{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T14:00:53Z","timestamp":1793023253375,"version":"4.5.0"},"reference-count":62,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Background: Universal accessibility is one of the most active lines of intervention for people with disabilities and older adults. This accessibility has become a topic of growing interest regarding home access and use. Therefore, the main objective of this study was to create and validate a home assessment tool: the HESA II. Methods: The study was conducted in four phases: (1) agreement on variables by an expert panel; (2) development of 90 items according to the AOTA framework; (3) pilot test with n = 20; and (4) final study with 156 subjects where confirmatory factor analysis was performed. Results: The tool consisted of 85 items divided into five subscales related to each of the main spaces of Spanish homes: living room; kitchen; bedroom; and bathroom. Conclusions: The tool demonstrates good psychometric properties of reliability. The HESA II assesses home accessibility based on limitations in activity and participation restriction of the evaluated person as per the International Classification of Functioning, Disability, and Health rather than on a diagnosis, making it applicable to a wide range of groups.<\/jats:p>","DOI":"10.3390\/clinpract14030089","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T08:45:50Z","timestamp":1718181950000},"page":"1123-1136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Development of the Home Environmental Scale of Accessibility Instrument for Spain"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5322-580X","authenticated-orcid":false,"given":"Est\u00edbaliz","family":"Jim\u00e9nez-Arberas","sequence":"first","affiliation":[{"name":"Faculty Padre Oss\u00f3, Occupational Therapy Degree, 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma Ru\u00edz","family":"Varela","sequence":"additional","affiliation":[{"name":"Faculty Educational Sciences, University Alfonso X el Sabio, 28691 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feliciano Francisco","family":"Ordo\u00f1ez Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Faculty Padre Oss\u00f3, Occupational Therapy Degree, 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel Fern\u00e1ndez","family":"M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Faculty Padre Oss\u00f3, Occupational Therapy Degree, 33001 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"ref_1","unstructured":"(2024, May 10). BOE-A-2023-7417 Real Decreto 193\/2023, de 21 de Marzo, por el que se Regulan las Condiciones B\u00e1sicas de Accesibilidad y no Discriminaci\u00f3n de las Personas con Discapacidad Para el Acceso y Utilizaci\u00f3n de los Bienes y Servicios a Disposici\u00f3n del P\u00fablico. Available online: https:\/\/www.boe.es\/buscar\/act.php?id=BOE-A-2023-7417."},{"key":"ref_2","unstructured":"(2024, May 20). BOE-A-2003-22066 Ley 51\/2003, de 2 de Diciembre, de Igualdad de Oportunidades, no Discriminaci\u00f3n y Accesibilidad Universal de las Personas con Discapacidad. Available online: https:\/\/www.boe.es\/eli\/es\/l\/2003\/12\/02\/51\/con."},{"key":"ref_3","unstructured":"JASP Team (2023). JASP Computer Software Buscar con Google, JASP Team. Available online: https:\/\/jasp-stats.org\/previous-versions\/."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Cho, H.Y., MacLachlan, M., Clarke, M., and Mannan, H. (2016). Accessible Home Environments for People with Functional Limitations: A Systematic Review. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13080826"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/09638280110066325","article-title":"Evaluating Home Environments of Persons with Dementia: Interrater Reliability and Validity of the Home Environmental Assessment Protocol (HEAP)","volume":"24","author":"Gitlin","year":"2002","journal-title":"Disabil. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1080\/09638280600976145","article-title":"Population-Based Study of Home Accessibility Features and the Activities of Daily Living: Clinical and Policy Implications","volume":"29","author":"Stineman","year":"2007","journal-title":"Disabil. