Abstract
The Pathways and Resources for Engagement and Participation (PREP), an environmental-based intervention, is effective in improving the participation of youth with disabilities in specific targeted activities; however, its potential impact on overall participation beyond these activities is unknown. This study examined the differences in participation levels and environmental barriers and supports following the 12-week PREP intervention. Existing data on participation patterns and environmental barriers and supports, measured by the Participation and Environment Measure for Children and Youth, pre-and post-PREP intervention, were statistically analyzed across 20 youth aged 12 to 18 (mean = 14.4, standard deviation (SD) = 1.82) with physical disabilities in three settings: home, school and community. Effect sizes were calculated using Cohen's d. Following PREP, youth participated significantly less often at home (d = 2.21; 95% Confidence Interval (CI) [1.79, 2.96]), more often (d = 0.57; 95% CI [-0.79, -0.14]) and in more diverse activities (d = 0.51; 95% CI [-1.99, -0.51]) in the community. At school, significantly greater participation was observed in special school roles (t = -2.46. p = 0.024). Involvement and desire for change remained relatively stable across all settings. A substantial increase in community environmental supports was observed (d = 0.67), with significantly more parents reporting availability of, and access to information as a support (χ(2) = 4.28, p = 0.038). Findings lend further support to the effectiveness of environmental-based interventions, involving real-life experiences.