Evaluative research in rehabilitation calls for approaches which recognize that rehabilitation outcome is determined by a complex group of factors, both internal and external to the rehabilitation system. Focusing on external Qr environmental influences affecting rehabilitation outcome, this presentation reviews the need for expanding the parameters of evaluative research to a system approved at both mezzo (intermediate) and macrosystem levels. Specific external factors at mezzo and macro levels include social climate, geography, social mores and folkways, economic conditions and institutional policies and practices.
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