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1136\/bmj.38601.447731.55","article-title":"Randomised Controlled Trial of Prevention of Falls in People Aged\u2265 75 with Severe Visual Impairment: The VIP Trial","volume":"331","author":"Campbell","year":"2005","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"296","DOI":"10.5014\/ajot.59.3.296","article-title":"Changes in ADL Dependence and Aspects of Usability Following Housing Adaptation\u2014A Longitudinal Perspective","volume":"59","author":"Iwarsson","year":"2005","journal-title":"Am. J. Occup. Ther."},{"key":"ref_9","unstructured":"Division for Inclusive Social Development (DISD) (2024, May 10). Convention on the Rights of Persons with Disabilities (CRPD). Available online: https:\/\/social.desa.un.org\/issues\/disability\/crpd\/convention-on-the-rights-of-persons-with-disabilities-crpd."},{"key":"ref_10","unstructured":"World Health Organization (2001). World Health Organization International Classification of Functioning, Disability and Health."},{"key":"ref_11","unstructured":"American Occupational Therapy Association (2020). Occupational Therapy Practice Framework: Domain et Process, American Occupational Therapy Association."},{"key":"ref_12","unstructured":"(2024, May 10). BOE.es\u2014DOUE-L-2019-80999 Directiva (UE) 2019\/882 del Parlamento Europeo y del Consejo, de 17 de Abril de 2019, Sobre los Requisitos de Accesibilidad de los Productos y Servicios. Available online: https:\/\/www.boe.es\/buscar\/doc.php?id=DOUE-L-2019-80999."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1177\/030802269906201104","article-title":"The Housing Enabler: An Objective Tool for Assessing Accessibility","volume":"62","author":"Iwarsson","year":"1999","journal-title":"Br. J. Occup. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1080\/16501970410014830","article-title":"Development of the Home and Community Environment (HACE) Instrument","volume":"37","author":"Keysor","year":"2005","journal-title":"J. Rehabil. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"289","DOI":"10.3109\/07380577.2013.843114","article-title":"Home Assessment of Person-Environment Interaction (HoPE): Content Validation Process","volume":"27","author":"Rousseau","year":"2013","journal-title":"Occup. Ther. Health Care"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1080\/J148v20n02_03","article-title":"Development of a Comprehensive Assessment for Delivery of Home Modifications","volume":"20","author":"Sanford","year":"2002","journal-title":"Phys. Occup. Ther. Geriatr."},{"key":"ref_17","unstructured":"(2024, May 10). Secci\u00f3n Prensa\/Encuesta de Poblaci\u00f3n Activa (EPA). Available online: https:\/\/www.ine.es\/prensa\/epa_prensa.htm."},{"key":"ref_18","unstructured":"(2024, May 10). Machine Translation of \u201cLaw 13\/1982 of 7 April, Social Integration of the Disabled.\u201d (Spain). Available online: https:\/\/www.global-regulation.com\/translation\/spain\/1485959\/law-13-1982-of-7-april%252c-social-integration-of-the-disabled.html."},{"key":"ref_19","unstructured":"(2024, February 24). Ley 8\/2013, de 26 de Junio, de Rehabilitaci\u00f3n, Regeneraci\u00f3n y Renovaci\u00f3n Urbanas. Available online: https:\/\/www.boe.es\/eli\/es\/l\/2013\/06\/26\/8\/con;."},{"key":"ref_20","first-page":"71","article-title":"An\u00e1lisis Factorial Exploratorio: Cuestiones Conceptuales y Metodol\u00f3gicas","volume":"19","author":"Mavrou","year":"2015","journal-title":"Rev. Nebrija De Linguistica. Apl."},{"key":"ref_21","unstructured":"(2024, May 10). An Empirical Test of the Utility of the Observations-To-Variables Ratio in Factor and Components Analysis\u2014Willem A. Arrindell, Jan van der Ende. Available online: https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/014662168500900205."},{"key":"ref_22","first-page":"7","article-title":"Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most from Your Analysis","volume":"10","author":"Costello","year":"2005","journal-title":"Pract. Assess. Res. Eval."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S2007-5057(13)72715-7","article-title":"C\u00e1lculo del tama\u00f1o de la muestra en investigaci\u00f3n en educaci\u00f3n m\u00e9dica","volume":"2","year":"2013","journal-title":"Investig. Educ. M\u00e9dica"},{"key":"ref_24","first-page":"55","article-title":"A Technique for the Measurement of Attitudes","volume":"22","author":"Likert","year":"1932","journal-title":"Arch. Psychol."},{"key":"ref_25","unstructured":"Aiken, L.R. (2003). Test Psicol\u00f3gicos y Evaluaci\u00f3n, Prentice Hall. Available online: https:\/\/filadd.com\/doc\/tests-psicologicos-y-evaluacion-pdf-el-ser-humano."