VERSION 3.0 Craig · PDF fileThe Creation of the Craig Hospital Inventory of Environmental...

VERSION 3.0

CraigHospitalInventory ofEnvironmentalFactors

Version 3.0 April 2001

1

The Creation of the Craig Hospital Inventory of Environmental Factors (CHIEF) ..................................... 2Background .................................................................................................................................... 2Creation of the Environmental Instrument ........................................................................................ 4Testing of the Environmental Instrument.......................................................................................... 6Further Evaluation of the Environmental Instrument ......................................................................... 8Table 1: Test-Retest comparisons (ICC, percent agreement, and mean differences) acrossimpairment group and total ........................................................................................................... 11Table 2: Test-Retest comparisons (ICC, percent agreement, and mean differences) across impairmentgroup and total using the product for each item.............................................................................. 12Table 3: Test-Proxy comparisons (ICC, percent agreement, and mean differences) across impairmentgroup and total ............................................................................................................................. 13Table 4: Test-Proxy comparisons (ICC, percent agreement, and mean differences) across impairmentgroup and total using the product for each item.............................................................................. 14Table 5: Frequency Distribution for SCI .......................................................................................... 15Table 6: Frequency Distribution for TBI .......................................................................................... 16Table 7: Frequency Distribution for Other Impairments ................................................................... 17Table 8: Mean Differences Across Groups ....................................................................................... 18

Craig Hospital Inventory of Environmental Factors.............................................................................. 29Craig Hospital Inventory of Environmental Factors.............................................................................. 32Short Form ...................................................................................................................................... 32

For Information regarding CHIEF or CHIEF Short Form please contact:

Craig HospitalResearch Department

3425 S. Clarkson StreetEnglewood, Colorado 80110

(303) [email protected] or [email protected]

2

The Creation of the Craig Hospital Inventory ofEnvironmental Factors (CHIEF)

Background

The World Health Organization (WHO) has been both praised and criticized for themodel of disablement conceptualized in the landmark publication, An InternationalClassification of Impairments, Disabilities, and Handicaps (ICIDH) (WHO, 1980, 1993).The WHO model of disablement has been praised for its important conceptualdistinctions among three types of outcomes – impairments (defined as limitations in thepresence or performance of organs or organ systems), disabilities (defined as limitationsin the performance of activities of daily living at the person level), and handicaps(defined as limitations in the performance of social roles as members of society). Onthe other hand, the WHO model of disablement has been criticized for its excessivereliance on the medical model, its failure to adequately recognize the importance of theenvironment in determining disablement outcomes, and its use of the term “handicap”(often used pejoratively in America) to describe limitations in the performance of socialroles. The WHO recognized these shortcomings in its forward to the 1993 reprint of theICIDH (WHO, 1980, 1993) by inaugurating a worldwide revision process that is underway. Current drafts of the revised model of disablement (WHO, 1999, 2000) addressthe areas that have been criticized while retaining the former areas of strength byadding a fourth domain of Environmental Factors and renaming the third domain ofsocial role fulfillment (formerly handicap) as “Participation”.

In the area of societal participation, considerable, conceptual and empirical researchhas been conducted to develop measurement instruments. Within the domain ofEnvironmental Factors, however, almost no research has been conducted towardsinstrument development. What little work has been done, has focused exclusively onarchitectural barriers in the physical environment (Steinfeld, 1997). What is needed is abroad-based measure of the environment which quantifies the degree to whichelements of the physical, social, and political environments act as barriers or facilitatorsto full participation for people with disabilities. This has therefore been the objective atthe heart of the research described herein; its goal, to provide a new type of instrumentthat will allow the quantification of Environmental Factors and lead to a betterunderstanding of the degree to which elements of the environment impede or facilitatethe lives of people with disabilities.

Several methods of conceptualizing Environmental Factors and their relationship todisability have been suggested. (Fougeyrollas, 1995) was the first within the field ofdisability studies to offer a taxonomy of Environmental Factors. He and the CanadianSociety for the International Classification of Impairments, Disabilities and Handicapscataloged over a hundred elements of the environment which they viewed as importantdeterminants of handicap or participation. This strategy has been incorporated into

3

the current classification scheme of the environment included in the beta draft of theICIDH-2 (WHO, 1999, 2000). While this strategy does provide an exhaustive list ofenvironmental elements which may influence the disablement process, it does notprovide a very useful conceptual framework for quantifying environment in survey tools.

In contrast to the approach of categorizing elements of the environment, Whiteneck, etal (1997) have attempted to identify a few salient characteristics of the environmentwhich correspond to major dimensions of the environment that act to either impede orfacilitate participation by people with disability. This conceptualization proposes fivecharacteristics of the environment:

1. Accessibility2. Accommodation3. Resource availability4. Social support5. Equality

Accessibility answers the question, “Can you get where you want to go?” It is definedin terms of physical access and includes architectural barriers such as steps andinaccessible bathrooms as well as the accessibility of transportation. These aspects ofthe environment either restrict or facilitate an individual’s ability to move about freely inhis or her community.

Accommodation addresses the question, “Can you do what you want to do?” It isdefined in terms of the equipment, services, or modifications to tasks which facilitatefull participation and independent living. Areas of accommodation include home,workplace, school, other business and organizations, and other community settings.This aspect of the environment either restricts or facilitates an individual’s ability toparticipate in an activity once he or she is at the location of that activity.

Resource availability addresses the question of, “Are your special needs met?” It isdefined in terms of the availability and provision of services and resources madenecessary by the particular disability. These may include medical care, personalassistant services, and income security. This category assesses the degree to which theextra resources needed by a person with a disability are available.

Social support addresses the question, “Are you accepted and supported by thosearound you?” It is defined in terms of the attitudes and prejudices of others whicheither discourage community integration or provide a supportive environment thatallows community integration to flourish. Social support may be provided by family andfriends, employers and teachers, neighbors and peers, and other community members.This category focuses on the social barriers which can only be remedied by attitudechange in others. Extra funding is not likely to solve these particular problems.

4

Finally, equality addresses the question, “Are you treated equally with others?” It isdefined in terms of the degree to which the policies and regulation of governments andinstitutions insure equality of opportunity for people with disabilities. Included in thiscategory are discrimination, financial disincentives, health care management andrationing, and legislative mandates to name a few.

These five environmental characteristics form useful criteria for evaluatingenvironments. However, they must be applied to each individual’s own situation, sincethe same environment that may restrict one person may assist or not affect another. Ineach case, these five environmental characteristics can be assessed on a continuumranging from restrictive barriers to inclusive facilitators.

In addition to these two methods of conceptualizing the environment (by listing itselements and by defining influential characteristics) a more recent method ofcharacterizing disability has also been suggested which plays a substantial role in thedesign of this project. For several years, the study of disability has progressed throughresearch isolated on the study of diagnostic categories. For example, considerableresearch relating to disability issues has focused on either spinal cord injury, traumaticbrain injury, stroke, visual impairments, hearing impairments, etc. Most research didnot cross diagnostic groups and was categorically funded due to interest in a particulardiagnosis. In 1997 the CDC announced two programs related to disability (730 and731, which funded the research described herein) which defined four primary disabilitydomains without reference to impairment diagnoses. These included mobilitylimitations, personal care/home management limitations, communication limitations,and learning limitations. This newer approach focuses disability research on commonthemes of limitation which cross multiple diagnoses. Furthermore, this approach isgrounded in a growing body of literature which demonstrates that considerablecommonality of secondary conditions result from a wide variety of primary diagnoses(White, et al, 1996).

Creation of the Environmental Instrument

Using multiple methodologies, pools of qualified persons were identified to participate infour separate advisory panels. Methods for identifying and selecting participantsassured that a wide and varied range of abilities, disabilities, attitudes, philosophies,knowledge and skills were reflected in the panel meetings. This group included adiverse array of 32 participants with expertise in the four areas of disability: mobility,self-care, learning, and communication limitations. Each individual brought his or herpersonal and professional perspectives and experiences on disability, participation, andthe impact of the environment. The group consisted of professors, researchers andacademicians representing the fields of sociology, occupational therapy, economics,public health and philosophy. Universities represented included Boston University,Rutgers University, the University of Denver, Queens University in Ontario, the StateUniversity of New York (Buffalo, Plattsburgh), University of Illinois at Chicago, Universityof California-Berkeley, Ohio State University, and the University of North Carolina.

5

There were representatives from such advocacy and policy implementation groups asthe Institute on Disability and Human Development, the American Foundation for theBlind, the Paralyzed Veterans of America, and the Access Board, while the U.S.government had representatives from the Centers for Disease Control and Preventionand the National Center for Health Statistics. Consumer representatives included NativeAmericans and individuals with hearing and visual impairments, spinal cord injuries,speech impairments, and cerebral palsy, as well as family members of people withmental retardation and traumatic brain injury. Finally, service providers’ input wasprovided by physicians, occupational and physical therapists, a former independentliving center director, a director of a university’s disabled student services program, anda vocational rehabilitation counselor. These meetings were very productive resulting in4 draft instruments, one from each group. Each draft instrument was designed to beused in a telephone or ‘paper pencil’ survey that would be appropriate for generalpopulation use, as well as applying to the full range of disability categories.

