Psychometric properties of home accessibility assessment tools: A systematic review.

BACKGROUND.: Although home environment assessments are commonly performed by occupational therapists working in home care, use of nonstandardized measures created in-house or lack of measure use can cast a shadow over the quality of these assessments for people with disabilities. To ensure quality of home environment assessments, occupational therapists need standardized measures with demonstrated psychometric properties.

PURPOSE.: This study provides a critical appraisal of objective accessibility measures of the home environment.

METHOD.: A systematic review was undertaken for which three databases-CINAHL, PubMed, and Embase-were searched to identify accessibility measures of the home environment and evaluate their psychometric properties. Two authors independently assessed the quality of selected studies using the critical appraisal form for psychometric articles.

FINDINGS.: Ten studies discussing seven accessibility measures were identified and selected for this review. No measures showed strong evidence of both good reliability and validity. Only one study addressed the responsiveness of a measure of accessibility.

IMPLICATIONS.: As occupational therapists are specialists of the person-environment relationship, the lack of evidence of the psychometric properties of objective accessibility measures of the home environment harms evidence-based occupational therapy practice. This review identified the most promising assessment tools, but further research is needed.