Kaleidoscopic associations between life outside home and the technological environment that shape occupational injustice as revealed through cross-sectional statistical modelling

Abstract

Background: Everyday life outside home and accessing a variety of places are central to occupation. Technology is ever more taken for granted, even outside home, and for some may culminate in occupational injustice. This study aims to explore the association between everyday technologies (ET), particularly out of home, and the number of places older adults with and without dementia go to, in rural and urban environments. Method: The Everyday Technology Use Questionnaire, and Participation in Activities and Places Outside Home Questionnaire, were administered with 128 people in England. Six logistic regression models explored the association between ET and the number of places people went to, with other demographic factors (i.e., rurality, diagnosis, deprivation). Results: The amount of out of home technologies a person perceived relevant and relative levels of neighbourhood deprivation were most persistently associated with the number of places people went to. Associations with ability to use technology, diagnosis, and education were more tentative. In no model was rurality significant. All models explained a low proportion of variance and lacked sensitivity to predict the outcome. Conclusion: For a minority of people, perceptions of the technological environment are associated with other personal and environmental dimensions. Viewed kaleidoscopically, these associations assemble to generate an impermanent, fragmented view of occupational injustice that may jeopardise opportunities outside home. However, there will be other influential factors not identified in this study. Greater attention to the intersections between specific environmental dimensions may deepen understanding of how modifications can be made to deliver occupational justice.

Out-of-home participation among people living with dementia: A study in four countries

“…Furthermore, there are variations in access to healthcare services across the four countries in terms of the location of services in the community and the affordability of the services depending on private or public healthcare systems. Socio-environmental or external factors, such as social deprivation of the living environment, may be of more importance in influencing the number of places a person goes to, compared to the influence of individual or internal factors ( Wallcook et al, 2020 ). Future research could examine contextual factors, such as rural versus urban areas, healthcare systems, socio-economic factors and built environmental, and the possible effects on community engagement and use of health care and other services.…”

“…This led us to develop the Participation in ACTivities and places OUTside the Home for older adults (ACT-OUT) survey tool, and this was simultaneously done in three languages (English, French and Swedish) using a pre-defined method to foster internal validity ( Margot-Cattin et al, 2019 ; Margot-Cattin, 2021). Previous studies have utilised and contributed to the validation of the ACT-OUT; where patterns of community participation among older adults with and without dementia have been investigated ( Chaudhury et al, 2021 ; Gaber et al, 2020a ; Gaber et al, 2019 ; Gaber et al, 2020b ; Margot-Cattin et al, 2021; Wallcook et al, 2020 ), and among people diagnosed with stroke ( Malinowsky et al, 2019 ; Olofsson et al, 2019 ).…”

Social Citizenship Through Out-of-Home Participation Among Older Adults With and Without Dementia

“…The ACT-OUT questionnaire was developed with older adults living with and without dementia and an in-depth explanation of the development process in three languages (English, French, and Swedish) can be found elsewhere (Margot-Cattin et al, 2019). Earlier studies using the ACT-OUT questionnaire in different countries (Chaudhury et al, 2021) and in conjunction with other instruments (Gaber et al, 2021; Margot-Cattin et al, 2021; Wallcook et al, 2021) contribute to the validity of the ACT-OUT questionnaire. Further psychometric testing is underway.…”

“…There are structural and contextual aspects that influence the living environment; thus, opportunities for out-of-home participation may vary among different countries (Townsend et al, 2021). Structural and contextual aspects include city planning, urban design and walkability (Biglieri, 2018; Houston et al, 2020), proximity to nature (Sturge et al, 2021), socio-economic status (d'Orsi et al, 2014; Gaber et al, 2020; Wallcook et al, 2021), access to public transport and transport services (Kizony et al, 2020; Mouratidis, 2018), access to health care services including diagnostic and support services for older adults living with dementia and other age-related or disabling conditions (Gan et al, 2021).…”