After reviewing and critically assessing the four instruments, project staff decided thebest instrument would come from synthesizing the vital elements, conceptualizations,and spirit of each draft into a fifth or “next generation” survey. Advisory panelmembers continued to be involved, and to participate via mail. Project staff appliedadvisory group comments and advice to the development of the draft instrument whichidentified 25 key elements of the environment. Two forms of the draft instrument wereproposed. Both had the same item content, but two different metrics were used toassess environmental impact. In one form, individuals were asked to indicate “howoften” a barrier is encountered using response categories of “daily, weekly, monthly,less than monthly, and never”. In the other form, individuals were asked to assess thedegree to which the environmental element “facilitates or hinders” participation usingresponse categories of “big barrier, little barrier, no impact, little help, and big help.”The first form had the advantage of easier response categories, while the second formhad the advantage of identifying facilitators as well as barriers.

Initial Pilot Testing

Both forms were tested on a group of 97 people, 50 with disabilities and 47 whoindicated they did not have a disability. Results of that pilot testing indicated:

1. The “frequency” response categories were strongly preferred by participants overthe “extent of barrier/facilitator” response categories.

2. The “frequency of barrier” response categories better differentiated people with andwithout disabilities than the “extent of barrier/facilitator” response categories.

3. Correlations between the two response categories, while significant, were relativelylow.

6

Discussions of the results from the comparison of response categories with project staffand representatives who attended advisory panel meetings, yielded a consensus that all25 items should be retained in the draft instrument, but that a follow-up impactquestion needed to be added since the correlation between frequency and impact wasnot particularly high. These discussions led to adding a follow-up question, “When thisproblem occurs, is it usually a big problem or a little problem?” This question wasadded after each item where the respondent indicated the frequency of the problem tobe anything other than never. The final draft instrument, the Craig Hospital Inventoryof Environmental Factors (CHIEF) was distributed to all advisory panel members forreview.

Testing of the Environmental Instrument

Instrument Validation - "CHIEF 400 Dataset"

A convenience sample of 409 individuals with disability was recruited for a validationstudy to test the psychometric properties of the CHIEF. The sample included availablepeople with spinal cord injury and traumatic brain injury who had been treated at CraigHospital (but not included in prior pilot tests of the instrument). The sample alsoincluded individuals recommended for recruitment by advisory panel members,professional colleagues, and acquaintances of other project staff and researchparticipants. In total, the sample included 124 participants with spinal cord injury, 120participants with traumatic brain injury and 165 participants with a wide variety of otherdisabilities. This included 55 persons with Multiple Sclerosis, 35 persons withamputations, and others with auditory and visual impairments, developmentaldisabilities, Cerebral Palsy and some with multiple impairments resulting in disability.While the spinal cord injury group was 80% male with an average age of 41 and thetraumatic brain injury group was 61% male with an average age of 41, the variety ofother impairments were 62% female with an average age of 48.

All 409 study participants were administered the CHIEF. In addition, 103 of the total409 participants (46 with SCI, 44 with TBI, and 13 with other impairments) wereinterviewed using CHIEF a second time, approximately two weeks after the firstadministration in order to assess test-retest reliability. Finally, family members orfriends of 125 subjects (46 with SCI, 54 with TBI, and 25 with other impairments), notincluded in the test-reliability sub-study, were successfully recruited and asked tocomplete the CHIEF as a proxy for the subject in order to assess subject-proxyagreement.

This completed dataset will be later referred to as the "CHIEF 400 Dataset". Analysis ofthis data began by defining three methods of scoring each item:

7

1. A frequency score on a scale of 0-4 indicating the frequency with which barrierswere encountered (0=never, 1=less than monthly, 2=monthly, 3=weekly, and4=daily).

2. A magnitude score on a scale of 0-2 indicating the size of the problem which abarrier typically presented (0=no problem since the barrier was neverencountered, 1=a little problem, and 2=a big problem).

3. A frequency-magnitude product score on a scale of 0-8 calculated as the productof the frequency score and the magnitude score, indicating the overall impact ofthe barrier.

Total scores across the 25 items were calculated as the average frequency score, theaverage magnitude score, and the average frequency-magnitude product score acrossall of the non-missing scale items.

Test-Retest Reliability

Test-retest reliability of individual items and the total scale were calculated using boththe intra-class correlation coefficient and the percent of cases with exact agreementbetween both tests. Mean difference scores between the test and retest were alsocalculated and significance assessed. This process was repeated for frequency scores,magnitude scores, and frequency-magnitude product scores. In general, the productscores showed slightly higher reliability co-efficient and they became the focus ofadditional psychometric analysis.

Table 1 presents all test-retest comparison data (separately for frequency andmagnitude), while Table 2 presents the test-retest reliabilities for the frequencymagnitude product scores. These tables report item and total scale reliability scores.Data are presented separately for spinal cord injury, traumatic brain injury, and "other"impairment groups, as well as total sample reliability statistics. These data indicate atotal scale score ICC reliability of .926, indicating acceptable reliability for theinstrument.

Subject-Proxy Agreement

After establishing test-retest reliability for CHIEF, the extent of subject-proxy agreementwas analyzed. Tables 3 and 4 present the results of frequency and magnitudecomparisons and frequency magnitude product data respectively in a format identical toTables 1 and 2. Across all disability sub-groups subject proxy interclass correlationsranged from .406-.699 with a total scale ICC of .618. These data indicate that subjectproxy agreement is marginal and result in the recommendation that proxies not beasked to complete CHIEF when subjects are unavailable to do so.

As one method of validating the data collected in CHIEF, differences in responsepatterns were compared across impairment groupings in an effort to determine if the

8

instrument differentiated among impairment groups in expected ways. Tables 5, 6 and7, report percent frequency distributions of the raw data across the 25 items for spinalcord injury, traumatic brain injury, and other impairment groups respectively. Table 8presents the mean frequency-magnitude product scores for persons with spinal cordinjury, traumatic brain injury, MS, amputees, and other impairments as well as the totalsample mean. Tests of differences among the five groupings were compared usingone-way analysis of variance with Bonferroni post hoc comparisons. Significant maineffects and significant differences between groups are indicated in the table. It can beseen that the majority of items and sub-scales produce statistically significantdifferences among the impairment groups. Cases with TBI scored dramatically loweron physical barriers than the other groups. These data lend support to the validity ofCHIEF by indicating that the tool differentiates scores among different disability groupsin ways that are consistent with the unique barriers faced by those groups.

Further Evaluation of the Environmental Instrument

Additional evaluation of the CHIEF was performed to: 1) examine the underlyingdimensions that might exist within the context of the 25 items; 2) demonstrates itsapplicability to large-scale disability surveillance; 3) establish scoring norms; and 4)develop a CHIEF Short Form. This was accomplished by adding the CHIEF to theBehavioral Risk Factor Surveillance System (BRFSS) survey in Colorado. In 1999, asecond population-based sample was drawn and this sample was administered the: 1)BRFSS core survey; 2) BRFSS Quality of Life Module; 3) BRFSS State-added DisabilityQuestions; 4) Craig Handicap Assessment and Reporting Technique Short Form(CHART-SF); and 5) CHIEF. The survey was administered via telephone to 2,259individuals. This completed dataset will be henceforth referred to as the "BRFSSDataset".

The BRFSS data was weighted using the standard BRFSS weighting formula. Inaddition, post-stratification weighting has been applied to account for differences in ageand gender between the sample and the population of Colorado. All analyses have beenperformed using the weighted data; therefore, the results can be generalized to theentire population of Colorado, 18 years or older.

Identification of CHIEF Subscales

Factor analysis was used to identify underlying dimensions, or subscales, within CHIEF.This analysis was performed on the 25 CHIEF items with five factors accounting for48% of the cumulative variance across the 25 items. After varimax rotation, each itemwas assigned to the factor with the highest positive loading. This resulted in fivefactors with 3-7 items included in each factor. Descriptive labels for the factors wereassigned including "attitude and support barriers", "services and assistance barriers","physical and structural barriers", "policy barriers" and "work and school barriers".

Scoring Differentiation Between Groups

9

Across items, subscales and total scores, the CHIEF was able to show differences inreported frequency and magnitude of environmental barriers between groups with avariety of impairments and activity limitations. Table 9 summarizes the mean andstandard deviation for each CHIEF item, subscale and total score using the two datasets(CHIEF 400 and BRFSS) grouped by disability status.

Subjects within the BRFSS Dataset were differentiated by whether or not they had a"disability". This was determined by using a definition where a subject was considered"disabled" if they responded "yes" to any of the following questions: 1) Are you limitedin the kind or amount of work you can do because of any impairment or healthproblem; 2) Because of any impairment or health problem, do you have any troublelearning, remembering or concentrating; 3) Do you use special equipment or help fromothers to get around; 4) Are you limited in any way in any activities because of anyimpairment or health problem. Within the "CHIEF 400 Dataset", subjects weredifferentiated by the same impairment categories as previously described.

Figures A through F provide a graphic summary of the information in Table 9. Figure Ashows the CHIEF subscales and total scale mean scores by disability status. This figureindicates that both people with and without disabilities experience environmentalbarriers. However, those with disabilities reported an overall higher frequency andmagnitude of environmental barriers. Further, individuals with TBI reported greaterbarriers than those identified as having a disability from the BRFSS data (see definitionabove), but fewer than individuals with SCI. Individuals with other types of impairments(i.e., MS, Amputees, other auditory, visual and multiple impairments, DD, CP) reportedthe greatest barriers.

