Social Participation and Perceived Quality of Environment of Adults with Disabilities

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Introduction - "disabilities still experiment participation restrictions in their daily life [7], with people with more severe disabilities experiment more participation restrictions"; the word should be 'experience'.

Materials and Methods

Why is Quebec City the IRB or ethics committee for France?

It is curious that your survey of people with disabilities participating in their community focused on those living in rehabilitation centers and long-term care facilities.  These two populations would be the least likely to be participating in their community by default.  I'm questioning your results based on how many of your respondents belonged to these two populations.  Community organizations would seem to be a much better way to seek participants.

Otherwise, your study is really about the social participation of individuals living in congregate care facilities.  And you need to recontextualize what your findings are.

The results suggest that only 24% live in congregate care facilities.  So do most of your respondents not come from rehabilitation and long-term care facilities?

2.5 Data Collection - if sociodemographic and personal characteristics were collected, please provide some statistical description/representation of your respondents, so the reader may assess the representativeness of the sample.

It appears that this data came later in the paper.  Move your participant statistics to the participants description section so the reader can see who participated before getting to the results.

It would be meaningful to see what the general population's LIFE-H scores are to see how individuals with disabilities' scores differed.  If the lower score is 'typical' for the general population then it isn't significant that it is lower.  You are comparing scores among disability groups, but a 'no disability' group would be most useful.

Why 24 for the LIFE-H but only 21 for the MQE?  If a participant is able to respond to the LIFE-H why can they not respond to the MQE due to comprehension of items issues?  This is unclear to me.

Page 8 the word 'primordial' should be a different word, I'm not sure which one but it should not be primordial.

Page 9 you introduce the MHAVIE assessment tool.  What is this tool?  Did you use it?  Why are you bringing it up here?

Page 10 - "the present study has proposed an inclusive methodology for individuals with disabilities..."  What methodology did you propose?  The use of the LIFE-H and MQE?  Please clarify.

Comments on the Quality of English Language

Well written.  I have noted the two inappropriately used words I saw.  

Author Response

Dear reviewers,

Thank you for your review.

Comments and suggestions helped to improve quality of our manuscript.

You will find our responses and actions in the table attached. Modifications in the manuscript are highlighted in grey.

Kindest regards,

Marie-Eve Lamontagne

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Abstract:

The text introduces a research study, which focuses on the relationship between social participation and perceived environmental quality among adults with disabilities in Brittany, France. The study is part of the 'Handicap Innovation Territoire' (HIT) project, aimed at enhancing the social participation of individuals with disabilities. Overall, the abstract provides a concise summary of the study's objectives, methods, and key findings.

Strengths:

Clear Objective: The abstract clearly states the research's aim to enhance social participation and assess environmental quality for individuals with disabilities.

Methodology: The methods used for the study, including the Assessment of Life Habits (LIFE-H) and Measure of the Quality of the Environment (MQE), are mentioned, providing a sense of the study's rigor.

Key Findings: The abstract outlines some of the key findings, indicating that there was a high level of social participation, but specific areas (work, education, and leisure) showed participation restrictions. It also highlights variations in environmental perception across disability groups.

Conclusion: The abstract concludes by mentioning the study's inclusive methodology and the actions taken within the HIT project to address challenges related to social participation.

Suggestions for Improvement:

Statistics: Adding some statistical data, such as percentages or actual scores, would enhance the abstract's credibility and provide a clearer understanding of the study's findings.

Keywords: The abstract could benefit from a few more specific keywords, such as "disability types" or "social integration," to aid discoverability and highlight the study's unique aspects.

Introduction:

The introduction of this scientific article effectively sets the stage for the research and provides relevant background information. It begins by addressing the World Health Organization's recognition of social participation as a fundamental right and introduces the Human Development Model-Disability Creation Process (HDM-DCP) as a conceptual framework for understanding social participation. The introduction also highlights the significance of social participation for quality of life and well-being and acknowledges the challenges faced by people with disabilities in this regard.

Strengths:

Clarity and Structure: The introduction is well-structured, presenting the background, relevant models, and the problem being addressed in a clear and logical sequence.

Citation of Previous Research: The inclusion of citations and references to previous research (e.g., [1], [2], [3]) strengthens the foundation for the study and demonstrates a well-informed approach.

Justification for the Study: The introduction provides a compelling justification for the research, especially in the context of the 'Handicap Innovation Territoire' (HIT) project, highlighting the need for understanding the social participation context of people with disabilities in Brittany.

