Opportunities For Social Participation Research Articles

The challenge of inclusion for older people with impairments: Insights from a stigma-based analysis

The intersection of disability and aging often presents obstacles and discomfort for older people with disabilities keen to access mainstream opportunities for social participation. Besides individual situations and preferences – disability-based or not – environmental and social factors may limit full access to participation for older people with disabilities. Although ageist and ableist trends of contemporary ideas of aging have been documented, few studies have examined how those discourses are enacted in the field. In the context of participatory action research carried out since 2014 in a seniors' leisure club, we conducted 14 individual interviews with volunteers and seven focus groups with 45 members in order to explore their personal experiences with impairments and disability within the club, whether members who develop impairments can continue to participate and whether prospective new members with different types of impairments would be welcomed. We used an interactionist framework inspired by Goffman's work and based on the concept of stigma to analyze participants' narratives. Results indicate that participation by members with disabilities is seen as unusual, disconcerting and disjunctive. Evidence exposes the stigmatizing practices, encompassing labeling, stereotyping, setting apart and discrimination against members with impairments. Their participation may be acceptable if it does not affect the normal course of activities; otherwise, stigmatizing discourses relegate them to the margins. Because stigma can have an overwhelming impact on the lives and social participation of older people with impairments, stakeholders' awareness should be raised so they can understand it and intervene more effectively.

EXPERIENCES OF SOCIAL PARTICIPATION AND PLACE AMONG OLDER ADULTS LIVING IN URBAN NEIGHBOURHOODS IN THE UK AND BRAZIL

Urban environments present opportunities and barriers in respect of social in/exclusion in old age. In response, policies and practices that support active ageing are increasingly being sought, central to which are the provision of opportunities for social participation. This paper presents qualitative data (including 180 face-to-face interviews, 120 walking interviews and 60 photo diaries), to examine experiences of social participation and place amongst older adults living across 6 cities and 18 neighbourhoods in the UK and Brazil. Thematic analysis identified key themes in relation to the urban environment and social participation: negotiating the built environment; place familiarity and control; place ownership and access; and security and safety. The findings support the integral role that urban environments play in shaping experiences of social participation in old age, identifying similarities and differences across case study areas. The paper offers suggestions for integrating social participation and place within age-friendly city frameworks.

Correction: Barriers to Social Participation among Lonely Older Adults: The Influence of Social Fears and Identity.

[This corrects the article DOI: 10.1371/journal.pone.0116664.].

Researcher/local health professionals’ collaborations for community health promotion and mortality among older adults in Japan: JAGES community intervention study

Introduction Health promoting interventions for long-term care prevention among older adults should target community social environment. However, in local government, many health sector staffs face challenges in essential activities including community diagnosis (risk and resource assessments) and intersectoral partnerships. Supporting municipality staffs for those actions, under the close researcher/municipality collaborations, may benefit them. However, the effectiveness of such support/collaborations has remained unclear. We evaluated that in terms of older residents’ community social participation and mortality risks. Methods In 2014, the half of the municipalities participating in the Japan Gerontological Evaluation Study (JAGES) received active supports from JAGES researchers for utilizing community diagnosis data and intersectoral collaborations with various organizations potentially contributing to health promotion for older adults. Participants were functionally independent community-dwelling older adults aged 65 years or more. First, we analyzed 107,292 older people in 25 municipalities participated in both 2013 and 2016 survey. Among them, 13 municipalities received active supports and community diagnosis data based on JAGES surveys (intervention) and remaining 12 municipalities obtained community diagnosis data only (control). We performed difference-in-difference (DID) analysis using multilevel Poisson regression to compare the changes in the prevalence of social participation among the older residents of the intervention and control group municipalities. Second, using the follow-up data (maximum 1267 days), we performed survival analyses applying Fine & Gray's proportional hazard model for assessing the relative risk for death, considering competing risks of moving out. In both analyses, to control selection bias we calculated propensity of receiving active supports from demographic data and performed inverse probability of treatment weighting (IPTW) analysis. We stratified all analyses by gender and adjusted for age, education, income, living alone or not, marital status, comorbidity, depressive symptoms, Instrumental Activities of Daily Livings (IADL), and considered the clusters of residential areas in 2013. Results In total, 4591 people have died for 235,534 person-year observation period. Among men, the estimated local activity participation was 46.6% (95% confidence interval [CI]: 45.5%, 47.7%) in 2013 and 57.1% (95% CI: 56.0%, 58.1%) in 2016, among residents in intervention group. In contrast, the participations were 46.4% (95% CI: 45.4%, 47.5%) in 2013 and 54.6% (95% CI: 53.0%, 55.3%) in 2016, among residents in the control municipalities (DID = 0.028, P = 0.006). Among women, there was no significant difference between the two groups (P = 0.131). The adjusted hazard ratio for death among those who lived in the supported municipality was 0.90 (95% CI: 0.84, 0.96) in men and 0.99 (95% CI: 0.90, 1.09) in women, compared to the control group. Conclusion Supporting health sector staffs in municipalities were associated with improved health risks among men. Better partnerships with various organizations, based on strategic risk and resource assessments, might lead to enrich community environment that provides more opportunities for social participation for older men. Building similar collaborating framework may be beneficial for advancing health promotion in local settings.

