Multi-stakeholder perspectives of environmental barriers to participation in travel-related activities after spinal cord injury

Experiences in the tourism industry after spinal cord injury: A scoping review

CONTEXT

Despite being important for health and wellbeing, people with a disability engage in tourism significantly less than people who are non-disabled. It is important to understand why this is occurring so that we can set an agenda toward accessible tourism.

OBJECTIVE

To understand the tourism experiences and needs of people living with spinal cord injury.

METHODS

Seven databases were searched for papers related to tourism engagement by people with a spinal cord injury. Included papers were published in English from 2000 and included gray material. Qualitative and quantitative papers were charted separately, with the key findings extracted.

RESULTS

The search identified 3513 papers, duplicates were removed, 2192 papers were screened at title and abstract, 90 papers screened at full text, and 31 papers were included in the final synthesis. Fifty-eight percent of the papers explored American tourism, and 45% were articles in a spinal cord injury magazine. Collectively, the studies, conference papers, and magazine articles highlighted environmental and personal factors that support or hinder engagement in tourism, the impacts on the experience, and recommendations.

CONCLUSION

People with a spinal cord injury want to engage in tourism, however environmental and personal factors create challenges that prevent engagement. Advocacy efforts and consumer partnering are required to support disability education and improve accessible tourism. The limited amount of high-quality research highlights a gap in our knowledge and minimizes the trustworthiness and transferability of the findings from this scoping review.

Craving inclusion: a systematic review on the experiences and needs of people with disability eating out

PURPOSE

To systematically review the research relating to views and experiences of people with disability eating out in cafés, restaurants, and other settings; and identify factors that impede or enhance accessibility of eating out experiences, inform future inclusive research, and guide policy development.

MATERIALS AND METHODS

This study involved systematic search and review procedures with qualitative metasynthesis of the barriers to and facilitators for participation and inclusion in eating/dining-out activities. In total, 36 studies were included.

RESULTS

Most studies reviewed related to people with physical or sensory disability eating out, with few studies examining the dining experiences of adults with intellectual or developmental disability, swallowing disability, or communication disability. People with disability encountered negative attitudes and problems with physical and communicative access to the venue. Staff lacked knowledge of disability. Improvements in the design of dining spaces, consultation with the disability community, and staff training are needed.

CONCLUSION

People with disability may need support for inclusion in eating out activities, as they encounter a range of barriers to eating out. Further research within and across both a wide range of populations with disability and eating out settings could guide policy and practice and help develop training for hospitality staff.

Dehumanizing air travel: a scoping review on accessibility and inclusion of people with disabilities in international airports

Introduction

Worldwide, one in six individuals live with a disability. Many people continue to experience disabling situations, particularly when travelling. Travel can be an important part of the lives of many people, including people with disabilities. Barriers to accessing air travel can lead to a reluctance to travel for these potential passengers. As early as the flight planning stage, options to facilitate accessibility are limited. At airports, passengers must travel long distances in areas where navigation is complex, and accessibility limited. Furthermore, few aircraft are accessible. The travel experience can have adverse effects on the health of people with disabilities. Practices are sometimes not inclusive, not always available, and may not address the full spectrum of possible needs. The objective of this study is to provide a state of art on accessibility features available to people with disabilities in the busiest international airports.

Methods

A scoping review of practices in airport accessibility was done. A search strategy was deployed in 4 databases (Avery index to architectural periodicals, Medline, CINAHL, and Web of science). The official websites of the 35 busiest airports were exhaustively consulted. All information regarding accessibility measures and inclusive services were extracted.

Results

31 scientific articles, out of 3,640 screened, and all extracted data from airports' website were considered for synthesis. While efforts are made in major airports, there is a great inconsistency in accessibility features. Both facilitators and challenges are encountered by people with disabilities at every stage of air travel. These stages include journey planning; getting to and from the airport, obtain human assistance, navigate in the premises, check in, security screening, using facilities, boarding and disembarking, customs and immigration procedures, and luggage management.

Discussion

Services need to be extensively planned, placing a significant burden on passengers. The disability-centric perspective disregard passengers' unique needs and capabilities, leading to a sense of dehumanization. The complexity of airport organizations, shared responsibilities, limited communication, training challenges can deter accessibility initiatives and create discomfort during travel. This study is the first step of a broader project supported by Canadian Accessibility Standards, focusing on enhancing inclusive accessibility in Canadian airports.

Environmental barriers perceived by the Finnish population with spinal cord injury: a cross-sectional survey

STUDY DESIGN

Cross-sectional survey of the Finnish population with spinal cord injury (SCI).

OBJECTIVES

To explore the frequencies of perceived environmental barriers (EB) that made participation harder for the Finnish population with SCI and to compare the occurrence of perceived EBs by gender, age, time since injury, and injury severity.

