摘要：Objective. We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. Methods. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. Results. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities’ equipment, information, policies, and professional staff. Conclusions. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities. An estimated 54 million Americans have disabilities, or approximately one out of every five individuals. 1 Incidence of disability is likely to be higher in older populations. 2 Relative to the general population, people with disabilities are more likely to be sedentary, 3 – 7 have greater health problems, 8 – 11 and have more physical activity barriers. 12 – 16 The Healthy People 2010 report 7 notes that significantly more people with disabilities reported having no leisure-time physical activity (56% among persons with disabilities vs 36% among nondisabled individuals). These patterns of low physical activity raise serious concerns regarding the health status of people with disabilities, particularly as they enter their later years, when the effects of the natural aging process are compounded by years of sedentary living, thereby resulting in further decline in health and physical fitness. 17 The chapter of Healthy People 2010 entitled Disability and Secondary Conditions 18 suggests that the significantly lower rate of participation among people with disabilities may be related to environmental barriers, including architectural barriers, organizational policies and practices, discrimination, and social attitudes, and recommends that public health agencies begin to evaluate which environmental factors enhance or impede participation. Although members of the general population obtain most of their physical activity in outdoor settings such as neighborhood streets, shopping malls, parks, and walking/ jogging paths, 19 – 23 access to walking for people with mobility disabilities who have difficulty walking (because of, e.g., arthritis, extreme obesity, or balance impairments), cannot walk (because of, e.g., some form of paralysis), or have limited or no vision is often restricted by these inaccessible environments. Some streets do not have safe curb cuts; sidewalks are damaged and thus create a higher risk of falling; walkways or walking paths are too narrow for a wheelchair user and partner to walk side-by-side; many communities do not have sidewalks; or the terrain has too steep a grade or slope. Other problems with outdoor environments include unsafe neighborhoods, poor weather causing slippery or impassable sidewalks, insufficient number of benches along a trail for people who need frequent rest periods, poorly designated signage, no accessible bathrooms along a trail or path, and no handicapped parking spaces in close proximity to a trail. 14 Given the high level of inaccessibility of outdoor physical activity environments pertaining to individuals with mobility disabilities and visual impairments, health clubs may present a viable alternative for participating in physical activity. To date, there has been little empirical research on the accessibility of fitness facilities/health clubs for people with disabilities. The purpose of this study was to evaluate the accessibility of a national sample of fitness facilities/health clubs.