Patient trajectories and their impact on mobility, social participation and quality of life in patients with vertigo/dizziness/balance disorders and osteoarthritis (MobilE-TRA): study protocol of an observational, practice-based cohort study

IntroductionMobility limitations have a multitude of different negative consequences on elderly patients including decreasing opportunities for social participation, increasing the risk for morbidity and mortality. However, current healthcare has several...

Seniors and Volunteering: An Italian Study into Gender Differences

Various studies on active ageing have focused on social participation as an element in the promotion of related policies. Literature on the subject reveals that the participation in voluntary activities is a factor which contributes positively to the process of active ageing. This article explores gender disparities related to active volunteerism among Italian seniors. Of the 900 active subjects aged between 65 and 74 who participated, 146 were engaged in voluntary activities. Constrained cluster analysis techniques based on a series of variables including age, income type, relationship networks, value attributions, and sector of volunteering association were applied to identify the statistical differences between elderly male and female volunteers. The results show a difference in volunteer profile between the genders. Male volunteers are younger, often married and more active, while women are older, often widows and possessing a strong religious vocation. Furthermore, while men are more likely to be involved in activities related to sports, women tend to donate time to solidarity and educational initiatives aimed at individuals. The promotion of active ageing policies should consider as crucial not only the differences in national welfare regimes, but also how gender disparities determine different forms and opportunities for social participation.

Institution Building from the Bottom and the Top: Long-Term Consequences of Missionary Activity and Settler Colonialism in Madagascar

There is broad agreement that the transfer of European institutions in the colonial period had important long-term consequences for developing regions. But how did ‘alien’ institutions that were introduced in an essentially top down and coercive manner become so deeply embedded in non-Western societies? This study from Madagascar exploits historical variation in the timing and organization of settler colonialism and missionary activity to test for long-term impacts of alternative ‘state-centric’ and ‘societal’ approaches to 19th and early 20th Century European institution building. Drawing on unusually detailed sub-national data, I find that colonial settlement and missionary work had distinctly different effects on formal and informal community-level institutions today. These differences appear to be explained by the higher degree of coercion in former settler districts and greater opportunities for social participation in missionary institutions. The results hold in a battery of robustness tests and in instrumental variable estimates.

Perceived Strengths and Needs After Rehabilitation in Community-Dwelling Adults With Chronic Stroke

Abstract Date Presented 3/31/2017 This study evaluated self-perceived impact of injury on activity performance and satisfaction of adults with chronic stroke. The results showed that being engaged in community-based support programs provided gains in self-perceived activity performance and offered opportunities for social participation. Primary Author and Speaker: Ala’a Jaber Contributing Authors: Jeff Radel, Dory Sabata

Increasing Community Mobility: The Role of Rehab Professionals in Complete Streets Implementation

Abstract Date Presented 3/30/2017 This research evaluates the implementation of Complete Streets across the United States, including a case study in Buffalo, New York. Findings will equip rehabilitation professionals, policymakers, and designers with best practices to create more social participation opportunities for a wider range of users. Primary Author and Speaker: Jordana Maisel Additional Authors and Speakers: Contributing Authors: Molly Ranahan, James Lenker

Procesos de integración social de inmigrantes en escuelas de Huelva, España: Diversidad cultural y retos educativos

