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Uncovering the Obstacles-A Typology of Environmental and Contextual Factors Affecting Occupational Participation: A Scoping Review.

IMPORTANCE: Environmental and contextual factors may facilitate or limit participation in daily activities. A detailed, systematic categorization of such factors enhances evaluation and intervention and promotes occupational engagement.

OBJECTIVE: To develop an inclusive, detailed, and comprehensive typology of terms for environmental and contextual factors that affect occupational engagement and participation.

DATA SOURCES: We searched the Avery Index of Architectural Periodicals, ERIC, EMBASE, CINAHL, MEDLINE, Google Scholar, and Engineering Village databases, using the keywords environment, factors, context, participation, people, disability, disabilities, aspects, barriers, assessment, and evaluation.

STUDY SELECTION AND DATA COLLECTION: Using Arksey and O'Malley's scoping review methodology, two reviewers screened and selected publications describing specific aspects of environmental and contextual factors that facilitate or diminish human occupational engagement or participation.

FINDINGS: Forty-three articles and two book chapters published in English between 1997 and 2020 met the inclusion criteria. Terms extracted from this literature were iteratively screened and categorized. The resulting typology is organized into four areas with 12 categories and 53 specific terms. The typology's terms allow more fine-grained analysis of environmental factors described in the Occupational Therapy Practice Framework: Domain and Process (4th ed.) and the International Classification of Functioning, Disability and Health.

CONCLUSIONS AND RELEVANCE: This typology provides occupational therapy practitioners with detailed language to identify, assess, intervene with, and research environmental and contextual factors that affect participation and participation choices of individuals, groups, and populations. What This Article Adds: The typology provides a comprehensive terminology for occupational therapy professionals and students to use, assess, and intervene at the environmental and contextual levels, thereby facilitating participation for more people.

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