},{"key":"ref_26","first-page":"29","article-title":"An\u00e1lisis de Concordancia de Atributos","volume":"21","year":"2008","journal-title":"Rev. Tecnol. Marcha"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1080\/03610910903548952","article-title":"Analysis of Type I Error Rates of Univariate and Multivariate Procedures in Repeated Measures Designs","volume":"39","author":"Vallejo","year":"2010","journal-title":"Commun. Stat. Simul. Comput."},{"key":"ref_28","first-page":"7","article-title":"Diez pasos para la construcci\u00f3n de un test","volume":"31","year":"2019","journal-title":"Psicothema"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"296","DOI":"10.5964\/meth.7185","article-title":"MSA: The Forgotten Index for Identifying Inappropriate Items Before Computing Exploratory Item Factor Analysis","volume":"17","author":"Ferrando","year":"2021","journal-title":"Methodology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1177\/0146621613487794","article-title":"Factor 9.2: A Comprehensive Program for Fitting Exploratory and Semiconfirmatory Factor Analysis and IRT Models","volume":"37","author":"Ferrando","year":"2013","journal-title":"Appl. Psychol. Meas."},{"key":"ref_31","first-page":"151","article-title":"Correlaciones polic\u00f3ricas y tetrac\u00f3ricas en estudios factoriales exploratorios y confirmatorios","volume":"7","author":"Stover","year":"2013","journal-title":"Cienc. Psicol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"936","DOI":"10.3758\/s13428-015-0619-7","article-title":"Confirmatory Factor Analysis with Ordinal Data: Comparing Robust Maximum Likelihood and Diagonally Weighted Least Squares","volume":"48","author":"Li","year":"2016","journal-title":"Behav. Res. Methods"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"417","DOI":"10.6018\/analesps.33.2.270211","article-title":"El An\u00e1lisis Factorial Exploratorio de los \u00cdtems: An\u00e1lisis Guiado Seg\u00fan los Datos Emp\u00edricos y el Software","volume":"33","author":"Lloret","year":"2017","journal-title":"An. Psicol. Ann. Psychol."},{"key":"ref_34","first-page":"55","article-title":"An\u00e1lisis de los Factores de Resiliencia Econ\u00f3mica en Baja California sur, Ante Crisis y Desastres Naturales","volume":"33","year":"2022","journal-title":"Rev. Econ. Y Pol\u00edtica"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Bollen, K.A. (1989). Structural Equations with Latent Variables, John Wiley & Sons.","DOI":"10.1002\/9781118619179"},{"key":"ref_36","unstructured":"Byrne, B.M. (1998). Structural Equation Modeling with LISREL, PRELIS, and SIMPLIS, Psychology Press."},{"key":"ref_37","unstructured":"Garc\u00eda, M.I.B., Enrique, V., and Tello, F.P.H. (2011). Introducci\u00f3n B\u00e1sica al An\u00e1lisis Factorial, Editorial UNED."},{"key":"ref_38","unstructured":"Cea, M.A. (2004). An\u00e1lisis Multivariante. Teor\u0131a y Practica en la Investigacion Social, Editorial S\u0131ntesis."},{"key":"ref_39","unstructured":"(2024, May 10). Alternative Ways of Assessing Model Fit\u2014Michael W. Browne, Robert Cudeck. Available online: https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/0049124192021002005."},{"key":"ref_40","unstructured":"Steiger, J.H. (1980, January 30). Statistically Based Tests for the Number of Common Factors. Proceedings of the Annual Meeting of the Psychometric Society, Iowa City, IA, USA."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1207\/s15327906mbr2502_4","article-title":"Structural Model Evaluation and Modification: An Interval Estimation Approach","volume":"25","author":"Steiger","year":"1990","journal-title":"Multivar. Behav. Res."},{"key":"ref_42","unstructured":"Joreskog, K., and Sorbom, D. (1983). LISREL VI: Analysis of Linear Structured Relations by the Method of Maximum Likelihood, Scientific Software."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1037\/0033-2909.88.3.588","article-title":"Significance Tests and Goodness of Fit in the Analysis of Covariance Structures","volume":"88","author":"Bentler","year":"1980","journal-title":"Psychol. Bull."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1037\/0033-2909.107.2.238","article-title":"Comparative Fit Indexes in Structural Models","volume":"107","author":"Bentler","year":"1990","journal-title":"Psychol. Bull."},{"key":"ref_45","unstructured":"(2007). Accesibilidad Universal. Parte 1: Criterios (Standard No. UNE 170001-1:2007). Available online: https:\/\/www.une.org\/encuentra-tu-norma\/busca-tu-norma\/norma?c=N0040254."