Public Transport Accessibility for People With Disabilities: Protocol for a Scoping Review.

BACKGROUND: Transportation is essential for people of all ages and backgrounds to live a fulfilling and satisfying life. Public transport (PT) can facilitate access to the community and improve social participation. However, people with disabilities may encounter barriers or facilitators in the whole travel chain that can lead to negative or positive perceptions in terms of self-efficacy or satisfaction. These barriers may be perceived depending on the nature of the disability. Few studies have identified PT barriers and facilitators experienced by people with disabilities. However, findings were focused mainly on specific disabilities. Access requires broader considerations of barriers and facilitators for various types of disabilities. OBJECTIVE: This scoping review aims to describe the barriers and facilitators to the use of PT experienced by people with various disabilities in the whole travel chain and to explore perceived experiences, self-efficacy, and satisfaction when using PT. METHODS: A scoping review will be conducted using Arksey and O'Malley's framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. The literature search will be conducted using the electronic databases MEDLINE, Transport Database, and PsycINFO via Ovid platform, Embase, and Web of Science from 1995 to 2022. Two reviewers will independently identify studies based on inclusion (published in English or French, outcomes on PT accessibility for people with disabilities, peer-reviewed or guideline reports or editorials) and exclusion (no full text, focused on a technology system, outcome validation study, study on no-fixed route PT accessibility, etc) criteria and extract the data. When a study has addressed the accessibility of multiple modes of PT, including fixed-route PT, it will be retained. However, only data on fixed-route PT will be extracted. Any related systematic reviews identified through the search will be retained, and the reference lists will be hand-searched and screened for inclusion criteria. RESULTS: The search we performed on July 21, 2022, in the databases mentioned above allowed us to retrieve 6399 citations. Of these citations, 31 articles were identified, and data extraction was performed. As of March 11, 2023, we have started data analysis. The findings will be synthesized narratively to summarize the barriers and facilitators to PT, perceived experiences with PT, self-efficacy for using PT, and satisfaction with PT according to the Human Development Model-Disability Creation Process conceptual framework. CONCLUSIONS: The results of this scoping review could lead to a better understanding of the potential barriers and facilitators to the use of PT by people with various types of disabilities and how negative or positive experiences throughout the travel may influence their self-efficacy and satisfaction. The results may be used to provide recommendations to PT providers and policy makers to work together to make PT accessible, usable, and inclusive for all people with disabilities. TRIAL REGISTRATION: Open Science Framework OSF.IO/2JDQS; https://osf.io/2jdqs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/43188.

Implementation Determinants of Knowledge Mobilization within a Quebec Municipality to Improve Universal Accessibility.

According to the UN-CRPD, cities must develop action plans about universal accessibility (UA). Operationalization of these plans is complex, and little is known about what municipal employees know about UA. AIM: The aim is to document implementation determinants of UA within a municipal organization in Quebec, Canada. METHODS: An observational cross-sectional study was performed. Employees answered a survey based on the TDF and the DIBQ. Facilitators, barriers, and factors influencing the determinants were identified. RESULTS: A total of 43% of the employees completed the survey. The implementation of UA measures is more facilitated by their beliefs about the impact on citizens, while the external context hinders the proper implementation. It is also influenced by six factors: (1) professional role, (2) capacity, (3) resources, (4) willingness, (5) characteristics, and (6) feedback. DISCUSSION: Results suggest that understanding the consequences, sufficient resources, abilities, and willingness can influence implementation of UA. CONCLUSION: These findings have informed the objectives of the next action plan of the municipal organization and could guide the development of solutions.

Providing Accessible ReCreation Outdoors-User-Driven Research on Standards: Protocol for Mobile and Web-Based Interviews for Winter Assessments.

