assessing environmental features important for understanding participation. The FABS can be used to assess the influence of environmental interventions at the individual and community levels of analysis. The type of primary mobility device that is used can be related to reported environmental barriers. Community-based improvements in built features, access to destinations, access to facilities and augmented support networks can be tracked through the reports of people with mobility impairments.