Assessment and analysis of housing accessibility: adapting the environmental component of the housing enabler to United States applications

Abstract

The home environment is a primary context for daily activities, especially among older adults and persons with disabilities. Functional and age-related decline can generate problems in relation to certain environmental features, necessitating modifications or other provisions of support. The determination of appropriate home interventions is best served using a person–environment (P–E) fit approach, which considers both environmental barriers and functional limitations in measuring the magnitude of accessibility problems. In the United States (U.S.), there are few valid and reliable instruments utilizing this approach. This study aimed to adapt the environmental component of the Swedish Housing Enabler (HE) for valid use in the U.S., and furthermore investigate the inter-rater agreement of the instrument. Statistical analyses of fifty pairwise home assessments show the environmental component of the U.S. HE to be sufficiently reliable (κ = 0.410, percentage of agreement = 81 %) for the region of study. A valid and reliable U.S. HE has the potential to inform appropriate housing environment interventions and therefore improve U.S. housing stock, the majority of which is currently considered inaccessible for residents with functional limitations.