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1.
  • Norin, Lizette, et al. (författare)
  • Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury
  • 2020
  • Ingår i: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226 .- 1477-6006. ; , s. 1-10
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method: Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings: Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grabbars (hygiene area) generated the most accessibility problems. Conclusion: Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.
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2.
  • Andersson, Nilla, et al. (författare)
  • Environmental barriers and housing accessibility problems for people with Parkinson’s disease : A three-year perspective
  • 2023
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 30:5, s. 661-672
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Although housing accessibility is associated with important health outcomes in other populations, few studies have addressed this in a Parkinson’s disease population. Aim: To determine the most severe environmental barriers in terms of housing accessibility problems and how these evolved over 3 years among people with Parkinson’s disease. Material and Methods: 138 participants were included (men = 67%; mean age = 68 years). The most severe environmental barrier were identified by the Housing Enabler instrument and ranked in descending order. The paired t-test was used to analyse changes in accessibility problems over time. Results: The top 10 barriers remained largely unchanged over 3 years, but with notable changes in order and magnitude. ‘No grab bar in hygiene area’ and ‘Stairs only route’ were top-ranked in generating accessibility problems at baseline but decreased significantly (p = 0.041; p = 0.002) at follow-up. ‘Difficulties to reach refuse bin’ was top-ranked at follow-up, with a significant increase (p < 0.001) of related accessibility problems. Conclusions and Significance: The new knowledge about how accessibility problems evolve over time could be used by occupational therapists to recommend more effective housing adaptations taking the progressive nature of Parkinson’s disease into account. On societal level, the results could be used to address accessibility problems systematically.
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3.
  • Andersson, Nilla, et al. (författare)
  • Psychometric properties of the external Housing-Related Control Belief Questionnaire among people with Parkinson’s disease
  • 2020
  • Ingår i: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 32:12, s. 2639-2647
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Housing-related control beliefs are associated with aspects of health among older people in general. Research on Parkinson’s disease (PD) focusing on perceptions of the home are rare and instruments capturing perceived aspects of home have seldom been used. Aims: To evaluate psychometric properties of the external Housing-related Control Beliefs Questionnaire (HCQ) among people with PD. Methods: The external HCQ were administrated to 245 participants with PD, (mean age = 69.9 years; mean PD duration = 9.7 years). External HCQ has 16-items, with five response options. The psychometric properties evaluated were data quality, structural validity (factor analysis), floor and ceiling effects, corrected item total correlations, internal consistency and construct validity (testing correlations with relevant constructs according to pre-defined hypotheses). Results: Data quality was high. Structural validity showed a unidimensional construct with removal of two items. Homogeneity was questionable, but strengthened after the removal of the two items. For the 14-item version internal consistency was α = 0.78 and SEM 4.47. Corrected item total correlation ranged between 0.31 and 0.54 and no floor or ceiling effects. Significant correlations with relevant constructs supported the construct validity. Conclusions: Taken together, the psychometric results suggest a 14-item version of the external HCQ to be sufficiently reliable and valid for use in the PD population. The results pave the way for further studies, using the HCQ to analyse how perceptions of control of the home may be associated with health among people ageing with PD.
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  • Andersson, Nilla, et al. (författare)
  • The meaning of home questionnaire revisited : Psychometric analyses among people with Parkinson's disease reveals new dimensions
  • 2020
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:12
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Research addressing perceptions of housing in people with Parkinson's disease (PD) is rare, and existing instruments capturing perceived aspects of housing are rarely used. Perceived housing comprises of several domains and is associated with health in general older populations. One such domain is meaning of home, captured by the Meaning of Home Questionnaire (MOH). The aim of this study was to evaluate psychometric properties of the MOH among people with PD. MATERIALS AND METHODS: The MOH was administrated to 245 participants with PD (mean age = 69.9 years; mean PD duration = 9.7 years). The instrument consisted of four sub-scales with 28 items, each with 11 response options (strongly disagree = 0; strongly agree = 10). We evaluated data quality, structural validity (factor analysis), construct validity (i.e., testing correlations with relevant constructs according to pre-defined hypotheses), corrected item total correlations, floor and ceiling effects and internal consistency. RESULTS: The data quality was high (0-1.2% missing data). The exploratory factor analysis suggested removal of five items and revealed three new factors; "My home is my castle", "My home is my prison" and "My home is my social hub". The 23-item MOH showed statistically significant correlations with life satisfaction, usability and ADL dependence, while not correlated with number of environmental barriers. These findings were largely as hypothesised, thus supporting construct validity (both convergent and discriminant). The corrected item total correlations were >0.3 for all items and the internal consistency was >0.70 for all sub-scales. No floor or ceiling effects were reported except for the sub-scale "My home is my castle" (ceiling effect = 15.6%). CONCLUSIONS: The 23-item MOH version with three new sub-scales is sufficiently reliable and valid for use in PD populations. This paves the way for further research of meaning of home among people with PD, using the 23-item MOH version.
