Understanding barriers and facilitators to accessibility in the built and natural environment for people with lower limb loss: A qualitative study

Objectives: To explore the facilitators and barriers to community accessibility from the perspective of persons with lower limb amputation (LLA). Methods: A qualitative study using an adapted version of the Photovoice methods described by Wang and Burris was undertaken. Analysis of the interviews and photos was conducted following thematic content analysis. Results: Seven adults with LLA who were ambulating with a prosthesis at the time of the interview participated in the Photovoice interviews. From the interviews with the participants, 3 main themes were developed: (1) current state of accessibility, (2) impact of community inaccessibility, and (3) hope for the future. Participants described what accessibility currently involved in their community (eg, the positive and negative structures) as well as the impact of inaccessibility on their physical and emotional health. Participants also spoke about what improvements they would like to see in the future regarding community accessibility. Conclusions: By using the Photovoice methods, participants were able to provide tangible examples of what influences their community accessibility. This study highlights the broad range of changes that could provide accessibility opportunities for individuals with LLA from simple changes (eg, adding handrails to arenas) to more complex changes (eg, improvements in parking lot accessibility).