Figures B through F show the mean scores for each CHIEF subscale and the items onthat subscale by disability status. Overall, the same general trend is seen, howeversome items and subscales do vary by disability status. This analysis confirms that theCHIEF has the ability to differentiate between those with and without disability andbetween different impairment groups.

Development of the CHIEF Short Form

Several criteria were used to determine which items should be retained for a "shortform" version of the CHIEF. In general, these criteria included items which: 1) had thehighest frequency of barrier mean scores; 2) had the highest magnitude of barriermean scores; 3) had the highest item score-subscale score correlations (using the meanfrequency-magnitude product score); 4) had the highest item score-total scorecorrelations (using the mean frequency-magnitude product score); 5) were the mostfrequently reported barriers; and 6) best differentiated between people with andwithout disability. In addition, taking all of the criteria into consideration, if an item wasto be excluded, but it was felt, conceptually should be in the scale, it was retained.

10

Results of this analysis identified 12 items within the original five subscales to beretained. Table 10 shows the mean and standard deviation for each CHIEF-SF item,subscale and total score using the two datasets (CHIEF 400 and BRFSS) grouped bydisability status. Figures G and H provide a graphic summary of the information in Table10. Figure G shows the CHIEF-SF subscales and total scale mean scores by disabilitystatus, and Figure H shows the total scale and item mean scores by disability status.These figures further substantiate the findings from the CHIEF Long Form.

REFERENCES

World Health Organization. International classification of impairments, disabilities, andhandicaps: A manual of classification relating to the consequences of disease. Geneva:World Health Organization, 1980, 1993 reprint.

World Health Organization. International classification of functioning and disability(ICIDH-2): Geneva: World Health Organization, 1999, 2000.

Steinfeld EH. “Environment as a mediating factor in functional assessment.” In DittmarS, Gresham G, editors. Functional Assessment and Outcome Measurement for theRehab Health Professional. Gaithersburg, MD: Aspen Publishers, 1997.

Fougeyrollas P. Documenting environmental factors for preventing the handicapcreation process: Quebec contributions relating to ICIDH and social participation ofpeople with functional differences. Disability and rehabilitation. 1995;17(3/4):145-153.

Whiteneck GG, Fougeyrolles P, Gerhart KA. “Elaborating the Model of Disablement.”In, Assessing Medical Rehabilitation Practices: The Promise of Outcomes Research.Fuhrer M, editor. Paul H. Brooks Publishing Co., 1997.

White GW, Seekins T, Gutierrez RT. Preventing and managing secondary conditions: aproposed role for independent living centers. J Rehab 1996;62(3):14-21.

11

Tabl

e 1:

Tes

t-R

etes

t co

mpa

riso

ns (

ICC

, per

cent

agr

eem

ent,

and

mea

n di

ffer

ence

s) a

cros

sim

pair

men

t gr

oup

and

tota

l

Test

-Ret

est

SC

In

=4

6TB

In

=4

4O

ther

n=

13

Tota

ln

=1

03

Que

stio

nM

easu

rem

ent

ICC

%Co

rrec

tM

ean

Diff

eren

ceIC

C%

Corr

ect

Mea

nD

iffer

ence

ICC

%Co

rrec

tM

ean

Diff

eren

ceIC

C%

Corr

ect

Mea

nD

iffer

ence

Tran

spor

tatio

nFr

eque

ncy

.713

73.9

.020

.703

79.5

.341

*.9

5176

.4-.

077

.749

76.7

.146

Mag

nitu

de.7

7276

.9.0

65.6

0363

.6.1

59.9

0580

.0.0

00.7

4380

.6.0

97D

esig

n ho

me

Freq

uenc

y.5

6363

.0.2

17.2

3981

.8.6

09.8

5984

.6.3

07.5

5673

.8.1

65M

agni

tude

.564

71.4

.091

.306

66.7

-.02

3.8

5175

.0.1

54.5

7378

.2.0

49D

esig

n w

ork/

scho

olFr

eque

ncy

.635

50.0

.300

.252

75.9

.276

.698

63.6

.454

.598

65.0

.316

*M

agni

tude

.412

81.8

.100

.568

100.

0.0

00.7

9810

0.0

.000

.629

75.0

.033

Des

ign

com

mun

ityFr

eque

ncy

.476

58.7

.369

*.5

2879

.5-.

027

.808

69.2

.307

.629

68.9

.194

Mag

nitu

de.6

6675

.8.0

87.5

6860

.0.0

21.6

8810

0.0

.154

.733

74.8

.068

Nat

ural

Env

ironm

ent

Freq

uenc

y.5

1058

.7.0

44.5

6167

.4.1

16.7

4046

.2.1

54.6

2560

.8.0

88M

agni

tude

.478

78.9

.087

.629

58.8

.139

.721

88.9

.000

.642

68.6

.098

Surr

ound

ings

Freq

uenc

y.5

7354

.3.0

21.6

7865

.9.0

23.7

6261

.5.1

54.6

4860

.2.0

38M

agni

tude

.378

93.3

.089

.670

88.9

.023

.861

87.5

.000

.575

72.5

.049

Info

rmat

ion

Freq

uenc

y.6

1963

.0.3

04*

.639

67.4

.047

.375

53.8

.154

.597

63.7

.176

Mag

nitu

de.3

4381

.8.2

17.5

8387

.5-.

024

.363

66.7

.154

.461

69.3

.109

Educ

atio

n/tr

aini

ngFr

eque

ncy

.511

73.9

-.10

9.3

2768

.2.0

00.0

7538

.5-*

.231

.369

67.0

-.07

7M

agni

tude

.618

70.0

.065

.559

57.1

-.02

3-.

030

33.3

-.07

7.4

9668

.6.0

09M

edic

al C

are

Freq

uenc

y.6

5963

.0-.

109

.318

77.3

-.18

2.4

3461

.5.6

15.5

1168

.9-.

048

Mag

nitu

de.6

8183

.3-.

174

.446

50.0

-.13

9.4

8033

.3.2

31.6

2671

.6-.

107

Equi

pmen

tFr

eque

ncy

.665

60.9

.130

.535

84.1

.045

.483

38.5

.077

.635

68.0

.087

Mag

nitu

de.7

5261

.1.0

00.5

0210

0.0

.093

.434

75.0

.000

.677

78.4

.039

Tech

nolo

gyFr

eque

ncy

.627

63.0

.413

*.4

7976

.7.1

16.1

4961

.5-.

462

.537

68.6

.177

Mag

nitu

de.5

6564

.3.1

09.4

5366

.7.1

86.5

3610

0.0

-.30

7.5

2474

.5.0

88H

elp

hom

eFr

eque

ncy

.752

50.0

.217

.652

84.1

-.06

8.6

1653

.8.0

77.7

3065

.0.0

77M

agni

tude

.624

72.7

.111

.706

60.0

.023

.515

60.0

.154

.684

72.5

.078

Hel

p w

ork

Freq

uenc

y.5

1368

.4-.

211

.537

65.5

-.03

5.8

1663

.6.0

91.6

0166

.1-.

067

Mag

nitu

de.8

2310

0.0

-.10

5.5

5466

.7-.

071

.878

75.0

.000

.755

75.9

-.06

9H

elp

com

mun

ityFr

eque

ncy

.563

63.0

.044

.796

86.4

.069

.385

46.2

.307

.627

71.6

.088

Mag

nitu

de.7

5182

.4.0

22.7

9785

.7.0

23.8

5480

.0-.

077

.794

80.4

.009

Attit

udes

hom

eFr

eque

ncy

.718

73.9

.022

.719

68.2

-.04

6.3

9076

.9.1

53.6

7472

.5.0

09M

agni

tude

.644

83.3

-.02

2.6

9763

.6-.

048

.536

33.3

.000

.649

75.2

-.02

9At

titud

es w

ork/

scho

olFr

eque

ncy

.382

60.0

-.40

0.8

7086

.2-.

035

.762

81.8

-.27

2.6

8776

.7-.

200*

Mag

nitu

de.2

8280

.0-.

250

.906

100.

0.0

00.7

1050

.0-.

182

.676

77.6

-.12

0At

titud

es c

omm

unity

Freq

uenc

y.8

5378

.3-.

044

.907

79.5

.136

.753

53.8

.000

.864

75.7

.038

Mag

nitu

de.5

9958

.3.0

87.7

8992

.3.1

14.5

3640

.0.1

54.4

4574

.8.0

29Su

ppor

t in

hom

eFr

eque

ncy

.560

89.1

.022

.845

86.4

-.04

5.7

9384

.6.0

77.7

7287

.4.0

00M

agni

tude

.460

50.0

.044

.864

80.0

-.06

8.6

9210

0.0

.307

.712

85.4

.029

Supp

ort

wor

k/sc

hool

Freq

uenc

y.4

0460

.0.3

00.8

0179

.3-.

034

.268

63.6

.000

.557

70.0

-.11

6M

agni

tude

.326

50.0

-.05

0.6

7960

.0.0

34.2

5010

0.0

-.30

0.4

6972

.9-.