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6.
  • Axmon, Anna, et al. (författare)
  • Detecting longitudinal changes in activities of daily living (ADL) dependence : Optimizing ADL staircase response choices
  • 2019
  • Ingår i: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226 .- 1477-6006. ; 82:10, s. 646-652
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Using a sum score based on a three-graded response scale for the activities of daily living staircase has previously been found to increase the statistical power compared to dichotomized responses when assessing longitudinal changes in activities of daily living. We aimed to investigate if the statistical power could be further increased by using a four-graded scale. Methods: We used data from two previous studies on community-living people to calculate sum scores based on a dichotomized (independent/dependent), a three-graded (independent/partly dependent/dependent), and a four-graded (independent without difficulty/independent with difficulty/partly dependent/dependent) response scale for the activities of daily living staircase. In total, 1818 paired observations (baseline to follow-up) from 482 people were included. Statistical power was estimated for the entire material as well as stratified by follow-up time and baseline activities of daily living using simulations. Results: The four-graded scale provided the highest statistical power, particularly for shorter follow-up times and low and high baseline activities of daily living, but had similar statistical power to the three-graded scale for longer follow-up times and medium baseline activities of daily living. Conclusion: Adding a second level to “independent” in the activities of daily living staircase improved the detection of changes over time.
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7.
  • Bukvic, Olivera, et al. (författare)
  • A review on the role of functional limitations on evacuation performance using the International Classification of Functioning, Disability and Health
  • 2021
  • Ingår i: Fire Technology. - : Springer Science and Business Media LLC. - 0015-2684 .- 1572-8099. ; 57:2, s. 507-528
  • Forskningsöversikt (refereegranskat)abstract
    • This scoping review addresses the role of functional limitations on evacuation performance of adults in public buildings. Although this topic has been addressed in evacuation research, no linkage is currently available between functional limitations, the predominant activities affected by them and evacuation performance. This review strives to open a debate on the need to classify the impact of disability in terms of functional limitations on evacuation performance according to methods adopted in health science. This paper reviews literature concerning evacuation from public buildings with adults aged ≥ 60 years and/or adults aged ≥ 18 years with functional limitations. The International Classification of Functioning, Disability and Health has been used to identify predominant activities during an evacuation and to perform a structured classification at different levels of resolution to address self-evacuation possibilities. Results of the review are presented in a tabular form linking predominant activities in terms of the International Classification of Functioning, Disability and Health and six categories of functional limitations with the engineering evacuation time-line. The suggested classification can facilitate the assessment of the evacuation-related issues in buildings in relation to the population under consideration. The main research gaps identified include the lack of studies concerning the impact of cognitive limitations on egress, and the need to add the temporal dimension to the methods adopted in accessibility research to allow for their use in the egress field.
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8.
  • Carlsson, Gunilla, et al. (författare)
  • Assessing environmental barriers by means of the swedish craig hospital inventory of environmental factors among people post-stroke
  • 2021
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 28:5, s. 366-374
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: When occupational therapists address environmental barriers to occupational engagement, some barriers might not be possible to reduce for single individuals, because decisions have to be taken at community or societal level, for example changes in public transport. Investigating environmental barriers by means of the Swedish Craig Hospital Inventory of Environmental Factors (CHIEF-S) may increase our understanding of the environmental impact on occupation engagement and the methodological challenges to assess environmental barriers. Aims: To investigate and describe the magnitude of encountered environmental barriers in a group of people post-stroke and to assess psychometric properties of the CHIEF-S. Material and methods: In total, 34 participants, who had sustained a stroke in Sweden were recruited. Results: The participants reported in average 2,7 barriers and the total frequency-magnitude score of barriers (CHIEF-S score) was 0.45. The Cronbach’s α for the total CHIEF-S was 0.80 and the analysis of test-retest reliability revealed ICC = 0.86. The entire instrument demonstrated better psychometric properties than the single sub-scales. Conclusion: In this study, the frequency-magnitude of environmental barriers encountered by people post-stroke are reported at a group level and adds information to the cumulative knowledge generation on perceived environmental barriers in the society. However, to inform which interventions are needed at a more detailed level, other data collection methods have to be added.