SETTING

Participants were recruited from the registers of the three SCI outpatient clinics responsible for the lifelong care of people with SCI in Finland.

METHODS

The self-administered Nottwil Environmental Factors Inventory Short Form (NEFI-SF) collected in the Finnish Spinal Cord Injury Study (FinSCI) (n = 1772) was used. Nonparametric tests and multinomial logistic regression models were utilized.

RESULTS

880 individuals responded to the NEFI-SF items (response rate 50%). Climate was perceived as a barrier by 72% and a serious one by 44% of the respondents. The rates regarding public access were 59% and 24%, private home access 46% and 18%, and long-distance transport 45% and 20%. Four out of ten respondents reported that finances, lack of assistive devices for short-distance transport, and political decisions restricted their participation. The NEFI-SF total scores were higher (meaning more perceived restrictions by EBs) for those more severely injured.

CONCLUSIONS

Climate, access to public and private places, challenges with transport, finances, and political decisions were the EBs most frequently perceived to restrict participation by the Finnish population with SCI. Most EBs that were prominent causes of restrictions are modifiable. Greater accessibility to the built environment, equal services to all, and positive special treatment could reduce their effects.

Travel and Social Isolation of People With Spinal Cord Injury

Background

People with spinal cord injury (SCI) are at high risk for social isolation because they face barriers to social participation owing to limitations in physical functioning, secondary health conditions, and environmental barriers. Research has shown that social isolation, an objective lack of contact with others, can lead to loneliness, mental health issues, and low life satisfaction. Leisure travel, which involves interactions with others, may have the potential to reduce social isolation.

Objectives

To explore the association of travel participation with social isolation among people with SCI.

Methods

A total of 11,091 cases from 2016-2021 in the SCI Model Systems database were included in the study. Participants were categorized into low and high social isolation groups. A hierarchical logistic regression was performed with social isolation as the dependent variable and travel groups as the independent variable, while controlling for age, family income, and health conditions.

Results

Travel participation is negatively associated with social isolation. People with SCI who traveled for one to two nights (odd ratio [OR] 0.52, 95% CI 0.40-0.67), three to four nights (OR 0.56, 95% CI 0.43-0.72), or more than five nights (OR 0.41, 95% CI 0.35-0.49) in the past 12 months are less likely to be socially isolated compared to those who have not traveled in the past 12 months.

Conclusion

Travel participation may help reduce the social isolation of individuals with SCI. Therapists and rehabilitation professionals should design effective travel training programs that encourage patients with SCI to travel more often.

Contribution of travel participation to social integration and life satisfaction after spinal cord injury

BACKGROUND

Research has found that participation in travel declines for people after spinal cord injury (SCI) because the traumatic injury usually results in impaired physical mobility and sensation, and barriers in the environment make travel more challenging. While travel participation can offer numerous physical, psychological, and emotional benefits, empirical evidence on positive outcomes of travel for people after SCI is scarce in the literature.

OBJECTIVE

To empirically examine the effects of travel participation on social integration and life satisfaction for people with SCI, along with other personal characteristics including income, self-perceived health status, levels of physical independence, occupational activities, and travel barriers.

METHODS

Cross sectional data are collected from 250 patients enrolled in a SCI Model System. Hierarchical regression analyses, followed by mediation analyses, are conducted to assess the effects of travel participation on social integration and life satisfaction.

RESULTS

Travel participation along with occupational activities is shown to significantly impact social integration, with participation in occupational activities partially mediating the relation from travel participation to social integration. The significant effect of travel participation on life satisfaction is fully mediated by social integration. Income and self-perceived health status both significantly contribute to social integration and life satisfaction.

CONCLUSIONS

Travel participation should be considered as an independent domain that directly impacts the social integration of people with SCI, which in turn enhances their life satisfaction. Systematic interventions with standard protocols for travel-related skill training and assessments procedures are needed for people after SCI.

Environmental Barriers and Facilitators to Physical Activity among University Students with Physical Disability-A Qualitative Study in Spain

This paper qualitatively examines environmental factors operating as barriers and/or facilitators to participation in physical activity (PA) of people with physical disabilities. Interview data were collected from 27 Spanish university students through the innovative method of two-on-one interviews. Thereafter, data were subject to a flexible thematic analysis. Three themes were constructed: associations; PA practice spaces; and nonhumans. Concepts from different theories were used to generate meaningful interpretations around each theme. Drawing on our results, we offer several reflections and directions. Two key messages can be highlighted. First, environmental barriers and facilitators are context dependent and thus do not precede the circumstances in which they emerge. Second, Spanish universities should work harder to become relevant PA promoting environments for students with physical disability. The knowledge generated in this study is expected to inform the design, implementation and evaluation of programs promoting PA among Spanish university students with physical disability.