The United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) enshrines the rights of people with disabilities to full and effective participation in all aspects of life, including employment.1 Despite these protections, workforce participation among people with disabilities varies across nations and is typically lower than among those without disabilities2 because of myriad employment barriers (e.g., access to training and skills development, legislation, negative attitudes and stigma in workplaces [for a review see Bonaccio et al.]3). In Canada, for instance, less than 60% of working-age adults with disabilities are employed compared with ∼80% of those without disabilities. As disability severity increases, employment falls from 76% for adults with mild disabilities to 31% for adults with very severe disabilities.4 Of those who are employed, many report underemployment, precarious work, insufficient access to supports and other challenges in sustaining paid work over time.5,6 Together, these situations suggest less than ‘full and effective’ participation by people with disabilities in the workforce—situations that could undermine critical social determinants of mental health and quality of life7.

The UN CRPD1 does not operationalize ‘full and effective’ participation in general, or with specific regards to employment. The World Health Organization’s International Classification of Functioning Disability and Health (ICF) model defines participation as “involvement in a life situation” (p. 10).8 Historically, consistent with the ICF definition, measures of employment participation for people with disabilities have quantified employment status, number of work hours or productivity losses (e.g., absenteeism, job disruptions).4,9 But when participation is conceptualized simply in terms of objective outcomes, such conceptualizations ignore meanings and satisfactions that one derives from participating.10,11 Some studies have incorporated measures of job quality; such as whether a person with a disability is working securely, receives competitive wages and has access to workplace supports (e.g., job accommodations, union representation).6,7,12 Other studies have assessed perceptions of work importance, perceived limitations in job tasks, and work satisfaction.13,14 These types of measures capture some qualitative dimensions of employment, but fail to account for a person’s subjective evaluations of participating in employment.

People with disabilities emphasize that participation is more than simply being counted as present (e.g., in the workplace), or meeting societal norms/expectations11 (e.g., working 40-hours per week in a permanent position). Rather, ‘full and effective’ participation must account for the person’s subjective experiences. Emerging models of participation in the occupational health sciences acknowledge this important perspective. For instance, in the family of participation-related constructs (fPRC) model of participation,15,16 participation is defined by two constructs: attendance and involvement. Attendance is defined as ‘being there’ and the frequency and range of activities in which the person takes part. Involvement is defined as the experience of participating while in attendance. Based on a review of pediatric and developmental disability literature, involvement is purported to include elements of affect, persistence, motivation and social connection.15 The Do-Live-Well framework for promoting occupation, health and well-being17 emphasizes that health and well-being are shaped not just by what activities people do, but how they participate in activities. Based on a review of health and wellness outcomes in the general population, optimal patterns of activity can involve experiences of engagement, meaning, balance, control/choice and routine.17

Concurrent to the development of the fPRC and Do-Live-Well models, a reconceptualization of the participation construct reinforced the importance of experiential aspects of participation when operationalizing the concept for use in research, practice and policy-design contexts involving people with physical disabilities. Researchers with the Canadian Disability Participation Project conducted a configurative review of definitions and conceptualizations of participation used in research involving children, youth and adults with physical disabilities.18 Characteristics associated with experiential aspects of participation were extracted and thematically analyzed. Six themes were identified: autonomy, belongingness, challenge, engagement, mastery, and meaning (see Table 1). The authors recommended that to fully measure the concept of participation, conceptualizations should be broadened beyond ‘performance’, to incorporate individuals’ perceptions of these six experiential aspects of participation. This recommendation aligns with both the fPRC and Do-Live-Well frameworks; what people do is distinguished from their experiences of doing.

Subsequently, the Measure of Experiential Aspects of Participation (MeEAP)19 was developed to assess the extent to which adults with physical disabilities experience the six themes of experiential participation in employment, mobility and physical activity domains. Relevant to the present study, construct validation analyses involving employed adults with physical disabilities (n=115) showed that those working as much as they wanted, reported greater experiences of autonomy, belongingness, challenge and mastery in the workplace, than people working less than they wanted. This finding suggests positive employment characteristics (i.e., working as much as desired) are related to more positive subjective experiences of employment participation as measured by the MeEAP. Additionally, MeEAP scores for perceptions of autonomy, belongingness, challenge, engagement, mastery and meaning in the workplace each had positive bivariate correlations with life satisfaction (rs = .25-.47), suggesting that positive employment participation experiences are related to more positive perceptions of overall life satisfaction. It is not yet known, however, whether experiential aspects of participation in the workplace are related to work-specific outcomes like job stress, work disruptions or productivity. If such relationships exist, findings could spur research on whether subjective experiences of participation influence work outcomes, thereby creating impetus to develop workplace interventions fostering more positive participation experiences for people with disabilities.

The purpose of the present cross-sectional study was to examine the relationship between experiential aspects of employment participation and work-specific outcome measures in a large sample of Canadian adults with physical disabilities. Our sample included adults who reported: (a) a physical disability; (b) a physical and a non-physical disability; or (c) no disability. The combination of both physical and non-physical disabilities may create multiple complexities20 that exacerbate challenges faced in employment participation and may contribute to more negative subjective experiences of participation when compared to the experiences of adults with physical disability20 alone. As such, we tested physical disability status as a moderator. Inclusion of a comparison group of adults without disability allowed testing whether experiential aspects of participation, and their association with work outcomes, differ for those with versus without disabilities.

We hypothesized that after controlling for relevant demographic and employment characteristics, more positive (i.e., higher) MeEAP scores for employment experiences of autonomy, belongingness, challenge, engagement, mastery and meaning would be associated with the work outcomes of less work stress, productivity loss, job disruptions, and absenteeism. These outcomes were selected as they are highly relevant and frequently studied outcomes in the disability and employment literature.21,22 While there is not yet a theory of how the experiential aspects of participation link to employment outcomes, our hypothesis aligns with theoretical perspectives on human motivated behaviour (e.g., Self-Determination Theory;23 Social Cognitive Theory24), and occupational/work behaviour (e.g., Do-Live-Well Framework,17 theory of purposeful work behaviour25), which emphasize the importance of constructs such as autonomy, mastery, and meaning with regard to motivation, well-being and work outcomes. Given the preliminary nature of this research, it was not possible to formulate hypotheses regarding relationships between specific experiential aspects of participation and work outcomes, or the moderating effects of disability type on these relationships.