051

Supp

ort

com

mun

ityFr

eque

ncy

.743

67.4

.044

.659

75.0

.136

.676

53.8

-.30

7.6

9668

.9.0

38M

agni

tude

.473

60.0

.044

.584

85.7

.000

.700

75.0

-.15

4.5

4073

.8.0

00D

iscr

imin

atio

nFr

eque

ncy

.768

67.4

.043

.788

70.5

.045

.787

69.2

-.30

7.7

7998

.9.0

00M

agni

tude

.867

80.8

.067

.719

91.7

.045

.799

66.7

-.23

0.8

0681

.4.0

19Se

rvic

es c

omm

unity

Freq

uenc

y.6

9557

.8.2

44.5

8979

.5.0

00.7

8661

.5-.

077

.693

67.6

.098

Mag

nitu

de.6

8875

.0.1

14.6

8980

.0-.

024

.680

50.0

.154

.703

74.7

.060

Polic

ies

of b

usin

ess

Freq

uenc

y.7

5360

.9-0

.11

.521

68.2

.091

.728

61.5

.385

.645

64.1

.068

Mag

nitu

de.5

0664

.3-.

065

.501

100.

0.0

46.7

4150

.0.2

31.5

4369

.6.0

19Ed

ucat

/Em

ploy

pol

icie

sFr

eque

ncy

.278

67.7

-.09

7.4

1969

.2.2

05.5

6033

.3-.

167

.407

63.4

.036

Mag

nitu

de.4

4250

.0-.

129

.129

60.0

.103

.173

66.7

.083

.258

61.0

.012

Gov

ernm

ent

polic

ies

Freq

uenc

y.6

3052

.2.0

00.7

4976

.7.0

00.7

2061

.5.0

00.6

9863

.7.0

00M

agni

tude

.590

77.3

.000

.721

87.5

.000

.649

60.0

.000

.679

71.6

.000

Tota

l Fre

quen

cy.9

04.0

67.9

11.0

50.9

15.0

61.9

12.0

59*

Tota

l Mag

nitu

de.8

49.0

34.8

90.0

29.8

86.0

25.8

81.0

31

12

Tabl

e 2:

Tes

t-R

etes

t co

mpa

riso

ns (

ICC

, per

cent

agr

eem

ent,

and

mea

n di

ffer

ence

s) a

cros

sim

pair

men

t gr

oup

and

tota

l usi

ng t

he p

rodu

ct f

or e

ach

item

Test

-Ret

est

scor

eS

CI

n=

46

TBI

n=

44

Oth

ern

=1

3To

tal

n=

10

3

Que

stio

nIC

C%

Corr

ect

Mea

nD

iffer

ence

ICC

%Co

rrec

tM

ean

Diff

eren

ceIC

C%

Corr

ect

Mea

nD

iffer

ence

ICC

% C

orre

ctM

ean

Diff

eren

ceTr

ansp

orta

tion

.769

71.7

.000

.634

77.3

.386

.924

76.9

.153

.753

74.8

.184

Des

ign

hom

e.5

8459

.1.3

18.1

0781

.8.1

36.8

6576

.9.6

15.5

3571

.3.2

77D

esig

n w

ork/

scho

ol.5

4350

.0.1

50.5

4375

.9.3

44.8

8563

.6.4

54.6

8065

.0.3

00D

esig

n co

mm

unity

.485

50.0

.652

.735

75.0

.068

.883

67.2

.538

.689

63.1

.388

*N

atur

al E

nviro

nmen

t.6

2847

.8.0

87.6

1062

.8.1

39.7

8246

.2.0

77.6

9453

.9.1

07Su

rrou

ndin

gs.6

6253

.3-.

044

.698

63.6

.045

.764

61.5

.462

.703

58.8

.058

Info

rmat

ion

.621

60.9

.413

.656

69.0

.071

.307

53.8

.615

.588

63.4

.297

Educ

atio

n/tr

aini

ng.5

5769

.6-.

022

.401

67.4

-.13

9-.

016

38.5

-.30

7.4

0964

.7-.

108

Med

ical

Car

e.7

0060

.6-.

195

.249

76.7

-.34

8.3

3761

.51.

00.5

0467

.6-.

107

Equi

pmen

t.6

5954

.3.2

83.5

4886

.0.0

69.3

3638

.5-.

076

.610

65.7

.147

Tech

nolo

gy.5

3060

.9.6

52.5

4772

.1.4

65.3

1761

.5-.

615

.533

65.7

.412

Hel

p ho

me

.742

44.4

.467

.756

84.1

.000

.653

46.2

-.76

9.7

5261

.8.3

03H

elp

wor

k/sc

hool

.728

68.4

-.10

5.6

9767

.9-.

214

.718

54.5

.454

.725

65.5

-.05

1H

elp

com

mun

ity.6

8560

.9.1

52.7

5588

.4.1

16.4

3446

.2.8

46.6

7870

.6.2

25At

titud

es h

ome

.790

73.9

.174

.788

66.7

.047

.169

69.2

.384

.705

70.3

.148

Attit

udes

wor

k/sc

hool

.383

55.0

-.45

0.9

6188

.9-.

074

.454

81.8

-.63

6.7

4175

.9-.

310*

Attit

udes

com

mun

ity.8

7869

.6-.

195

.949

77.3

.204

.553

53.8

.538

.882

70.9

.068

Supp

ort

hom

e.6

1287

.0.0

65.8

5384

.1-.

136

.736

76.9

.461

.727

84.5

.029

Supp

ort

wor

k.3

3660

.0-.

250

.821

75.9

.034

.678

70.0

-.30

0.5

6469

.5-.

118

Supp

ort

com

mun

ity.7

4563

.0.2

17.6

9875

.0.1

59.8

8653

.8-.

307

.743

67.0

.126

Dis

crim

inat

ion

.829

64.4

.111

.804

70.5

.181

.746

61.5

-.61

5.8

0766

.7.0

49Se

rvic

es c

omm

unity

.823

56.8

.409

*.6

4383

.3.0

71.8

2453

.8.3

07.7

7167

.7.2

52Po

licie

s bu

sine

ss.8

3854

.3-.

043

.567

69.8

.069

.677

46.2

1.00

.689

59.8

.137

Educ

at/E

mpl

oy p

olic

ies

.339

54.8

-.29

0.2

3666

.7.4

62.5

7033

.3.3

33.3

3257

.3.1

58G

over

nmen

t po

licie

s.7

0347

.8.1

30.7

4576

.7.0

93.7

1053

.8.1

53.7

2860

.8.1

17To

tal

.915

3.26

*.9

331.

97.9

236.

31*

.926

3.09

*

13

Tabl

e 3:

Tes

t-P

roxy

com

pari

sons

(IC

C, p

erce

nt a

gree

men

t, a

nd m

ean

diff

eren

ces)

acr

oss

impa

irm

ent

grou

p an

d to

tal

Test

-Pro

xySC

In

=4

6TB

In

=5

4O

ther

n=

25

Tota

ln

=1

25

Que

stio

nM

easu

rem

ent

ICC

%Co

rrec

tM

ean

Diff

eren

ceIC

C%

Corr

ect

Mea

nD

iffer

ence

ICC

%Co

rrec

tM

ean

Diff

eren

ceIC

C%

Corr

ect

Mea

nD

iffer

ence

Tran

spor

tatio

nFr

eque

ncy

.571

67.4

.044

.488

64.2

.000

.616

44.0

-.32

0.5

7261

.3-.

048

Mag

nitu

de.4

5169

.6-.

239

.543

69.8

-.09

4.5

3764

.0-.

400*

.542

68.5

-.20

9*D

esig

n ho

me

Freq

uenc

y.4

9158

.7.0

44.4

7881

.5.1

48.3

9152

.0-.

520

.513

67.2

-.02

4M

agni

tude

.442

65.2

-.02

2.5

1285

.2.0

74.2

6348

.0-.

480*

.477

70.4

-.07

2D

esig

n w

ork/

scho

olFr

eque

ncy

.242

35.0

-.20

0.3

4579

.4-.

235

.147

14.3

-1.5

7*.4

0357

.4-.

377*

Mag

nitu

de.0

1350

.0-.

150

.281

76.5

.000

.172

28.3

-.85

7*.3

5162

.3-.

147

Des

ign

com

mun

ityFr

eque

ncy

.488

30.4

-.30

.653

77.8

.000

.576

40.0

-.40

0.6

6252

.8-.

128

Mag

nitu

de.1

7245

.7-.

231

.543

81.5

.037

.622

64.0

-.16

0.5

7264

.8-.

104

Nat

ural

Env

ironm

ent

Freq

uenc

y.1

9441

.3.0

65.3

1749

.1-.

132

.473

28.0

-.04

0.3

6941

.9-.

040

Mag

nitu

de.0

5530

.4-.

087

.410

52.8

.037

.274

48.0

.080

.393

43.5

.000

Surr

ound

ings

Freq

uenc

y.3

5141

.3.0

22.5

1440

.0-.

326

.399

25.0

-.08

3.4

7837

.7-.

147

Mag

nitu

de.4

0847

.8-.

044

.632

61.5

-.13

4.5

8845

.8-.

125

.573

53.3

-.09

8In

form

atio

nFr

eque

ncy

.009

54.3

.109

-.00

150

.9-.

