• Gale Whiteneck, Michelle A Meade, Marcel Dijkers, Denise G Tate, Tamara Bushnik, and Martin B Forchheimer.
• Craig Hospital, Englewood, CO 80113, USA. gale@craig-hospital.org
• Arch Phys Med Rehabil. 2004 Nov 1; 85 (11): 1793-803.

ObjectivesTo investigate environmental barriers reported by people with spinal cord injury (SCI), and to determine the relative impact of environmental barriers compared with demographic and injury characteristics and activity limitations in predicting variation in participation and life satisfaction.DesignCross-sectional, follow-up survey.SettingIndividuals rehabilitated at 16 federally designated Model Spinal Cord Injury Systems of care, now living in the community.ParticipantsPeople with SCI (N=2726) who completed routine follow-up research interviews between 2000 and 2002.InterventionsNot applicable.Main Outcome MeasuresThe Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), the Craig Handicap Assessment and Reporting Technique-Short Form, and the Satisfaction With Life Scale.ResultsThe top 5 environmental barriers reported by subjects with SCI, in descending order of importance, were the natural environment, transportation, need for help in the home, availability of health care, and governmental policies. The CHIEF-SF subscales accounted for only 4% or less of the variation in participation; they accounted for 10% of the variation in life satisfaction.ConclusionsThe inclusion of environmental factors in models of disability was supported, but were found to be more strongly related to life satisfaction than to societal participation.

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