Research Paper
Validity of the Participation and Environment Measure for Children and Youth (PEM-CY) for Health Impact Assessment (HIA) in sustainable development projects

https://doi.org/10.1016/j.dhjo.2013.11.003Get rights and content

Abstract

Background

Participation in home, school, and community activities is an important indicator of child health and well-being. Evaluating environmental influences on children's participation can inform efforts to develop sustainable built environments, but few validated measures exist.

Objective

To examine the concurrent validity and utility of the Participation and Environment Measure for Children and Youth (PEM-CY) for Health Impact Assessment in non-urban sustainable development projects affecting children with disabilities.

Methods

Eighty-nine parents of children and youth with disabilities who identified as residing in a small town or rural community were sampled. Sixty-six caregivers completed the PEM-CY online, and 23 caregivers completed the PEM-CY and CHIEF-CP paper forms. Spearman correlational analyses were conducted to establish the concurrent validity of the PEM-CY environment sections against the CHIEF-CP. Group comparisons by child's age, number of functional limitations, and annual household income were used to examine differences in summary and item-level responses on the PEM-CY community section.

Results

Moderate to strong associations were found between CHIEF-CP Total Product and Magnitude Scores and all PEM-CY Environment Summary Scores. CHIEF-CP Physical/Structural and Policies Subscale Scores were most consistently associated with PEM-CY Environment Summary Scores. Group differences by household income were found for participation frequency and number of supports, including perceived availability and adequacy of money and information about programs and services, even when controlling child's age and number of functional limitations.

Conclusion

Study results lend support to the use of the PEM-CY in HIA to reliably assess for environmental impact on children's participation. Implications for using the PEM-CY to inform decision-making in non-urban sustainable development projects affecting families of children and youth with disabilities are discussed.

Section snippets

Sample

Using a cross-sectional design, participants were 89 caregivers of children and youth with disabilities residing in non-urban communities. Sample 1 (obtained May–October 2010) included 66 families who participated in the PEM-CY validation study via the provision of recruitment materials (e.g., flyers, electronic mailing lists, website posting, presentations, direct solicitation, and newsletters) to staff from community-based agencies and groups by three collaborating institutions in their

Child and family characteristics

Table 1, Table 2 summarize the distribution of selected demographic characteristics for Samples 1, 2, and the combined study sample. A total of 89 caregivers of children (M = 11.91 years, SD = 3.36) with a broad range of diagnoses identified as residing in smaller towns or rural communities within the United States (60.6%) and Canada (39.4%). Most respondents were mothers (91.0%), Caucasian (75.0%), and had at least 2 children living at home. Roughly half of the participants reported annual

Discussion

Children's participation in daily life activities as a major influence on health and well-being is well established.20, 21 For children with disabling conditions, there is evidence that physical and social features of environments positively and negatively impact activity participation.19, 29, 30, 35, 36, 37 Depending in part on the type and severity of the child's health condition, environmental modifications may be a feasible option for promoting participation.45 Sustainable development teams

Conclusion

HIA is a process for appraising environmental impact on human health and often includes vulnerable populations at greater risk for health inequities in the assessment process; such as community members with disabilities.12 This study provides preliminary support of the validity and utility of the PEM-CY for HIA in sustainable development projects affecting children with disabilities in non-urban communities. When used in this particular decision-making context, the PEM-CY may enable

Acknowledgments

We thank Renee Lee, Jenna Moriarty, and Anna Cliff for oversight of participant recruitment for Sample 2 data collection, Sarah Pickle for assistance with data management and entry, and Gale Whiteneck for permission to use the Craig Hospital Inventory of Environmental Factors for Children–Parent Version.

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    This research was supported by funds from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research (Grant # H133G070140) and the Department of Occupational Therapy, Colorado State University. We declare no additional conflicts of interest.

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