207

.375

36.0

-.28

0.1

8249

.2-.

105

Mag

nitu

de.3

6556

.5.0

22-.

027

53.8

-.07

6.1

2436

.0-.

160

.187

51.2

-.05

7Ed

ucat

ion/

trai

ning

Freq

uenc

y.2

8363

.0-.

456*

.218

63.0

-.29

6.2

0628

.0-.

600

.281

56.0

-.41

6*M

agni

tude

.309

65.2

-.26

1*.4

5470

.4-.

074

.225

32.0

-.52

0*.3

8960

.8-.

232*

Med

ical

Car

eFr

eque

ncy

.357

54.3

.108

.456

6938

-.22

6.4

3641

.7-.

485*

.428

58.5

-.14

6M

agni

tude

.599

56.5

.000

.309

67.9

-.16

3.3

6950

.0-.

333

.478

60.2

-.11

3Eq

uipm

ent

Freq

uenc

y.0

2637

.0.1

96.1

2589

.0-.

185

.525

48.0

-.60

0*.3

2460

.8-.

128

Mag

nitu

de.0

9145

.7.1

96.2

1689

.0-.

074

.524

56.0

-.40

0*.3

9865

.6-.

040

Tech

nolo

gyFr

eque

ncy

-.14

057

.8.0

89.3

8176

.5.0

3919

540

.0.6

40.2

0662

.0-.

181

Mag

nitu

de-.

058

55.6

.022

.295

78.0

-.04

0.4

1648

.0.1

20.2

6163

.3-.

050

Hel

p ho

me

Freq

uenc

y.6

0345

.7-.

087

.282

67.3

-.50

0*.3

9844

.0-.

160

.486

54.5

-.27

6*M

agni

tude

.262

36.4

-.40

9*.3

5669

.2-.

231

.182

48.0

-.44

0.3

4252

.9-.

338*

Hel

p w

ork/

scho

olFr

eque

ncy

.026

65.0

.100

.076

69.7

-.09

0.4

5142

.9-.

428

.309

65.0

-.06

7M

agni

tude

.452

65.0

-.10

0-.

024

72.3

-.03

0.6

0042

.9.0

00.4

7566

.7-.

050

Hel

p co

mm

unity

Freq

uenc

y.2

3447

.8-.

282

.152

75.5

-.26

4-.

085

32.0

.120

.201

56.5

-.19

3M

agni

tude

.519

52.2

-.13

0.5

5580

.8-.

096

.229

40.0

.080

.516

61.8

-.07

3At

titud

es h

ome

Freq

uenc

y.3

4160

.9-.

311

.436

60.4

-.05

6.6

3344

.0.0

40.4

5757

.7-.

130

Mag

nitu

de.2

2364

.4-.

222

.393

67.9

.037

.528

48.0

-.16

0.3

7862

.6-.

097

Attit

udes

wor

k/sc

hool

Freq

uenc

y.0

1060

.0-.

300

.332

60.6

-.18

1.4

5533

.3-.

667

.334

57.6

-.27

1M

agni

tude

-.03

465

.0-.

300

.383

66.7

-.09

0-.

102

33.3

-.88

3.2

2662

.7-.

237*

Attit

udes

com

mun

ityFr

eque

ncy

.454

47.8

.108

.345

67.3

-.13

5.5

5437

.5-.

208

.461

54.1

-.05

7M

agni

tude

.333

47.8

.087

.535

69.2

-.07

7.3

5054

.2-.

333

.434

58.2

-.06

5Su

ppor

t ho

me

Freq

uenc

y.2

2262

.2-.

159

.116

67.3

.039

.127

48.0

.080

.161

62.0

-.02

4M

agni

tude

.020

65.9

-.27

2*.2

2967

.2.0

57.0

3452

.0.0

00.1

0564

.5-.

074

Supp

ort

wor

k/sc

hool

Freq

uenc

y-.

026

75.0

-.05

0.3

1669

.7.2

12.5

4633

.3-.

500

.397

67.8

.051

Mag

nitu

de.1

5975

.0-.

050

.683

78.8

.151

.300

33.3

-.16

7.5

7572

.9.0

51Su

ppor

t co

mm

unity

Freq

uenc

y.0

8765

.2-.

196

.043

75.5

-.28

3*.2

1140

.0-.

200

.145

64.5

-.23

3*M

agni

tude

.185

63.0

-.17

4.0

6273

.6-.

188*

.233

48.0

-.28

0.2

0664

.5-.

202*

Dis

crim

inat

ion

Freq

uenc

y.5

7252

.2.0

23.4

0166

.0-.

113

.549

37.5

.000

.543

55.3

-.04

1M

agni

tude

.318

57.8

-.08

9.3

1967

.9-.

189

.449

50.0

.083

.395

60.7

-.09

8Se

rvic

es c

omm

unity

Freq

uenc

y.2

8260

.9-.

239

.492

73.6

-.09

4.1

3525

.0-.

083

.358

59.3

-.14

6M

agni

tude

.413

63.0

-.10

8.6

8476

.9.0

39.1

8245

.8-.

208

.479

65.6

-.06

5Po

licie

s bu

sine

ssFr

eque

ncy

.146

58.7

-.36

9*.0

6962

.3.0

56.2

0432

.0-.

160

.205

54.8

-.14

5M

agni

tude

.307

58.7

-.17

4.1

2566

.7.0

98.2

8145

.8.0

00.3

0959

.5-.

024

Educ

at/E

mpl

oy p

olic

ies

Freq

uenc

y.4

4966

.7-.

138

.269

68.6

-.23

5.6

5861

5-.

384

.455

67.0

-.22

0M

agni

tude

.418

65.7

-.17

1.2

8773

.5-.

102

.416

50.0

-.33

3.3

9867

.7-.

156*

Gov

ernm

ent

polic

ies

Freq

uenc

y.1

4628

.3.2

39.3

3668

.5.0

00.4

1432

.0.0

40.3

2346

.4.0

96M

agni

tude

.204

50.0

.087

.389

69.8

-.07

5.5

2164

.0-.

120

.408

61.3

-.02

4To

tal F

requ

ency

.572

-.07

5.5

87-.

134

.506

-.17

9.6

25-.

121*

Tota

l Mag

nitu

de.5

22-.

112*

.718

-.04

7.4

62-.

191

.658

-.10

0*

14

Tabl

e 4:

Tes

t-P

roxy

com

pari

sons

(IC

C, p

erce

nt a

gree

men

t, a

nd m

ean

diff

eren

ces)

acr

oss

impa

irm

ent

grou

p an

d to

tal u

sing

the

pro

duct

for

eac

h it

em

Test

-Pro

xy s

core

SC

In

=4

6TB

In

=5

4O

ther

n=

25

Tota

ln

=1

25

Que

stio

nIC

C%

Corr

ect

Mea

nD

iffer

ence

ICC

%Co

rrec

tM

ean

Diff

eren

ceIC

C%

Corr

ect

Mea

nD

iffer

ence

ICC

%Co

rrec

tM

ean

Diff

eren

ceTr

ansp

orta

tion

.567

63.0

-.21

7.5

2264

.2.0

18.6

1244

.0-.

680

.592

59.7

-.20

9D

esig

n ho

me

.604

56.5

-.04

3.5

6781

.5.2

78.4

5740

.0-.

880

.580

64.0

-.07

2D

esig

n w

ork

.005

35.0

-.65

0.3

6376

.5-.

352

.194

14.3

-3.1

4*.3

5255

.7-.

771*

Des

ign

com

mun

ity.5

5126

.1-.

456

.668

77.8

-.03

7.6

9732

.0-.

400

.699

49.6

-.26

4N

atur

al E

nviro

nmen

t.2

0426

.1.1

08.3

2847

.2-.

169

.419

28.0

-.20

0.3

6335

.5-.

072

Surr

ound

ings

.469

41.3

.043

.502

42.3

-.80

7*.4

4416

.7-.

583

.511

36.9

-.44

3*In

form

atio

n.1

6254

.3-.

043

-.10

950

.0-.

500

.256

32.0

-.48

0.1

5448

.0-.

325

Educ

atio

n/tr

aini

ng.2

0715

2-.

826*

.291

63.0

-.57

4.2

6920

.0-1

.28*

.290

53.6

-.80

8*M

edic

al C

are

.358

43.5

-.04

4.4

4367

.9-.

339

.491

37.5

-.75

0.4

3152

.8-.

309

Equi

pmen

t.0

4339

.1.2

39.0

6687

.0-.

314

.596

48.0

-1.0

0*.3

4561

.6-.

248

Tech

nolo

gy-.

116

55.6

.266

.377

78.0

.180

.558

36.0

.640

.312

60.8

.308

Hel

p ho

me

.493

36.4

-.40

9.2

6267

.3-.

750*

.381

32.0

-.84

0.4

3348

.8-.

645*

Hel

p w

ork

.110

60.0

.000

.013

69.7

-.06

0.5

7228

.6-.

283

.408

61.7

-.08

3H

elp

com

mun

ity.2

3847

.8-.

587

.225

76.9

-.50

0*.0

2332

.0.4

00.2

4256

.9-.

349

Attit

udes

hom

e.4

4662

.2-.

577

.268

60.4

-.18

8.6

4040

.0.2

00.4

5656

.9-.