BACKGROUND: Although there have been recent efforts to improve access to Canadian national parks, many remain not fully accessible to people with disabilities. Winter conditions, in particular, present challenges that limit their participation in outdoor activities. OBJECTIVE: This study aimed to develop a novel method to assess park access during winter, which will inform recommendations for national park standards to meet the needs of all park visitors (regardless of ability) during winter conditions. METHODS: A larger participatory mixed methods research project exploring park access was adapted. A 3-phase approach has already been proposed to achieve the study objectives. In the first phase, a scoping review of the existing accessibility standards will be conducted. In the second phase, objective audits of trails and features in 6 parks, 3 in western Canada and 3 in eastern Canada, will be conducted, as well as mobile interviews with 24 various participants in each region regarding their experiences of and recommendations for improving the park's accessibility. In the final phase, a Delphi participatory consensus development process will be used, based on the data gathered in the first 2 phases, to prioritize recommendations for standards. This paper will focus on the second phase of the study, specifically on whether the in-person winter mobile interviews (ie, walking and wheeling interviews) with people who have a wide range of disabilities while visiting 3 parks in 2 provinces were modified. Changes were made to accommodate the extreme winter weather conditions in Quebec while using safe and informative data collection methods. RESULTS: In Quebec, one park, where winter conditions are safer, has been assessed in person (n=4). Web-based interviews were used to facilitate the assessment of other winter and summer conditions in two other parks (n=8). Winter and web-based interviews were completed in April 2022. Data are currently being collected and analyzed, and results will be completed by December 2022. CONCLUSIONS: We expect that adapting the protocol to gather further information on winter conditions and access to parks will provide high-quality and rich data to better inform park access standards. This participatory mixed methods research will inform the development of park standards that consider the accessibility needs of all people. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38715.

Providing Accessible Recreation Outdoors-User-Driven Research on Standards (PARCOURS): Protocol for a Multiphase Study.

BACKGROUND: Canada's national parks are world-renowned. However, despite recent attempts to improve access, many are not accessible to people with disabilities. With the advent of provincial and federal legislation, standards are being developed to assist with the design and management of parks. OBJECTIVE: The overarching objective of this study is to inform accessibility standards for federal parks that meet the needs of all park visitors, regardless of ability. The specific objectives of this study are to identify park accessibility standards that exist internationally, identify the accessibility challenges that people with disabilities face in park environments, and prioritize and recommend accessibility standards for national parks. METHODS: A 3-phase approach will be used to achieve the study objectives. In the first phase, a scoping review of the existing accessibility standards will be conducted. The second phase will include objective audits of trails and features in 6 parks, 3 in western Canada and 3 in eastern Canada, as well as mobile interviews with 24 diverse participants in each region regarding their experiences of and recommendations for improving the park's accessibility. In the final phase, a Delphi participatory consensus development process will be used, based on the data gathered in the first 2 phases, to prioritize recommendations for standards. RESULTS: We expect to find gaps in existing standards that do not account for the diverse range of accessibility requirements that people with disabilities have for visiting parks. We also expect to find that existing standards, on their own, may not be enough to ensure equitable access to all the experiences and amenities that parks have to offer. Development of subsequent guidelines and best practices may be necessary to address complex scenarios for which standards may not be the best approach to ensuring accessibility. CONCLUSIONS: The participatory and mixed methods approaches used in this study will provide rich insights for developing accessible park standards that consider the diverse needs of people with disabilities. The findings will also support the development or enhancement of park standards at all levels of government. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33611.

Scoping review of propelling aids for manual wheelchairs.

Manual wheelchair (MWC) users face a variety of obstacles limiting their participation. Different MWC models and new add-on components intended to improve propulsion may impact users' function and participation, although there is a lack of research on this topic. The aims of this study were to: 1) identify MWC propelling aids (PA) that are reported in the literature; 2) classify the outcomes used to evaluate the influence of PA according to the International Classification of Functioning, Disability and Health (ICF); and 3) summarize evidence for the influence of PA. A scoping review was conducted in 2017 using Pubmed, Medline, Embase, CINAHL, Compendex, IEEE Xplore, RESNA and ISS proceedings, Google, and Google Scholar. The content of each manuscript was assessed by two independent reviewers. A total of 28 PA (19 human-powered; 9 power-assisted) were identified from 163 manuscripts. The three most cited ICF subdomains were "Activity & Participation" (n = 125), "Body Function" (n = 100), and "Personal Factors" (n = 55). The findings suggest an overall positive influence of PA on various ICF domains/subdomains, but initial findings should be interpreted with caution. Confirmation of the effect and safety of PA requires higher levels of evidence.

The Elaboration of an Intersectoral Partnership to Perform Health Impact Assessment in Urban Planning: The Experience of Quebec City (Canada).

Health impact assessments (HIA) allow evaluation of urban interventions' potential effects on health and facilitate decision-making in the urban planning process. However, few municipalities have implemented this method in Canada. This paper presents the approach developed with partners, the process, and the outcomes of HIA implementation after seven years of interinstitutional collaborations in Quebec City (ten HIA). Using direct observation and meeting minutes, information includes: perceived role of each institution taking part in HIA beforehand, how the HIA process was implemented, if it was appreciated, and which outcomes were observed. The intersectoral interactions contributed to the development of a common language, which sped up the HIA process over time and fostered positive collaborations in unrelated projects. It was an effective tool to share concerns and responsibilities among independent institutions. This experience resulted in the creation of an informal group of stakeholders from four different institutions that perform HIA to this day in collaboration with researchers.