},{"key":"ref_46","unstructured":"Fisher, A.G., and Marterella, A. (2019). Powerful Practice: A Model for Authentic Occupational Therapy, Center for Innovative OT Solutions."},{"key":"ref_47","unstructured":"(2024, February 24). BOE-A-2006-5155 Real Decreto 314\/2006, de 17 de marzo, por el que se aprueba el C\u00f3digo T\u00e9cnico de la Edificaci\u00f3n. Available online: https:\/\/www.boe.es\/eli\/es\/rd\/2006\/03\/17\/314\/con."},{"key":"ref_48","unstructured":"(2024, May 10). Modelos de Ecuaciones Estructurales: Modelos Para el An\u00e1lisis de Relaciones Causales (Cuadernos de Estad\u00edstica): Batista Foguet, Joan Manuel, Coenders Gallart, Germ\u00e0: Amazon.es: Libros. Available online: https:\/\/www.amazon.es\/Modelos-ecuaciones-estructurales-relaciones-estad%C3%ADstica\/dp\/8471336944."},{"key":"ref_49","unstructured":"Confirmatory Factor Analysis (2024, May 10). Recommendations for Unweighted Least Squares Method Related to Chi-Square and RMSEA|Acci\u00f3n Psicol\u00f3gica. Available online: https:\/\/revistas.uned.es\/index.php\/accionpsicologica\/article\/view\/14362."},{"key":"ref_50","unstructured":"Schumacker, R.E., and Lomax, R.G. (1996). A Beginner\u2019s Guide to Structural Equation Modeling: Fourth Edition, Psychology Press. [2nd ed.]."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1111\/1440-1630.12823","article-title":"Barriers and Facilitating Factors Influencing Implementation of Occupational Therapy Home Assessment Recommendations: A Mixed Methods Systematic Review","volume":"69","author":"Harper","year":"2022","journal-title":"Aust. Occup. Ther. J."},{"key":"ref_52","unstructured":"FOESSA (2024, May 10). Available online: https:\/\/www.caritas.es\/main-files\/uploads\/sites\/31\/2022\/01\/Informe-FOESSA-2022.pdf."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1086\/209405","article-title":"A Meta-Analysis of Cronbach\u2019s Coefficient Alpha","volume":"21","author":"Peterson","year":"1994","journal-title":"J. Consum. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/j.1745-6606.2006.00047.x","article-title":"Perceived Third-Person Effects and Consumer Attitudes on Prevetting and Banning DTC Advertising","volume":"40","author":"Jisu","year":"2006","journal-title":"J. Consum. Aff."},{"key":"ref_55","first-page":"831","article-title":"Revisi\u00f3n\/Review Propiedades Psicom\u00e9tricas de Una Escala: La Consistencia Interna","volume":"10","author":"Oviedo","year":"2008","journal-title":"Rev. Salud P\u00fablica"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1157\/13057542","article-title":"An\u00e1lisis Factorial Confirmatorio. Su Utilidad En La Validaci\u00f3n de Cuestionarios Relacionados Con La Salud","volume":"122","author":"Coenders","year":"2004","journal-title":"Med. Clin."},{"key":"ref_57","first-page":"103","article-title":"Revisi\u00f3n Del Concepto de Causalidad En El Marco Del An\u00e1lisis Factorial Confirmatorio","volume":"1","year":"2020","journal-title":"Rev. Iberoam. Diagn. Y Eval. E Avalia\u00e7\u00e3o Psicol."},{"key":"ref_58","first-page":"383","article-title":"Robustez de Los \u00cdndices de Ajuste Del An\u00e1lisis Factorial Confirmatorio a Los Valores Extremos","volume":"27","year":"2020","journal-title":"Rev. Mat. Teor. Y Apl."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1177\/0008417418824731","article-title":"Psychometric Properties of Home Accessibility Assessment Tools: A Systematic Review","volume":"86","author":"Patry","year":"2019","journal-title":"Can. J. Occup. Ther."},{"key":"ref_60","unstructured":"Linn, R.L. (1989). The specifications and development of tests of achievement and ability. Educational Measurement, American Council on Education. [3rd ed.]."},{"key":"ref_61","first-page":"67","article-title":"Fiabilidad y Validez","volume":"31","author":"Prieto","year":"2010","journal-title":"Papeles Psicol."},{"key":"ref_62","first-page":"11","article-title":"Sample Size and Subject to Item Ratio in Principal Components Analysis","volume":"9","author":"Osborne","year":"2019","journal-title":"Pract. Assess. Res. Eval."}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/14\/3\/89\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:57:20Z","timestamp":1760108240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/14\/3\/89"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,12]]},"references-count":62,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["clinpract14030089"],"URL":"https:\/\/doi.org\/10.3390\/clinpract14030089","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,12]]}}}