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  • Carlsson, Gunilla, et al. (författare)
  • Exploration of a Web-based accessibility tool for public facilities
  • 2023
  • Ingår i: Facilities. - 0263-2772. ; 41:15/16, s. 66-84
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose – This study aims to explore how an accessibility database (AD) has been developed and implemented as a tool for facility managers to evaluate and increase the accessibility of public facilities.Design/methodology/approach – Eight participants were strategically sampled for semi-structured interviews, and documents on the AD were gathered. The Consolidated Framework for Implementation Research (CFIR) was used for a directed content analysis of the data. The CFIR domains used for the analysis were: intervention characteristics, outer setting, inner setting, characteristics of individuals and process.Findings – The development and implementation of the AD demonstrated the complexity in assessing and planning for increased accessibility. The communication and iterative processes within the inner as well as with the outer setting was an important part of the development and implementation, as well as anchoringeach step locally, regionally and nationally, within public authorities and disability organizations.Practical implications – The assessments of environmental barriers and the results reported in the AD can serve as a guide for identification of accessibility issues. However, singular identified barriers were reported as a fragmentation of the building regulations, and thereby when retrofitting is carried out, experts who have the competence to suggest solutions based on the entirety need to be involved to reach the goals of increased accessibility and countering of exclusion and discrimination.Originality/value – By structuring the implementation process by means of the CFIR, facilitators and barriers of using an AD as a basis for retrofitting were revealed. The practical challenges outlined in assessing and increasing accessibility can guide facility managers when considering actions to increase accessibility.
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  • Carlsson, Gunilla, et al. (författare)
  • Towards a screening tool for housing accessibility problems: a reduced version of the Housing Enabler.
  • 2009
  • Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 1552-4523 .- 0733-4648. ; 28:1, s. 59-80
  • Tidskriftsartikel (refereegranskat)abstract
    • To present a reduced version of the Housing Enabler, useful as a screening tool in practice contexts and in research, this study identifies the core items of the environmental component of the instrument, that is, the items most important in terms of the instrument's overall validity to measure accessibility problems. Utilizing cross-national data and interdisciplinary knowledge through an iterative process, a set of core items was identified. The environmental component of the reduced version comprises 61 items, compared to 188 in the original instrument. The rank correlation between the accessibility scores generated by the original and reduced versions was r ≥ .97 (p < .001). Based on comprehensive empirical research in three countries, the reduced version of the Housing Enabler is a time-efficient and valid screening instrument. It is a powerful tool for research and interventions focusing on housing accessibility problem identification.
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13.
  • Denvall, Verner, et al. (författare)
  • Participationens metodologi
  • 2022
  • Ingår i: Participation - vad, när, hur. - 9789144153155 ; , s. 271-308
  • Bokkapitel (populärvet., debatt m.m.)
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14.
  • Elf, Marie, 1962-, et al. (författare)
  • Housing Accessibility at Home and Rehabilitation Outcomes After a Stroke : An Explorative Study
  • 2023
  • Ingår i: Health Environments Research & Design Journal. - 1937-5867 .- 2167-5112. ; 18:3, s. 237-237
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To explore if aspects of the physical home environment are related to rehabilitation outcomes among community-living persons poststroke.BACKGROUND: Research demonstrates that healthcare environments are important for high-quality care and that the design of the physical environment is associated with improved rehabilitation outcomes. However, relevant research focusing on outpatient care settings, such as the home, is sparse.METHODS: In this cross-sectional study, data on rehabilitation outcomes, physical environmental barriers, and housing accessibility problems were collected during home visits of participants (N = 34), 3 months poststroke. Data were analyzed with descriptive statistics and correlation analysis.RESULTS: Few participants had adapted their homes, and the relevance of the physical environment was not always discussed with the patient during discharge from the hospital. Accessibility problems were associated with suboptimal rehabilitation outcomes such as worse perceived health and recovery after stroke. Activities most restricted by barriers in the home concerned hand and arm use. Participants who reported one or more falls at home tended to live in houses with more accessibility problems. Perceived supportive home environments were associated with more accessible dwellings.CONCLUSIONS: Many face problems adapting their home environments poststroke, and our findings highlight unmet needs that should be considered in the rehabilitation practice. These findings could be used by architectural planners and health practitioners for more effective housing planning and inclusive environments.