Clearly Stated Objectives: The objectives of the study are explicitly mentioned, which helps the reader understand the research's purpose and focus.

Suggestions for Improvement:

Scope of the Problem: While the introduction effectively highlights the issues surrounding social participation for people with disabilities, it could briefly delve into the broader global context of disability-related challenges and their impact to provide a more comprehensive understanding.

Engage the Reader: Adding a more engaging opening statement or anecdote related to social participation and disability could capture the reader's attention and make the introduction more engaging.

Research Gap Identification: The introduction could more explicitly state how this research bridges the existing knowledge gap. In particular, it should highlight how the proposed study contributes to addressing the lack of information mentioned regarding the social participation of people with disabilities in Brittany.

Materials and Methods:

The "Materials and Methods" section of the scientific article provides a detailed account of the research approach, data collection, and analysis. Here's a critical evaluation:

Strengths:

Clear Research Context: The section begins by establishing the context of the HIT project, its significance, and its role in improving the social participation of people with disabilities. This context is essential for readers to understand the study's background.

Ethical Consideration: The section mentions that ethical approval was obtained from relevant review boards and committees, demonstrating that the research was conducted with ethical principles in mind.

Detailed Participant Selection Criteria: The criteria for participant inclusion and exclusion are clearly defined, which ensures transparency and consistency in participant selection.

Data Collection Method: The section provides a thorough explanation of the data collection process, including the use of standardized questionnaires, the assistance of a research assistant, and the estimated interview duration.

Tools Used: The choice of assessment tools, namely the Assessment of Life Habits (LIFE-H) and the Measure of the Quality of the Environment (MQE), is well-justified. The section also highlights the training received by the authors in using these tools.

Data Analysis: The section outlines the data analysis plan, including the use of descriptive statistics, non-parametric tests, and post-hoc tests, and the significance threshold for results.

Suggestions for Improvement:

Participant Recruitment: While the section mentions the use of convenience sampling, it would be beneficial to briefly discuss the potential limitations of this approach, such as selection bias, to ensure transparency.

Explanation of Domains in MQE: A brief explanation of the six domains within the Measure of the Quality of the Environment (MQE) could aid in understanding the instrument's components.

Training of Authors: While the section mentions author training, adding a sentence about the duration or nature of the training could provide insight into the authors' competence in using the assessment tools.

Results:

The "Results" section of this scientific article provides a comprehensive overview of the study's findings related to social participation, satisfaction, and perceived environmental quality. Here is a critical evaluation:

Strengths:

Clear Presentation of Participant Demographics: The section begins by providing essential demographic information about the participants, including age, gender, marital status, employment status, living arrangements, and disability types. This provides a clear picture of the study sample.

Descriptive Statistics: The use of descriptive statistics, such as means, standard deviations, and percentages, helps readers understand the data and the characteristics of the study sample.

Detailed Presentation of Results: The section offers a detailed breakdown of results, particularly in the assessment of social participation using the LIFE-H questionnaire. It includes mean scores for different life habits and satisfaction levels.

Graphical Representation: The inclusion of figures and tables (e.g., Figure 1 and Figure 2) aids in visualizing the differences in social participation and perceived environmental quality among different age and disability groups.

Statistical Analysis: The section employs appropriate statistical tests to evaluate differences in social participation and perceived environment, enhancing the reliability of the results.

Suggestions for Improvement:

More Information on Unanswered Questions: The section mentions that some participants were unable to answer due to comprehension issues. Further information on these issues and how they were addressed, or any potential impact on the study, would be informative.

Discussion:

The "Discussion" section of this scientific article elaborates on the findings presented in the "Results" section and provides an insightful interpretation of these results. Here is a critical evaluation:

Strengths:

Contextualization of the Study: The discussion appropriately begins by emphasizing the significance of the study in exploring social participation among individuals with disabilities in Brittany. It highlights the uniqueness of the study's inclusive approach.

Integration of Findings: The discussion effectively integrates the study's results into a broader context, referencing prior research and existing knowledge on disability-related social participation. This contextualization helps readers understand how the current study contributes to the field.

In-Depth Analysis of Factors: The discussion provides a comprehensive analysis of both facilitators and barriers to social participation, shedding light on environmental factors that impact the lives of individuals with disabilities. It addresses the practical implications of these factors.