<p><span lang="ES">Este artículo surge como resultado de una Tesis de Maestría desarrollada en la Ciudad de Huelva (España), sobre procesos de integración social de inmigrantes en el entorno escolar. El objetivo consiste en analizar los procesos de integración de niños inmigrantes en las escuelas de Huelva, reconociendo el rol social que cumple la escuela con respecto a su formación y sus oportunidades de socialización. En cuanto a la metodología, se recurre al análisis del discurso a partir de datos obtenidos en entrevistas en profundidad y talleres de interculturalidad donde participaron estudiantes, docentes y padres de familia. Como principal resultado del análisis, se plantea que el reto de la escuela no consiste en adaptar los contenidos curriculares a la diversidad existente en su entorno, sino que los debe gestionar efectivamente, atendiendo a las necesidades particulares de los inmigrantes.</span>Pues allí, se ejercen derechos y deberes ciudadanos así como oportunidades de participación social. De esta manera, se concluye que el reto de la escuela en contextos interculturales consiste en fomentar la integración social a través del <span lang="ES">desarrollo de </span><span lang="ES">habilidades para la vida y la socialización. Para ello, debe reorientar la trayectoria vital de niños que han dejado sus raíces, promoviendo un diálogo entre su pasado y su presente, permitiéndoles desarrollar estrategias concretas en favor de la construcción de su proyecto de vida en un nuevo contexto social. </span></p><p class="Prrafodelista1CxSpLast"> </p>

Social dominance in children with cerebral palsy during a problem-solving task with peers

Purpose: Children with cerebral palsy tend to have poorer social competence outcomes than their peers without a disability in mainstream school settings. To understand their social competence, this study compared children with cerebral palsy with paired children without cerebral palsy with respect to their ability to access resources, defined here as “social dominance”, in a problem-solving situation.Method: Children with cerebral palsy were randomly paired to a peer (teammate) and put in a competitive context where each team of two children was instructed to solve an impossible problem. To control for social status, a sociometric measure was administered previously in the classroom (Social Preference score). Behaviors related to social dominance (prosocial and coercive behaviors) were coded using an observation scale validated for this study.Results: The results showed that regardless of social status, children with cerebral palsy were less socially dominant than controls without cerebral palsy. Furthermore, their teams seemed to be less dominant than teams composed of two controls.Conclusions: The lower social competence in children with cerebral palsy could be partly explained by their reduced social dominance behavior in activities requiring speed and fluidity as an expression of executive functions. This might be viewed as a marker for social risks in the integration process at school.Implications for rehabilitationGross Motor Function Classification System level I or II cerebral palsy is a condition that affects not only motor abilities but also social competence in children.Lower social competence in children with cerebral palsy could be partly explained by reduced social dominance behavior in activities such as problem solving with peers.To improve social competence, rehabilitation interventions should include social participation opportunities in which children with cerebral palsy are encouraged to take an active role in the activity.

Micro-scale environment and mental health in later life: Results from the Cognitive Function and Ageing Study II (CFAS II)

BackgroundPoor micro-scale environmental features, such as graffiti and broken windows, have been associated with crime and signs of social disorder with a potential impact on mental health. The aim of this study is to investigate the association between micro-scale environment and mental health problems in later life, including cognitive (cognitive impairment and dementia) and common mental disorders (depressive and anxiety symptoms). MethodsThe method of visual image audits was used to collect micro-scale environmental data for 3590 participants in the Cognitive Function and Ageing Study II, a population-based multicentre cohort of people aged 65 or above in England. Multilevel logistic regression was used to examine the associations between the quality of micro-scale environment and mental health problems taking into account urban/rural difference. ResultsPoor quality of micro-scale environment was associated with nearly 20% increased odds of depressive (OR: 1.19; 95% CI: 0.99, 1.44) and anxiety symptoms (OR: 1.17; 95% CI: 0.99, 1.38) while the direction of association for cognitive disorders differed across urban and rural settings. Although higher odds of cognitive disorders were found in rural settings, living in a poor quality environment was associated with nearly twice higher odds of cognitive impairment (OR: 1.88; 95% CI: 1.18, 2.97) in urban conurbations but 20% lower odds in rural areas (OR: 0.80; 95% CI: 0.57, 1.11). LimitationsThe causal direction could not be fully determined due to the cross-sectional nature of the data. The visual nature of the environmental assessment tool means it likely does not fully capture features related to the availability of local support services, or opportunities for social participation and interaction. ConclusionsThe quality of micro-scale environment appears to be important to mental health in older people. Interventions may incorporate the environmental aspect to reduce cognitive and common mental disorders.