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15.
  • Eriksson, Erik, et al. (författare)
  • Perceived Housing in Relation to Retirement and Relocation : A Qualitative Interview Study among Older Adults
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:20
  • Tidskriftsartikel (refereegranskat)abstract
    • As people age the home environment becomes increasingly important. Retirement commonly leads to spending more time in one’s home, and relocating from your own home in older age could be associated with reduced health or wellbeing. The relationship between home and person is complex and perceived aspects of one’s housing such as social, emotional and cognitive ties are considered important factors for health and wellbeing. However, little is known about how perceived aspects of the home change in relation to retirement and relocation. This paper used Situational Analysis to explore, via situational mapping, how community dwelling older adults (aged 60–75) perceived their housing situation in relation to retirement and relocation. The results suggest complex relations between relocation/retirement and perceived housing, and between different aspects of perceived housing. Furthermore, the results suggest that the relationship between life transitions and perceived housing can be seen as bi-directional, where different life transitions affect aspects of perceived housing, and that perceived housing affects (decisions for) relocation. The results suggest complex relations between retirement and relocation, as well as other life transitions, and perceived aspects of one’s housing. It is important to consider these interactions to understand factors that affect health and wellbeing in older adults.
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16.
  • Frögren, Joakim, et al. (författare)
  • Awareness of and attitudes towards public involvement in research on ageing and health among older people in Sweden
  • 2022
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:6
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: While the importance of involving older people in research is increasingly acknowledged, quantitative studies exploring the perspectives of larger samples of older people who take an active role in research on ageing and health are scarce. The aim of this study was to investigate the awareness of and attitudes towards public involvement in research on ageing and health among older people in Sweden.MATERIALS AND METHODS: Data derived from a survey (N = 881) of people aged 60 years or older in Sweden. Demographics, self-rated health, and attitudes were analysed using descriptive statistics. Awareness of and previous active involvement in research were analysed using chi-square tests and Mann Whitney tests. Factors associated with willingness to be actively involved in research were determined by logistic regressions.RESULTS: Of the 26% who responded (N = 881), 39% (n = 343) were aware that they could be actively involved in research. Awareness and previous active involvement in research were significantly associated with a higher level of education. Public involvement was believed to enhance research communication and enable valuable contributions related to ageing. The proportion of respondents who were willing to be actively involved in research was significantly higher for respondents with previous experience and a higher level of education.CONCLUSIONS: Engaging older people in Sweden in research targeting active involvement in research presents a challenge. The study shows an over-representation of people with higher education, who tend to be more aware, have previous experience, and are more willing to be involved in research with public involvement. This implies a risk that groups with lower education are not represented, and that knowledge co-produced with mostly highly educated groups will lead to a biased picture. Further studies are needed to understand how an increased awareness of research and willingness to participate can be achieved. IRRID: RR2-10.2196/17759.
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17.
  • Gefenaite, Giedre, et al. (författare)
  • Associations among housing accessibility, housing-related control beliefs and independence in activities of daily living : a cross-sectional study among younger old in Sweden
  • 2020
  • Ingår i: Journal of Housing and the Built Environment. - : Springer Science and Business Media LLC. - 1566-4910 .- 1573-7772. ; 35:3, s. 867-877
  • Tidskriftsartikel (refereegranskat)abstract
    • There is some evidence that housing accessibility, external housing-related control beliefs (HCB) and activities of daily living (ADL) are associated in complex ways; however, these pathways have not been explored in younger old. The aim was to assess the role of external HCB in the relationship between housing accessibility and ADL by applying moderation and mediation models. This was a cross-sectional study involving 366 community-living 67–70 years old participants from the Skåne part of the Swedish National Study of Aging and Care. We assessed moderation by including an interaction term in a logistic regression analysis (significant if p value < 0.05). We assessed mediation with a series of regression analyses with effect size measures expressed as proportion mediated and its 95% confidence interval (CI). In the absence of statistically significant interaction there was no support for external HCB as a moderator. There was evidence for partial mediation as external HCB was associated with ADL when controlled for housing accessibility, while housing accessibility remained associated with independence in ADL when adjusted for external HCB. The proportion mediated was 6% (95% CI 1; 14). While the results did not support external HCB as a moderator, external HCB mediated the association between housing accessibility and ADL. These results were different from previous findings suggesting that external HCB plays a marginally significant moderating and mediating role among very old. Such differences call for further studies that would allow further exploration and validation of the findings at different stages of the ageing process, preferably utilizing longitudinal study designs.