Differentiation by Disability Type: The discussion effectively highlights that social participation varies significantly depending on the type of disability. This distinction adds depth to the analysis and reinforces the idea that disability situations encompass more than just physical aspects.

Consideration of Age: The discussion also considers the role of age in social participation, emphasizing the challenges faced by older participants. This discussion aligns with the current understanding of the relationship between aging and disability.

Suggestions for Improvement:

Subgroup Differentiation: While discussing the differences in social participation by disability type, it would be beneficial to provide specific examples or anecdotes from the study that illustrate these disparities. This can make the findings more relatable and engaging.

Clarification of Missing Data: The section mentions that some individuals were unable to answer the questionnaires due to comprehension issues. Providing additional details about the nature of these issues and their potential impact on the study's findings would enhance transparency.

Discussion on Generalizability: The limitations section is briefly mentioned, acknowledging the small sample size, but it would be helpful to discuss the implications of this limitation more explicitly. How does the sample size affect the generalizability of the findings, and what are the potential biases introduced by this limitation?

Further Research Directions: The discussion mentions ongoing qualitative research related to the life experiences of people with disabilities in Brittany. It would be helpful to briefly outline the objectives and potential contributions of this ongoing work.

Conclusions:

The "Conclusions" section of this scientific article provides a summary of the study's main findings and outlines the actions taken or planned to address the issues identified. Here is a critical evaluation:

Strengths:

Clear Summary: The conclusions offer a concise summary of the study's key findings and implications, making it easy for readers to grasp the main takeaways.

Action-Oriented: The section highlights the practical steps and initiatives taken in response to the study's findings, demonstrating a commitment to translating research into action.

Alignment with Objectives: The conclusion aligns the study's objectives with the actions proposed, emphasizing that addressing the identified environmental factors can improve social participation, which is consistent with the goals of the HIT project.

Future Evaluation: The intention to conduct an evaluation of the implemented measures in three years is a positive aspect. This reflects a commitment to ongoing assessment and adaptation.

Suggestions for Improvement:

Specific Actions: While the conclusion mentions "targeted interventions to enhance leisure activities" and a "comprehensive mapping initiative," it would be beneficial to provide more specific details about these actions. What, specifically, will these interventions entail? How will the mapping initiative be conducted?

Measurement of Success: It would be helpful to define what constitutes "optimal outcomes" in the context of the evaluation of implemented measures. Clearly stating the criteria for success will enable better assessment.

Wider Implications: The conclusion could expand on the broader implications of the study's findings. How might the approach and actions taken in Brittany be relevant to other regions or countries facing similar challenges in promoting social participation for individuals with disabilities?

Clarity on Study's Unique Contribution: While the conclusion references the study's inclusive methodology, it could explicitly state why this is a unique and valuable contribution. What sets this study apart from previous research in the field?

Author Response

Dear reviewers,

Thank you for your review.

Comments and suggestions helped to improve quality of our manuscript.

You will find our responses and actions in the table attached. Modifications in the manuscript are highlighted in grey.

Kindest regards,

Marie-Eve Lamontagne

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for addressing the comments I previously offered.  I do appreciate the clarification that this research is limited to Brittany, although the (2.1.Context) indicates that it is intended for nationwide and international deployment and dissemination.  And your concluding paragraph suggests that what was learned here should generalize to other regions and countries.  Perhaps the abstract should be slightly modified to indicate that this research is only applicable to Brittany.

2.3.Participants and recruitment - please revise to read...

"Convenience sampling was used to recruit participant mainly through community organizations and associations.  However, recruiting also took place through rehabilitation centre and long-term care facilities."

Your response is applicable to selection bias introduced by convenience sampling.  But some acknowledgement of sampling bias should be made.  Particularly as I am somewhat concerned with your response to 2.5.Data Collection.  You indicate the you used an intentional sampling strategy, but it was a convenience sample, and that providing sociodemographic data is not available for your sample.  It is therefore very unclear that the sample is representative of people with disabilities living in Brittany.  I'm not looking to extend the findings beyond Brittany.  But any information on the probability of the sample representing your target population would be helpful.

Author Response

Dear reviewer,

Thank you for your review.

The feedback provided contributed to clarify recruitment procedures and intentions of the authors.

You will find our responses and actions in the table below. Modifications in the manuscript are highlighted in yellow.

Kindest regards,

Marie-Eve Lamontagne

Author Response File: Author Response.pdf