Disparities among Older Persons in China

This study shows that, despite unprecedented economic progress, major disparities in the wellbeing of older persons in China persist. These include disparities between the elderly in urban and rural areas, between the elderly in wealthier Eastern coastal regions and the poorer Western and Central regions, and between elderly men and women. These disparities exist largely because of differential life course experiences that tend to be magnified in old age due to their cumulative effects. Utilizing the “Active Ageing Framework”, developed by the WHO Ageing and Life Course Programme, and core indicators of the Active Ageing Index of European Union countries, this report examines three areas in which there are disparities in the situations of different groups of older persons; health, security and participation.The study finds that older persons in rural areas are in a disadvantaged position in terms of access to healthcare services, and that women live longer but are less healthy than men in China. Older persons in Western and Central regions of China are in poorer health than those in the Eastern coastal region. Huge disparities also exist in the annual pension incomes received by different subgroups of older persons. Pension schemes are highly differentiated among subgroups of older persons. Gaps of community-based elderly care between urban and rural areas are remarkably pronounced. In terms of participation, the study finds that older persons in rural areas have a higher labour force participation rate, largely as a result of low pension income security. Elderly men participate more than elderly women in political activities. Older persons have more social participation opportunities in wealthier areas. The findings of this study contribute to an understanding of the situation of older persons in China and can be used as the basis for recommendations for policy reforms.

Mediating effect of decline in social activities on urinary incontinence and negative mood: Do sex and marital differences exist?

We tested the mediating effect of decline in social participation on urinary incontinence (UI) and negative mood in older adults by sex and marital status. We carried out secondary analysis of data collected from 5301 Chinese adults aged 60 years or older in Hong Kong who had completed an initial screening instrument for subsidized long-term care services in 2010. Path analysis within structural equation modeling was carried out. Satisfactory model fit was obtained: male-married group (n = 1949, standardized root means squared residual [SRMR] = 0.034, robust root mean square error of approximation [R-RMSEA] = 0.045, robust comparative fit index [R-CFI] = 0.965), male-other group (n = 519, SRMR = 0.023, R-RMSEA = 0.011, R-CFI = 0.988), female-married group (n = 948, SRMR = 0.018, R-RMSEA = 0.002, R-CFI = 1.000) and female-other group (n = 2251, SRMR = 0.023, R-RMSEA = 0.048, R-CFI = 0.970). In the male-married subsample, UI had both a significant direct effect (β = 0.046) and significant indirect effect on mood through decline in social participation (β = 0.021); for the female-other subsample, UI (β = 0.058) and decline in social participation (β = 0.335) had significant direct effects on negative mood. Decline in social participation had a significant direct effect on negative mood in the male-other subsample (β = 0.306) and the female-married subsample (β = 0.325). Decline in social participation mediated the relationship between UI and negative mood in married older men, but not male-other group or women. It is important to recognize these sex and marital status differences, and expand social participation opportunities for UI patients. Geriatr Gerontol Int 2017; 17: 1829-1836.

Longitudinal study of social participation and well-being among persons with spinal cord injury and their partners (pro-WELL)

PurposeSocial participation is an important determinant of well-being. Among persons with disabilities, and with spinal cord injury (SCI) in particular, opportunities for social participation are restricted and may impact well-being....

Issue Editor Foreword

Issue Editor Foreword

Found Opportunities for Social Participation

Lack of communicatively supportive opportunities for social participation is a critical barrier for many people with aphasia. Speech–language pathologists need to address this barrier by playing a key role in ensuring that adults with aphasia have appropriate social participation choices in their communities. Speech–language pathologists may provide these services themselves or may draw on their unique expertise in communication and aphasia to work with people with aphasia, family, friends, other health care professionals, and disability support organizations to advocate for and/or develop opportunities. This article provides examples of specific approaches that can help achieve this important goal in relation to 4 levels of social participation: interacting with others without doing a specific activity with them (e.g., having satisfying conversations), interacting with others during activities in which there is a common goal (e.g., participating in enjoyable recreational activities), interacting with others to help a specific person or group of people (e.g., volunteering), and interacting with others to make a contribution to society (e.g., being involved in an aphasia advocacy organization).