252

Attit

udes

wor

k-.

057

60.0

-.60

0.3

1060

.6-.

212

.398

33.3

-1.1

6.3

3357

.6-.

441

Attit

udes

com

mun

ity.2

6543

.5-.

152

.355

61.5

-.30

7.4

6833

.3-.

333

.365

49.2

-.25

4Su

ppor

t ho

me

.293

63.6

-.29

5.1

5767

.3-.

057

.253

48.0

.280

.239

62.0

-.07

4Su

ppor

t w

ork

-.02

575

.0-.

050

.614

69.7

.212

.619

50.0

.167

.632

69.5

.085

Supp

ort

com

mun

ity.0

2960

.9-.

413

.004

73.6

-.58

5.3

3940

.0-.

400

.148

62.1

-.48

4*D

iscr

imin

atio

n.6

5251

.1-.

089

.339

66.0

-.24

5.5

3333

.3.2

50.5

3454

.1-.

090

Serv

ices

com

mun

ity.1

9758

.7-.

326

.467

75.0

-.26

9.1

3825

.0-.

083

.316

59.0

-.25

4Po

licie

s bu

sine

ss.1

2356

.5-.

804*

.175

64.7

.078

.218

33.3

.042

.230

55.4

-.26

4Ed

ucat

/Em

ploy

pol

icie

s.5

4565

.7-.

485

.338

73.5

-.38

8.5

5750

.0-.

333

.479

67.7

-.41

6*G

over

nmen

t po

licie

s.1

7728

.3.2

61.3

6467

.9-.

113

.444

32.0

.240

.348

46.0

.096

Tota

l.4

94-5

.28

.618

-.50

7.5

70-7

.20

.618

-5.5

7*

15

Tabl

e 5:

Fre

quen

cy D

istr

ibut

ion

for

SCI

Never

Less thanmonthly

Monthly

Weekly

Daily

Littleproblem

Bigproblem

Qu

esti

onP

erc

en

tP

erce

nt

Tran

spor

tatio

n64

.215

.48.

15.

76.

515

.420

.3D

esig

n of

hom

e52

.117

.45.

85.

819

.036

.411

.6D

esig

n of

wor

k37

.931

.06.

913

.810

.351

.710

.3D

esig

n of

com

mun

ity22

.026

.820

.322

.88.

146

.331

.7N

atur

al E

nviro

nmen

t15

.435

.025

.214

.69.

843

.141

.5Su

rrou

ndin

gs49

.630

.113

.05.

71.

638

.212

.2In

form

atio

n59

.322

.08.

18.

12.

429

.311

.4Ed

ucat

ion

71.3

18.0

5.7

2.5

2.5

15.6

13.1

Med

ical

Car

e52

.825

.215

.44.

12.

425

.222

.0Eq

uipm

ent

48.0

27.6

11.4

4.9

8.1

30.1

22.0

Tech

nolo

gy68

.39.

84.

19.

88.

117

.913

.8H

elp

in h

ome

43.8

21.5

14.0

8.3

12.4

33.1

23.1

Hel

p at

wor

k64

.910

.57.

014

.03.

521

.114

.0H

elp

in c

omm

unity

61.0

19.5

12.2

4.1

3.3

27.6

11.4

Attit

udes

at

hom

e79

.78.

92.

44.

14.

913

.07.

3At

titud

es a

t w

ork

75.9

15.5

5.2

3.4

0.0

22.4

1.7

Attit

udes

in c

omm

unity

58.5

20.3

15.4

4.1

1.6

32.5

8.9

Supp

ort

in h

ome

88.6

4.9

0.8

0.8

4.9

5.7

5.7

Supp

ort

in w

ork

79.3

13.8

3.4

3.4

0.0

17.2

3.4

Supp

ort

in c

omm

unity

75.6

12.2

6.5

3.3

2.4

17.1

7.3

Dis

crim

inat

ion

48.8

29.8

12.4

5.8

3.3

34.7

16.5

Serv

ices

in c

omm

unity

60.3

19.0

10.7

4.1

5.8

20.7

19.0

Polic

ies

of b

usin

ess

64.2

17.9

13.0

1.6

3.3

17.1

18.7

Educ

atio

nal p

olic

ies

68.3

17.8

7.9

4.0

2.0

19.8

11.9

Gov

ernm

ent

polic

ies

42.3

21.1

17.9

7.3

11.4

19.5

38.2

16

Tabl

e 6:

Fre

quen

cy D

istr

ibut

ion

for

TBI

Never

Less thanmonthly

Monthly

Weekly

Daily

Littleproblem

Bigproblem

Qu

esti

onP

erc

en

tP

erce

nt

Tran

spor

tatio

n65

.010

.85.

08.

310

.820

.015

.0D

esig

n of

hom

e83

.32.

53.

35.

05.

810

.06.

7D

esig

n of

wor

k79

.011

.12.

53.

73.

714

.86.

2D

esig

n of

com

mun

ity73

.313

.35.

86.

70.

818

.38.

3N

atur

al E

nviro

nmen

t47

.131

.911

.86.

72.

530

.322

.7Su

rrou

ndin

gs44

.223

.313

.310

.09.

238

.317

.5In

form

atio

n68

.110

.36.

07.

87.

815

.516

.4Ed

ucat

ion

76.5

16.0

1.7

2.5

3.4

15.1

8.4

Med

ical

Car

e79

.810

.15.

93.

40.

89.

210

.9Eq

uipm

ent

88.2

6.7

5.0

0.0

0.0

7.6

4.2

Tech

nolo

gy77

.35.

01.

77.

68.

46.

716

.0H

elp

in h

ome

80.0

6.7

5.8

4.2

3.3

10.0

10.0

Hel

p at

wor

k81

.59.

93.

74.

90.

012

.36.

2H

elp

in c

omm

unity

83.9

6.8

5.9

2.5

0.8

8.5

7.6

Attit

udes

at

hom

e62

.715

.36.

87.

67.

621

.216

.1At

titud

es a

t w

ork

73.4

12.7

6.3

5.1

2.5

15.2

11.4

Attit

udes

in c

omm

unity

69.2

15.8

7.5

3.3

4.2

19.2

11.7

Supp

ort

in h

ome

72.5

15.8

5.8

2.5

3.3

18.3

9.2

Supp

ort

in w

ork

71.6

17.3

4.9

4.9

1.2

22.2

6.2

Supp

ort

in c

omm

unity

80.8

9.2

3.3

4.2

2.5

13.3

5.8

Dis

crim

inat

ion

66.7

17.5

6.7

4.2

5.0

20.8

12.5

Serv

ices

in c

omm

unity

78.0

9.3

4.2

3.4

5.1

11.9

10.2

Polic

ies

of b

usin

ess

70.9

12.0

10.3

3.4

3.4

12.8

16.2

Educ

atio

nal p

olic

ies

79.5

8.0

4.5

4.5

3.6

8.9

11.6

Gov

ernm

ent

polic

ies

75.2

6.0

6.8

2.6

9.4

9.4

15.4

17

Tabl

e 7:

Fre

quen

cy D

istr

ibut

ion

for

Oth

er I

mpa

irm

ents

Never

Less thanmonthly

Monthly

Weekly

Daily

Littleproblem

Bigproblem

Qu

esti

onP

erc

en

tP

erce

nt

Tran

spor

tatio

n49

.114

.99.

916

.19.

918

.632

.3D

esig

n of

hom

e57

.49.

35.

67.

420

.418

.524

.1D

esig

n of

wor

k57

.513

.811

.56.

910

.326

.416

.1D

esig

n of

com

mun

ity29

.426

.420

.915

.38.

038

.731

.9N

atur

al E

nviro

nmen

t16

.937

.519

.415

.610

.637

.545

.6Su

rrou

ndin

gs45

.419

.012

..912

.99.

827

.027

.6In

form

atio

n51

.514

.712

.311

.79.

820

.927

.6Ed

ucat

ion

68.7

11.7

6.1

6.1

7.4

11.7

19.6

Med

ical

Car

e61

.319

.09.

85.

54.

312

.326

.4Eq

uipm

ent

54.7

17.4

10.6

4.3

13.0

15.5

29.8

Tech

nolo

gy55

.713

.97.

010

.113

.319

.624

.1H

elp

in h

ome

51.9

11.9

11.3

13.1

11.9

18.8

29.4

Hel

p at

wor

k63

.313

.96.

311

.45.

116

.520

.3H

elp

in c

omm

unity

59.0

116.

811

.86.

26.

219

.921

.1At

titud

es a

t ho

me

68.1

11.9

5.6

6.9

7.5

15.0

16.9

Attit

udes

at

wor

k73

.47.

68.

96.

33.

815

.211

.4At

titud

es in

com

mun

ity58

.617

.912

.34.

96.

223

.517

.9Su

ppor

t in

hom

e75

.011

.33.

85.

05.

07.

415

.6Su

ppor

t in

wor

k71

.811

.56.

42.

67.

712

.815

.4Su

ppor

t in

com

mun

ity66

.315

.38.

65.

54.

319

.014

.7D

iscr

imin

atio

n50

.327

.79.

46.

36.

323

.925

.8Se

rvic

es in

com

mun

ity56

.215

.413

.07.

48.

016

.027

.8Po

licie

s of

bus

ines

s51

.325

.09.