Mapping review of accessible pedestrian infrastructures for individuals with physical disabilities.

BACKGROUND: Due to the ageing population and higher prevalence of individuals living with physical disabilities, there is a critical need for inclusive practices when designing accessible pedestrian infrastructures for ensuring social participation and equal opportunities. PURPOSE: Summarize the physical characteristics of current pedestrian infrastructure design for individuals with physical disabilities (IPD - motor, visual and hearing) found in the scientific literature and assess its quality. MATERIALS AND METHODS: A mapping review of the existing literature on pedestrian infrastructures specifically built for individuals with physical disabilities identifying measurable physical characteristics for their design was done using online databases (Urban Studies Abstracts, Geobase, PubMed, and Cairn and secondary research). Information about accessibility (physical characteristics) of existing pedestrian infrastructures was extracted. The quality of the evidence was assessed using the Guidelines for critical review form - Quantitative studies and Qualitative studies version 2.0 (SAGE Publications, Inc., Thousand Oaks, CA). RESULTS: Of the 1131 articles identified, forty-one articles examined access to bus stops, curb ramps, lighting, pedestrian crossings, ramps, shared spaces, sidewalks and steps. Six articles reported on more than one physical disability. Quality scores were generally low (quantitative: 2-11/15 and qualitative: 1-22/23). Recommended design features differed for the same infrastructure. CONCLUSIONS: While there were a fair number of articles (n = 41) documenting accessible design features of pedestrian infrastructures, the quality of the evidence was low. The review identified knowledge gaps. Although specific design solutions exist, they have not yet been tested among individuals with various or multiple types of physical disabilities to ensure access to pedestrian infrastructures by all. Implications for Rehabilitation Pedestrian infrastructures still pose problems to mobility, limiting social participation and quality of life outcomes for individuals with physical disabilities (motor, visual and hearing). The results of this mapping review show that few articles are concerned with the accessibility of pedestrian infrastructures for more than one type physical disability, which might lead to recommendations that are inadequate for individuals with differing disabilities, few recommendations have been compared, most studies have been performed in environments not representative of northern countries and their quality score was generally low. Health professionals and State Parties have a complementary expertise that should be put to use in the determination and implementation of best design solutions to ensure the respect of the needs of individuals with physical disabilities. This review can thus help them have an idea of what has already been done to identify what needs to be achieved to fill the gap of knowledge required to insure access for individuals with motor, visual as well as hearing disabilities. Rehabilitation profesionals should take part in the assessment of the proposed solutions as well as the development of new designs to fill knowledge gaps.

Integration of the social environment in a mobility ontology for people with motor disabilities.

BACKGROUND: Our contemporary understanding of disability is rooted in the idea that disability is the product of human-environment interaction processes. People may be functionally limited, but this becomes a disability only when they engage with their immediate social and physical environments. Any attempt to address issues of mobility in relation to people with disabilities should be grounded in an ontology that encompasses this understanding. PURPOSE: The objective of this study is to provide a methodology to integrate the social and physical environments in the development of a mobility ontology for people with motor disabilities (PWMD). METHODS: We propose to create subclasses of concepts based on a Nature-Development distinction rather than creating separate social and physical subclasses. This allows the relationships between social and physical elements to be modelled in a more compact and efficient way by specifying them locally within each entity, and better accommodates the complexities of the human-environment interaction as well. Based on this approach, an ontology for mobility of PWMD considering four main elements - the social and physical environmental factors, human factors, life habits related to mobility and possible goals of mobility - is presented. CONCLUSIONS: We demonstrate that employing the Nature-Development perspective facilitates the process of developing useful ontologies, especially for defining the relationships between the social and physical parts of the environment. This is a fundamental issue for modelling the interaction between humans and their social and physical environments for a broad range of applications, including the development of geospatial assistive technologies for navigation of PWMD. Implications for rehabilitation The proposed perspective may actually have much broader interests beyond the issue of disability - much of the interesting dynamics in city development arises from the interaction between human-developed components - the built environment and its associated entities - and natural or organic components. The proposed approach facilitates the process of developing useful ontologies, especially for defining the relationships between the social and physical parts of the environment. This is a fundamental issue for modeling the interaction between human -specially people with disabilities -and his social and physical environments in a broad range of domains and applications, such as Geographic Information Systems and the development of geospatial assistive technologies for navigation of people with disabilities, respectively.