Theses and Dissertations

Date of Award

8-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Rehabilitation Counseling

First Advisor

Bruce Reed

Second Advisor

Noreen Graf

Third Advisor

Saara Grizzell

Abstract

Social participation is a key determinant of health-related quality of life (HRQoL) of adults with neurodevelopmental disabilities (NDDs), yet how individuals with NDDs engage socially to support their HRQoL remains poorly understood. Furthermore, the influences of personal capabilities, employment status, and Social Security Disability Insurance (SSDI) as social factors for well-being are underexplored with this population.

This cross-sectional study investigated the direct and indirect effects of social participation on HRQoL, examining capabilities as a mediator and employment status and SSDI receipt as moderators. The study sample comprised 304 adults with NDDs (females = 83.3%; age range 18 to 60 years old). Participants completed validated measures via Qualtrics and Amazon Mechanical Turk: the Temple University Community Participation Measure (Shea, 2022) for social participation; the World Health Organization Quality of Life – Brief Version (WHOQOL-BREF; The WHOQOL Group, 1998) for HRQoL; and the Interpersonal Support Evaluation List – 12 Item Version (ISEL-12; Cohen & Hoberman, 1983; Hedley et al., 2017) for capabilities and categorical questions on their employment status, and SSDI). Data were analyzed using SPSS version 28 with PROCESS Macro Models 4 and 59 to assess mediation and moderation effects, respectively.

Findings indicate higher social participation to predict HRQoL in adults with NDDs. Capabilities partially mediate this relationship, so that the social participation and HRQoL is stronger with higher capability. SSDI benefit receipt significantly moderated the direct effect of social participation for higher HRQoL. However, SSDI did not moderate indirect effects through capabilities. Employment status did not significantly moderate the relationship between social participation and HRQoL.

These results underscore the complex interplay of individual resources, social support, and structural factors influencing HRQoL in adults with NDDs. Effective policy and program development should adopt a comprehensive approach that integrates these dimensions to improve social inclusion and quality of life for this population.

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Copyright 2025 Kayi Ntinda. All Rights Reserved. https://proquest.com/docview/3246879740

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