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  • Gefenaite, Giedre, et al. (författare)
  • Longitudinal association between housing accessibility and activities of daily living : The role of self-efficacy and control in people ageing with Parkinson's disease
  • 2020
  • Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 20
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: External housing-related control beliefs (HCB) and general self-efficacy (GSE) influence different health outcomes in the general ageing population, but there is no information of their role in people ageing with Parkinson's disease (PD). This study aimed to longitudinally assess the role of external HCB and GSE on the association between housing accessibility and activities of daily living (ADL) among people ageing with PD. Methods: Baseline and 3-year follow-up data on 130 community-living participants from the Swedish project 'Home and Health in People Ageing with PD' were collected. Assessments addressed housing accessibility, external HCB, GSE, generic ADL and ADL specific to PD. The moderating effects of external HCB and GSE were assessed by including an interaction term in multivariable logistic regression. Results: There were statistically significant interactions between housing accessibility and GSE on ADL (p = 0.03), and housing accessibility and external HCB on PD specific ADL (p = 0.03). After stratifying the analyses by GSE, housing accessibility problems led to more dependence and difficulty in ADL in participants with low GSE (OR 1.14; 95% CI 1.02-1.28). After stratifying by external HCB, housing accessibility increased dependence and difficulty in PD specific ADL in participants with low external HCB (OR 1.35; 95% CI 1.03-1.76). Discussion: The results suggest that housing accessibility predicts ADL in people with PD with GSE and external HCB playing a moderating role for generic ADL and ADL specific to PD, respectively. Further longitudinal studies should validate these findings and explore their potential application in PD-related care and rehabilitation.
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  • Granbom, Marianne, et al. (författare)
  • A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing
  • 2016
  • Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Housing environments that hinder performance of daily activities and impede participation in social life have negative health consequences particularly for the older segment of the population. From a public health perspective accessible housing that supports active and healthy ageing is therefore crucial. The objective of the present study was to make an inventory of environmental barriers and investigate accessibility problems in the ordinary housing stock in Sweden as related to the functional capacity of senior citizens. Particular attention was paid to differences between housing types and building periods and to identify environmental barriers generating the most accessibility problems for sub-groups of senior citizens.METHODS: Data on environmental barriers in dwellings from three databases on housing and health in old age was analysed (N = 1021). Four functional profiles representing large groups of senior citizens were used in analyses of the magnitude and severity of potential accessibility problems. Differences in terms of type of housing and building period were examined.RESULTS: High proportions of one-family houses as well as multi-dwellings had substantial numbers of environmental barriers, with significantly lower numbers in later building periods. Accessibility problems occurred already for senior citizens with few functional limitations, but more profound for those dependent on mobility devices. The most problematic housing sections were entrances in one-family houses and kitchens of multi-dwellings.CONCLUSIONS: Despite a high housing standard in the Swedish ordinary housing stock the results show substantial accessibility problems for senior citizens with functional limitations. To make housing accessible large-scale and systematic efforts are required.
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  • Granbom, Marianne, et al. (författare)
  • Community Relocation in Very Old Age: Changes in Housing Accessibility.
  • 2016
  • Ingår i: American Journal of Occupational Therapy. - : AOTA Press. - 0272-9490 .- 1943-7676. ; 70:2, s. 1-7002270020
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study was to compare environmental barriers, housing accessibility, and usability before and after relocation of very old, single-living people in the community. It also examined whether accessibility improved after relocation compared with a simulated scenario in which participants would have remained in their former dwellings.