45.

68.

816

.931

.9Ed

ucat

iona

l pol

icie

s72

.210

.43.

56.

96.

96.

920

.8G

over

nmen

t po

licie

s51

.916

.713

.66.

211

.79.

338

.9

18

Tabl

e 8:

Mea

n D

iffe

renc

es A

cros

s G

roup

s

[S]CI

[T]BI

[M]S

[A]mputee

[O]ther

Total

Tran

spor

tatio

n1.

19 o

1.31

o2.

18 o

1.11

o2.

52 st

a1.

59**

Des

ign

hom

e1.

600.

72 m

ao2.

21 t

2.31

t1.

79 t

1.51

**D

esig

n w

ork

1.62

t0.

51 so

0.75

1.57

1.57

t1.

16**

Des

ign

com

mun

ity2.

51 t

0.64

smao

2.51

t1.

88 t

2.30

t1.

87**

Nat

ural

Env

ironm

ent

2.60

t1.

29 sm

ao3.

22 t

2.51

t2.

49 t

2.27

**Su

rrou

ndin

gs1.

05 o

1.66

1.94

1.08

o2.

41 sa

1.60

**In

form

atio

n0.

95 o

1.24

o1.

29 o

1.14

o2.

72 st

ma

1.42

**Ed

ucat

ion/

trai

ning

0.74

0.62

1.02

1.14

1.32

0.88

Med

ical

Car

e1.

200.

58 a

1.20

1.68

t1.

051.

03*

Equi

pmen

t1.

45 t

0.24

smao

1.54

t1.

62 t

2.14

t1.

24**

Tech

nolo

gy1.

221.

162.

200.

802.

071.

44**

Hel

p ho

me

1.90

t0.

71 so

1.76

1.00

o2.

71 ta

1.59

**H

elp

wor

k1.

170.

45 o

0.30

1.00

1.70

t0.

95**

Hel

p co

mm

unity

0.97

0.47

o1.

240.

821.

70 t

0.98

**At

titud

es h

ome

0.69

1.27

1.38

0.68

1.35

1.07

Attit

udes

wor

k0.

370.

820.

221.

001.

060.

75At

titud

es c

omm

unity

0.89

0.87

1.09

0.91

1.60

1.04

Supp

ort

hom

e0.

480.

711.

290.

620.

770.

72Su

ppor

t w

ork

0.37

0.62

0.33

0.96

1.31

0.72

Supp

ort

com

mun

ity0.

640.

550.

910.

681.

240.

76D

iscr

imin

atio

n1.

170.

97 o

1.38

0.82

1.87

t1.

23**

Serv

ices

com

mun

ity1.

230.

81 o

1.52

1.00

2.09

t1.

28**

Polic

ies

busi

ness

1.00

o0.

93 o

1.72

0.97

2.04

st1.

26**

Educ

at/E

mpl

oy p

olic

ies

0.76

o0.

75 o

0.53

o0.

971.

75 st

m0.

94**

Gov

ernm

ent

polic

ies

2.25

t1.

14 so

1.69

1.94

2.35

t1.

84**

Tota

l Ave

rage

1.26

o0.

88 m

o1.

60 t

1.19

1.90

st1.

31**

Supe

rscr

ipt

lett

er in

dica

tes

sign

ifica

nt d

iffer

ence

fro

m t

he g

roup

with

initi

al in

bra

cket

.*

p<.0

5*

p<.0

1

19

Tabl

e 9

: M

ean

pro

duct

sco

res

for

CH

IEF

item

s, s

ubs

cale

s an

d to

tal b

y D

isab

ility

Sta

tus

CH

IEF

BRFS

S D

ata

CH

IEF

400

Dat

aAl

l Cas

esD

isab

led

Not

Dis

able

dAl

l Cas

esSC

ITB

IO

ther

Dx'

sM

ean

SDM

ean

SDM

ean

SDM

ean

SDM

ean

SDM

ean

SDM

ean

SDPo

licie

s Su

bsca

le0.

510.

960.

631.

090.

470.

921.

381.

811.

371.

650.

941.

651.

711.

99Po

licie

s bu

sine

sses

0.71

1.61

0.96

1.99

0.64

1.48

1.26

2.17

1.01

1.84

0.93

1.88

1.70

2.51

Polic

ies

empl

oym

ent/e

duca

tion

0.46

1.31

0.49

1.39

0.45

1.29

0.94

2.03

0.76

1.54

0.75

1.85

1.20

2.41

Serv

ices

com

mun

ity0.

220.

860.

270.

850.

210.

871.

282.

291.

232.

140.

812.

051.

672.

51Po

licie

s go

vern

men

t0.

641.

640.

821.

920.

601.

551.

842.

722.

222.

731.

152.

482.

062.

79Ph

ysic

al/S

truc

tura

l Sub

scal

e0.

470.

790.

781.

220.

390.

601.

721.

581.

801.

341.

051.

302.

151.

77D

esig

n ho

me

0.33

1.15

0.65

1.78

0.24

0.88

1.52

2.59

1.60

2.37

0.72

1.93

2.05

3.00

Surro

undi

ngs

0.54

1.42

0.91

1.99

0.44

1.20

1.60

2.25

1.05

1.56

1.67

2.30

1.97

2.55

Des

ign

com

mun

ity0.

210.

920.

421.

260.

160.

791.

872.

312.

512.

390.

641.

372.

282.

45D

esig

n w

ork/

scho

ol0.

311.

190.

501.

600.

271.

081.

162.

001.

622.

130.

521.

281.

452.

31N

atur

al e

nviro

nmen

t0.

761.

441.

252.

190.

631.

112.

272.

342.

612.

261.

291.

842.

742.

51Te

chno

logy

0.64

1.61

0.88

1.99

0.57

1.48

1.45

2.57

1.23

2.34

1.16

2.48

1.84

2.77

Wor

k/Sc

hool

Sub

scal

e0.

661.

130.

891.

340.

621.

080.

811.

520.

640.

910.

631.

361.

121.

93Su

ppor

t wor

k/sc

hool

0.48

1.29

0.71

1.58

0.44

1.22

0.73

1.75

0.38

0.99

0.63

1.44

1.09

2.34

Attit

udes

wor

k/sc

hool

0.99

1.72

1.31

2.17

0.93

1.61

0.75

1.73

0.38

0.77

0.82

1.86

0.95

2.06

Hel

p w

ork/

scho

ol0.

541.

430.

761.

820.

501.

340.

951.

901.

182.

080.

461.

231.

302.

23A

ttitu

des/

Supp

ort S

ubsc

ale

0.46

0.88

0.72

1.39

0.39

0.66

0.97

1.44

0.78

1.25

0.88

1.44

1.19

1.55

Supp

ort c

omm

unity

0.19

0.91

0.39

1.52

0.14

0.64

0.77

1.72

0.64

1.59

0.56

1.58

1.01

1.90

Attit

udes

com

mun

ity0.

371.

040.

521.

380.

320.

921.

041.

910.

891.

510.

881.

881.

282.

16Su

ppor

t hom

e0.

411.

210.

741.

790.

320.

980.

731.

850.

491.

760.

721.

660.

922.

04At

titud

es h

ome

0.82

1.65

1.29

2.37

0.69

1.38

1.07

2.21

0.69

1.87

1.28

2.29

1.22

2.35

Dis

crim

inat

ion

0.53

1.37

0.79

1.78

0.47

1.23

1.24

2.02

1.17

1.69

0.98

2.02

1.48

2.22

Serv

ices

/Ass

ista

nce

Subs

cale

0.39

0.72

0.58

0.93

0.33

0.64

1.27

1.42

1.20

1.16

0.75

1.18

1.70

1.62

Tran

spor

tatio

n0.

481.

380.

501.

440.

481.

361.

592.

441.

192.

081.

322.

312.

102.

70M

edic

al c

are

0.48

1.39

0.96

1.96

0.34

1.16

1.04

1.85

1.20

1.81

0.59

1.50

1.24

2.05

Hel

p ho

me

0.40

1.15

0.57

1.40

0.35

1.07

1.59

2.48

1.90

2.58

0.72

1.83

2.01

2.67

Educ

atio

n/tra

inin

g0.

341.

180.

431.

330.

321.

130.

891.

920.

751.

660.

621.

671.

182.

21H

elp

com

mun

ity0.

200.

700.

300.

880.

170.

640.

981.

890.

981.

760.

471.

381.

362.

21In

form

atio

n0.

611.

370.

811.

750.

561.

241.

422.

310.

961.

601.

242.

351.

902.

64Pe

rson

al e

quip

men

t0.

190.

990.

461.

550.

110.

761.

252.

231.

462.

120.

240.

801.

832.