From the Editors

Without opportunities to communicate, improved language is a trivial accomplishment. Nina Simmons-Mackie (2008, p. 304) We selected these words to introduce this issue because, with them, Dr. Nina Simmons-Mackie (2008), speech–language pathologist and ethnographic researcher, conveyed its essential message. Simmons-Mackie's words are quoted in the Foreword for Volume 37, Issue 1, of Topics in Language Disorders by the Issue Editors Tami Howe and Robyn O'Halloran (2017). Howe and O'Halloran titled the issue, “A Turning Point for Inclusion” of Adults With Aphasia: Removing Barriers and Implementing Facilitators. We point readers to their issue editors' Foreword for a more detailed overview of the articles and their contributions to the topic. Briefly, Issue Editors Howe and O'Halloran conceptualized this issue as a collection of articles that could illuminate facilitators and barriers to participation for people with aphasia for whom communication difficulty is a defining feature. They invited contributors to describe recent developments about inclusion and participation for people with aphasia from around the globe. First, Menger, Morris, and Salis (2017) review a method of using the International Classification of Functioning, Disability, and Health (World Health Organization, 2001) to evaluate Internet use in people with aphasia. Next, Sather, Howe, Nelson, and Lagerwey (2017) describe the concept of flow as it is experienced by people with aphasia. Third, Howe (2017) provides a closer look at the impact of environmental factors affecting participation of people with aphasia through an exploration of found opportunities for social participation. Fourth, Solarsh and Johnson (2017) provide an overview of a program designed to increase communication access throughout the community. Fifth, Pearl and Cruice (2017) describe methods and provide examples of ways in which researchers may include people with aphasia in research studies. Finally, O'Halloran, Carragher, and Foster (2017) describe the use of two conceptual models as a framework for understanding environmental factors that affect people with aphasia. Overall, we think that readers will agree that the articles in this issue provide an important overview of issues that affect the ability of people with aphasia to participate in their lives in meaningful and desired ways. Although many questions remain about how to improve outcomes, gaining a deeper understanding of the issues using a variety of methods from the perspectives of participants in multiple countries is a solid place to start. The articles in this issue echo a call from another aphasiology pioneer, Audrey Holland. Dr. Holland used her remarks during the 1982 Clinical Aphasiology Conference to encourage clinicians and researchers to employ natural observation as a powerful tool to understand aphasia's impact on people's lives. These current articles further the notion that participation is a complex and multifaceted concept that requires immediate attention by aphasiologists. —Sarah E. Wallace, PhD Associate Editor —Nickola Wolf Nelson, PhD Editor-in-Chief

Place-making with older persons: Establishing sense-of-place through participatory community mapping workshops

Principles of aging-in-place emphasize the importance of creating sustainable environments that enable older people to maintain a sense of belonging, autonomy, independence, safety and security. Simply altering the built environment is insufficient for creating more inclusive environments for older persons, as creating ‘meaningful’ places for aging involves consideration of psychosocial and cultural issues that go beyond issues of physical space. This paper illustrates how applications of community-based participatory research methods, in particular, participatory community mapping workshops (PCMWs), can be used to access experiences of place, identify facilitators and barriers to accessing the built environment and co-create place-based solutions among older people and service providers in a new affordable housing development in Western Canada. Founded on tenets of empowerment and relationship building, four PCMWs were undertaken with 54 participants (N = 38 older people; N = 16 local service providers). PCMWs comprised (i) experiential group walks around the community to access understandings of place and community and (ii) mapping exercises, whereby participants articulated their place-based needs within the context of the new affordable housing development and surrounding neighbourhood. Dialogues were digitally recorded, transcribed and thematically analysed. Visual data, including photographs taken during experiential group walks were categorized and integrated into the narrative to illustrate place meanings. PCMWs enabled senior housing and social care professionals and decision-makers to co-construct knowledge with older tenants that facilitated place action and change. Key themes identified by participants included: identifying services and needs for health and wellbeing, having opportunities for social participation and overcoming cross-cultural challenges. PCMWs were found to be a nuanced method of identifying needs and resources and generating knowledge.

Design of evidence-based gardens and garden therapy for neurodisability in Scandinavia: data from 14 sites.

A total of 14 Scandinavian therapy gardens were visited and data collected on plantings, therapeutic activities and assessment of effectiveness in Spring 2014. Data were gathered by a questionnaire and by interviewing staff in Sweden, Denmark and Norway. The data collection structured proforma used the post-occupation assessment method. Gardening promoted physical movement, presented cognitive challenges and provided opportunities for social participation. Half the gardens were enclosed with sensory plants and 85% were adapted for wheelchairs. A total of 57% of gardens visited had simple designs with flowers, shrubs, lawns and trees. A social center was important especially for dementia clients. Planted pots were used in 79% of gardens. The effectiveness of therapy gardens was assessed at 71% of sites.