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  • Granbom, Marianne, et al. (författare)
  • Involving Members of the Public to Develop a Data Collection App for a Citizen Science Project on Housing Accessibility Targeting Older Adults
  • 2023
  • Ingår i: Citizen Science - Theory and Practise. - 2057-4991. ; 8:1, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: While citizen science approaches are emerging within both social and health sciences, projects aimed at improving the living conditions of older adults remain rare. To enable forward-looking housing provision for the ageing population, valid and detailed information is needed on environmental barriers in the housing stock. Moreover, to promote active ageing and avoid involuntary moves to residential care facilities, there is a need for both increased public knowledge and raised awareness about accessible housing among older adults. Thus, Swedish senior citizens were engaged in a citizen science project—the Housing Experiment 2021—using a smartphone application to report environmental barriers in dwellings. Aim: This paper describes in detail the process by which varied members of the public participated to develop an application that assured reliable data collection of environmental barriers by older adults. Methods and Results: The scientific foundation for the app was the Housing Enabler. The development process comprised six iterative phases including participatory activities, namely, developing a citizen science version of the Housing Enabler; developing a print mock-up; developing an app prototype; testing and improving usability; beta version testing for reliability; final tests; and finishing touches. Discussion: Through an iterative development process involving researchers, professionals, and members of the public, a reliable app suitable for senior citizens was created. The results can serve as an inspiration for development protocols increasing the involvement of older adults in app development as well as for citizen science projects targeting older adults.
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29.
  • Haak, Maria, et al. (författare)
  • Cross-National User Priorities for Housing Provision and Accessibility - Findings from the European innovAge Project.
  • 2015
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 12:3, s. 2670-2686
  • Tidskriftsartikel (refereegranskat)abstract
    • To develop an innovative information and communication technology (ICT) tool intended to help older people in their search for optimal housing solutions, a first step in the development process is to gain knowledge from the intended users. Thus the aim of this study was to deepen the knowledge about needs and expectations about housing options as expressed and prioritized by older people, people ageing with disabilities and professionals. A participatory design focus was adopted; 26 people with a range of functional limitations representing the user perspective and 15 professionals with a variety of backgrounds, participated in research circles that were conducted in four European countries. An additional 20 experts were invited as guests to the different research circle meetings. Three themes illustrating cross-national user priorities for housing provision and accessibility were identified: "Information barrier: accessible housing", "Information barrier: housing adaptation benefits", and "Cost barrier: housing adaptations". In conclusion, early user involvement and identification of cross-national differences in priorities and housing options will strengthen the development of a user-friendly ICT tool that can empower older people and people with disabilities to be more active consumers regarding housing provision.
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  • Helle, Tina, et al. (författare)
  • Combining apps targeting professionals and senior citizens to improve housing accessibility and influence housing provision policies.
  • 2015
  • Ingår i: Studies in Health Technology and Informatics. - 0926-9630. - 9781614995654 ; 217, s. 300-305
  • Konferensbidrag (refereegranskat)abstract
    • Two separate apps that address the increasingly important issue of accessible housing for senior citizens have been developed in different project settings. One of the apps was developed to facilitate the process for professional raters to assess housing accessibility in the context of individual housing adaptations. The other app was developed for senior citizens to raise their awareness of possible accessibility problems in their current dwelling and in other apartments within the available housing stock. Both apps were developed with a high degree of active user involvement in processes utilizing multiple state of the art methods. The results are two well accepted prototype apps perceived as user-friendly and appropriate for the intended user groups. By combining these two apps, our ambition is for the professional raters to benefit by gaining knowledge of their clients' perceived needs and desires, and for senior citizens to benefit by getting access to a database of professionally rated dwellings. The ultimate goal is the generation of sound knowledge reflecting the needs and desires of senior citizens and professional requirements regarding accessible housing as a means to inform and influence housing provision policies.
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  • Helle, Tina, et al. (författare)
  • Lack of research-based standards for accessible housing: problematization and exemplification of consequences.
  • 2011
  • Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8564 .- 1661-8556. ; 56:6, s. 635-644
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To increase the understanding of how definitions of standards for housing design influence the proportion of dwellings not meeting the standards and the proportion of individuals defined as having accessibility problems. METHODS: The sample included old people and their dwellings in three European countries (N = 1,150). Frequencies and percentages were reported and empirical distribution functions were used. RESULTS: Depending on the functional profile and standards in question, the magnitude of influence of the standards differs in extent, e.g., the existing standard for door openings at the entrance (defined ≥75 cm) implied that the proportion of dwellings not meeting it was 11.3% compared to 64.4%, if the standard was set to ≥83 cm. The proportion of individuals defined as having accessibility problems for profiles not using mobility devices was 4-5, 57% for profiles using them and 1-3% for the total sample if the standard was set to 90 cm. CONCLUSION: Research-based standard definitions for housing design are necessary to ensure that they actually lead to enhanced accessibility, which is a prerequisite for the independence and health of persons with functional limitations.
