Community Participation and Enfranchisement Among Adults With Mobility Impairments.

Adults with paralysis often experience restricted community participation, yet less is known about participation enfranchisement, including perceived control and importance. This study aimed to describe patterns of participation enfranchisement and examine associations with demographic and functional factors among adults with mobility impairments. Thirty adults with paralysis using mobility aids completed the Community Participation Indicators (CPI) at an adaptive fitness center. Social and recreational activities were most frequently performed, whereas employment, volunteering, and civic activities were least frequently performed. Adjusted CPI ratios indicated higher meaningful participation in social and household activities (≥.60) and lower meaningful participation in employment, volunteering, and civic roles (≤.36). Independent driving (τb = -.490, p =.002) and independent living (τb =.409, p =.009) were associated with greater perceived control. Longer disability duration (rs = -.573, p <.001) and earlier onset (rs =.481, p =.007) were associated with lower perceived importance. Findings highlight barriers and opportunities for occupational therapy to enhance participation enfranchisement.