Development of the Home Environmental Scale of Accessibility Instrument for Spain

Area of Science:

• Occupational therapy
• Rehabilitation science
• Assistive technology

Background:

• Universal accessibility is a key focus for individuals with disabilities and older adults.
• Home access and usability are increasingly important areas of interest.
• Existing tools may not adequately address the complexities of home environments.

Purpose of the Study:

• To develop and validate a novel home assessment tool, the HESA II.
• To create a reliable instrument for evaluating home accessibility.
• To provide a functional assessment of home environments.

Main Methods:

• A four-phase study involving expert consensus, item development based on the AOTA framework, a pilot test (n=20), and a final validation study (n=156).
• Confirmatory factor analysis was utilized in the final study phase.
• The tool was developed with 90 items initially, refined to 85.

Main Results:

• The final HESA II tool comprises 85 items.
• Items are organized into five subscales corresponding to major home areas: living room, kitchen, bedroom, and bathroom.
• The tool demonstrated strong psychometric properties, particularly in reliability.

Conclusions:

• The HESA II is a reliable tool for assessing home accessibility.
• It evaluates accessibility based on functional limitations (activity and participation) aligned with the ICF framework, not medical diagnosis.
• This functional approach ensures broad applicability across diverse user groups.