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37.
  • Helle, Tina, et al. (författare)
  • The Nordic Housing Enabler: Inter-rater reliability in cross-Nordic occupational therapy practice
  • 2014
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 21, s. 71-79
  • Tidskriftsartikel (refereegranskat)abstract
    • This study addresses development of a content-valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients, and their home environments. The instrument was translated from the original Swedish version of the Housing Enabler, and adapted according to accessibility norms and guidelines for housing design in Sweden, Denmark, Finland, and Iceland. This iterative process involved occupational therapists, architects, building engineers, and professional translators, resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently of each other, collected data from 106 cases by means of the Nordic Housing Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa statistics. Overall good percentage agreement for the personal and environmental components of the instrument was shown, indicating that the instrument was sufficiently reliable for application in practice and research in the Nordic context. The varying kappa results highlight the need for further study in order to understand the influence of prevalence more profoundly, which should be kept in mind when interpreting the results.
  •  
38.
  • Helle, Tina, et al. (författare)
  • The Nordic Housing Enabler: Inter-rater reliability in cross-Nordic occupational therapy practice
  • 2010
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 17:4, s. 258-266
  • Tidskriftsartikel (refereegranskat)abstract
    • This study addresses development of a content-valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients, and their home environments. The instrument was translated from the original Swedish version of the Housing Enabler, and adapted according to accessibility norms and guidelines for housing design in Sweden, Denmark, Finland, and Iceland. This iterative process involved occupational therapists, architects, building engineers, and professional translators, resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently of each other, collected data from 106 cases by means of the Nordic Housing Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa statistics. Overall good percentage agreement for the personal and environmental components of the instrument was shown, indicating that the instrument was sufficiently reliable for application in practice and research in the Nordic context. The varying kappa results highlight the need for further study in order to understand the influence of prevalence more profoundly, which should be kept in mind when interpreting the results.
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39.
  • Heller, Christina, et al. (författare)
  • Exploring housing policies in five Swedish municipalities : alternatives and priorities
  • 2022
  • Ingår i: BMC Public Health. - : BioMed Central Ltd.. - 1471-2458. ; 22:1, s. 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Housing shortage due to population growth within metropolitan areas, combined with an ageing population, has put pressure on current housing provision in Sweden. Thus, there is an urgent need to develop sustainable housing policies to accommodate the growing number of seniors in accessible home environments. This study aimed to gain an in-depth understanding of how municipalities currently address housing accessibility issues and to explore what types of policy solutions they consider for the future.  Material and methods: Five Swedish municipalities were selected to represent a diversity of the population, housing provision approaches, and geographical areas. To understand current housing policies, two key actors (e.g. public officials, housing adaptation grant managers, city architects, etc.) from each municipality participated in semi-structured interviews (N = 10). Subsequently, those key actors, two senior citizens, and three researchers participated in a research circle to explore future policy solutions. Data were analyzed using content analysis.  Results: The interviews revealed common approaches to deal with housing accessibility issues such as regular renovations and maintenance, individual adaptations based on specific needs, and seeking collaboration with private housing actors on housing provision matters. Possible measures suggested for the future included increasing the national coordination of housing accessibility policies, amending legislation to only allow the construction of housing according to strengthened accessibility standards, and introducing economic incentives for seniors to move from housing with poor accessibility to more accessible accommodations.  Conclusions: Municipalities struggle with the lack of accessible and affordable housing for their ageing population, despite a large variety of policies from economic incentives to research and development policies. The results suggest that collaboration needs to be improved between all actors involved in housing policies. Preventive measures within the current laws may be needed to strengthen the construction of more accessible and affordable housing for populations ageing in place.
  •  
40.
  • Heller, Christina, et al. (författare)
  • Exploring Housing Policies in Five Swedish Municipalities: Alternatives and Priorities
  • 2021
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • IntroductionHousing shortage due to population growth within metropolitan areas, combined with an ageing population has put pressure on current housing provision policies in Sweden. Thus, there is an urgent need to develop sustainable housing policies to accommodate the growing number of seniors in accessible home environments. This study aimed to gain an in-depth understanding of how municipalities currently address housing accessibility issues and to explore what types of policy solutions they consider for the future.Material and methodsFive Swedish municipalities were selected to represent a diversity of population, housing situations and geographical areas. Two key actors from each municipality (public officials, housing adaptation grant managers, city architects etc.) participated in semi-structured interviews (N=10). Data were analysed using content analysis, i.e. inductive category formation, described by Mayring (2014). ResultsImportant themes included how such factors as the organizational structure of the municipality and the level of collaboration between municipal and private actors impacted the goals and ambitions of current housing policies. Emerging themes concerning possible measures and policies for the future were innovative types of housing and the need for economic incentives for older people to move from housing with poor accessibility to housing designed to better meet their needs. ConclusionMunicipalities struggle with the lack of accessible and affordable housing for the ageing population. The results suggest there is a need to consider how to prevent organizational issues from hampering policy initiatives and implementation and how to improve collaboration between municipal and private actors involved in housing provision.
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41.
  • Heller, Christina, et al. (författare)
  • The Relationship Between Physical Housing Characteristics, Housing Accessibility and Different Aspects of Health Among Community-Dwelling Older People : A Systematic Review
  • 2023
  • Ingår i: Journal of Aging and Health. - : SAGE Publications Inc.. - 0898-2643 .- 1552-6887. ; 36:1-2, s. 120-132
  • Forskningsöversikt (refereegranskat)abstract
    • Objectives : To synthesize the evidence on the relationships between physical housing characteristics or housing accessibility and different aspects of health among community-dwelling people 60 years and older.  Methods : A systematic review of recent evidence with a narrative synthesis was conducted.  Results : We included 15 studies and found three themes covering physical housing characteristics or housing accessibility that are associated with aspects of health among community-dwelling older adults: (1) interventions by home modifications targeting housing features both at entrances and indoors; (2) non-interventions targeting indoor features; (3) non-interventions targeting entrance features, that is, the presence of an elevator or stairs at the entrance. The overall quality of evidence across studies was assessed as very low.  Discussion : The findings highlight the need for studies with a stronger research design and higher methodological quality that address the physical housing environment in relation to health among older adults to strengthen the body of evidence.
  •  
42.
  • Hultqvist, Sara, et al. (författare)
  • “Why involve older people in research?” Revisiting Alan Walker’s earlier editorial based on recent experiences from the UserAge research programme
  • 2023
  • Ingår i: Research Involvement and Engagement. - : BioMed Central (BMC). - 2056-7529. ; 9:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Posed 16 years ago in a much-cited editorial by gerontologist, Alan Walker, “Why involve older people in research?” is a question that has since inspired researchers in many countries and from diverse disciplines. In Sweden, researchers and older people have been collaborating in the 6-year UserAge research programme, focusing on user involvement in research on ageing and health, UserAge aims at contributing to an in-depth understanding of the challenges and benefts of user involvement in diferent phases of the research process. Approaching programme completion, the authors take the opportunity to dwell upon current reasons for and modes of user involvement in ageing research in light of the argument originally put forward by Alan Walker back in 2007.
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43.
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44.
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45.
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46.
  • Iwarsson, Susanne, et al. (författare)
  • Current developments of the Housing Enabler methodology
  • 2012
  • Ingår i: British Journal of Occupational Therapy. - 1477-6006. ; 75, s. 517-521
  • Tidskriftsartikel (refereegranskat)abstract
    • Twenty years of methodological development, empirical research and practice application have resulted in an updated version of the Housing Enabler instrument and a screening version. The methodology rests on Lawton’s and Nahemow’s ecological model, with accessibility defined as the relationship between the individual’s functional capacity and the demands of the physical environment. The complete instrument is based on one checklist of functional capacity in the individual (personal component) and another of environmental barriers (environmental component), followed by an analysis of person-environment fit giving an accessibility score. The Housing Enabler Screening Tool requires a less complex and less time-consuming procedure.
  •  
47.
  •  
48.
  • Iwarsson, Susanne, et al. (författare)
  • Housing Enabler
  • 2016. - 1
  • Ingår i: Agir sur l’environnement pour permettre les activités. ; , s. 463-473
  • Bokkapitel (refereegranskat)
  •  
49.
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50.
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