72C

HIE

F To

tal

0.47

0.63

0.69

0.87

0.41

0.53

1.31

1.30

1.25

1.08

0.89

1.19

1.66

1.42

20

Figu

re A

: CH

IEF

Subs

cale

s an

d To

tal b

y D

isab

ility

Sta

tus

0.00

0.50

1.00

1.50

2.00

2.50

3.00

CHIEF Total

Policies Subscale

Physical/StructuralSubscale

Work/SchoolSubscale

Attitudes/SupportSubscale

Services/AssistanceSubscale

CHI

EF T

otal

and

Sub

scal

es

CHIEF Mean Score

BRFS

S No

t Dis

able

d

BRFS

S Di

sabl

ed

CHIE

F 40

0 TB

I

CHIE

F 40

0 SC

I

CHIE

F 40

0 O

ther

Dx'

s*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er a

udito

ry,

visu

al a

nd m

ultip

le im

pair

men

ts,

DD, C

P

21

Figu

re B

: CH

IEF

Polic

ies

Subs

cale

by

Dis

abili

ty S

tatu

s

0.00

0.50

1.00

1.50

2.00

2.50

3.00

Policies Subscale

Policies businesses

Policiesemployment/education

Services community

Policies governmentCH

IEF

Polic

ies

Subs

cale

and

Item

s

CHIEF Mean Score

BRFS

S No

t Dis

able

d

BRFS

S Di

sabl

ed

CHIE

F 40

0 TB

I

CHIE

F 40

0 SC

I

CHIE

F 40

0 O

ther

Dx'

s*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er a

udito

ry,

visu

al a

nd m

ultip

le im

pair

men

ts,

DD, C

P

22

Figu

re C

: CHI

EF P

hysi

cal/S

truc

tura

l Sub

scal

e by

Dis

abili

ty S

tatu

s

0.00

0.50

1.00

1.50

2.00

2.50

3.00


Design home

Surroundings

Design community

Designwork/school

Naturalenvironment

Technology

CHI

EF P

hysi

cal/S

truc

tura

l Sub

scal

e an

d Ite

ms

CHIEF Mean Score

BRFS

S No

t Dis

able

dBR

FSS

Disa

bled

CHIE

F 40

0 TB

I CH

IEF

400

SCI

CHIE

F 40

0 O

ther

Dx'

s*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er

audi

tory

, vis

ual a

nd

mul

tiple

impa

irm

ents

, DD,

C

P

23

Figu

re D

: CH

IEF

Wor

k/Sc

hool

Sub

scal

e by

Dis

abili

ty S

tatu

s

0.00

0.50

1.00

1.50

2.00

2.50

3.00

Wor

k/Sc

hool

Sub

scal

e Su

ppor

t wor

k/sc

hool

Atti

tude

s w

ork/

scho

olH

elp

wor

k/sc

hool

CH

IEF

Wor

k/Sc

hool

Sub

scal

e an

d Ite

ms

BR

FSS

Not

Dis

able

dB

RFS

S D

isab

led

CH

IEF

400

TBI

CH

IEF

400

SCI

CH

IEF

400

Oth

er D

x's*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er a

udito

ry,

visu

al a

nd m

ultip

le

impa

irmen

ts, D

D, C

P

24

Figu

re E

: CH

IEF

Attit

udes

/Sup

port

Subs

cale

by

Dis

abili

ty S

tatu

s

0.00

0.50

1.00

1.50

2.00

2.50

3.00


Support community

Attitudes community

Support home

Attitudes home

Discrimination

CHI

EF A

ttitu

des/

Supp

ort S

ubsc

ale

and

Item

s

CHIEF Mean Score

BRFS

S N

ot D

isab

led

BRFS

S D

isab

led

CHIE

F 40

0 TB

I CH

IEF

400

SCI

CHIE

F 40

0 O

ther

Dx'

s*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er a

udito

ry,

visu

al a

nd m

ultip

le

impa

irm

ents

, DD,

CP

25

Figu

re F

: CH

IEF

Serv

ices

/Ass

ista

nce

Subs

cale

by

Dis

abili

ty S

tatu

s

0.00

0.50

1.00

1.50

2.00

2.50

3.00


Transportation

Medical care

Help home

Education/training

Help community

Information

Personal equipment

CHIE

F Se

rvic

es/A

ssis

tanc

e Su

bsca

le a

nd It

ems

CHIEF Mean Score

BRFS

S N

ot D

isab

led

BRFS

S D

isab

led

CHIE

F 40

0 TB

I CH

IEF

400

SCI

CHIE

F 40

0 O

ther

Dx'

s*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er

audi

tory

, vis

ual a

nd m

ultip

leim

pair

men

ts, D

D, C

P

26

Tabl

e 1

0:

Mea

n p

rodu

ct s

core

s fo

r th

e C

HIE

F S

hor

t Fo

rm it

ems,

su

bsc

ales

an

d to

tal b

yD

isab

ility

Sta

tus

CH

IEF-

SF19

99 B

RFS

S D

ata

CH

IEF

400

Dat

a

All C

ases

Dis

able

dN

ot D

isab

led

All C

ases

SCI

TBI

Oth

er D

x's

Mea

nSD

Mea

nSD

Mea

nSD

Mea

nSD

Mea

nSD

Mea

nSD

Mea

nSD

Polic

ies

Subs

cale

0.68

1.34

0.89

1.66

0.64

1.34

1.55

2.05

1.61

1.86

1.04

1.84

1.88

2.25

Polic

ies

busi

ness

es0.

711.

610.

961.

990.

631.

481.

262.

171.

011.

840.

931.

881.

702.

51Po

licie

s go

vern

men

t0.

641.

640.

821.

920.

601.

551.

842.

722.

222.

731.

152.

482.

062.

79Ph

ysic

al/S

truc

tura

l Sub

scal

e0.

651.

181.

081.

790.

530.

921.

951.

831.

831.

521.

481.

692.

382.

04Su

rroun

ding

s0.

541.

420.

911.

990.

441.

211.

602.

251.

051.

561.

672.

301.

972.

55N

atur

al e

nviro

nmen

t0.

761.

441.

252.

190.

631.

112.

272.

342.

612.

261.

291.

842.

742.

51W

ork/

Scho

ol S

ubsc

ale

0.76

1.24

1.00

1.50

0.71

1.18

0.85

1.57

0.77

1.12

0.63

1.43

1.13

1.90

Attit

udes

wor

k/sc

hool

0.99

1.72

1.31

2.17

0.93

1.61

0.75

1.73

0.38

0.77

0.82

1.86

0.95

2.06

Hel

p w

ork/

scho

ol0.

541.

430.

761.

820.

501.

340.

951.

901.

182.

080.

461.

231.

302.

23A

ttitu

des/

Supp

ort S

ubsc

ale

0.67

1.21

1.00

1.77

0.57

0.99

1.17

1.77

0.96

1.50

1.13

1.74

1.36

1.97

Attit

udes

hom

e0.

821.

651.

292.

370.

691.

381.

072.

210.

691.

871.

282.

291.

222.

35D

iscr

imin

atio

n0.

541.

370.

791.

790.

471.

231.

242.

021.

171.

690.

982.

021.

482.

22Se

rvic

es/A

ssis

tanc

e Su

bsca

le0.

490.

910.

711.

130.

430.

831.

431.

611.

311.

320.

981.

501.

851.

78Tr

ansp

orta

tion

0.48

1.38

0.50

1.44

0.48

1.36

1.59

2.44

1.19

2.08

1.32

2.31

2.10

2.70

Med

ical

car

e0.

481.

390.

961.

960.

341.

161.

041.

851.

201.

810.

591.

501.

242.

05H

elp

hom

e0.

401.

150.

571.

400.

351.

071.

592.

481.

902.

580.

721.

832.

012.

67In

form

atio

n0.

611.

370.

811.

750.

561.

241.

422.

310.

961.

601.

242.

351.

902.

64C

HIE

F-SF

Tot

al0.

620.

800.

881.

100.

540.

681.

471.

431.

351.

121.

091.

381.

831.

58

27

Figu

re G

: CH

IEF-

SF S

ubsc

ales

and

Tot

al b

y D

isab

ility

Sta

tus

0.00

0.50

1.00

1.50

2.00

2.50

3.00

CHIEF-SF Total

Policies Subscale


Work/SchoolSubscale



CHIE

F-SF

Tot

al a

nd S

ubsc

ales

CHIEF-SF Mean Score

BRFS

S No

t Dis

able

dBR

FSS

Disa

bled

CHIE

F 40

0 TB

I CH

IEF

400

SCI

CHIE

F 40

0 O

ther

Dx'

s*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er

audi

tory

, vis

ual a

nd

mul

tiple

impa

irm

ents

, DD,

C

P

28

Figu

re H

: CH

IEF-

SF b

y D

isab

ility

Sta

tus

0.00

0.50

1.00

1.50

2.00

2.50

3.00

CHIEF-SF Total

Policies businesses

Policies government

Surroundings

Natural environment

Attitudeswork/school

Help work/school

Attitudes home

Discrimination

Transportation

Medical care

Help home

Information

CHI

EF-S

F To

tal a

nd It

ems

CHIEF-SF Mean Score

BRFS

S No

t Dis

able

dBR

FSS

Disa

bled

CHIE

F 40

0 TB

I CH

IEF

400

SCI

CHIE

F 40

0 O

ther

Dx'

s*

*Oth

er D

x's=

33%

MS,

21%

A

mpu

tee,

46%

oth

er a

udito

ry,

visu

al a

nd m

ultip

le

impa

irm

ents

, DD,

CP

29

Craig Hospital Inventory of Environmental Factors© (for information contact [email protected] or [email protected])

Being an active, productive member of society includes participating in such things as working, going to school, taking care ofyour home, and being involved with family and friends in social, recreational and civic activities in the community. Many factorscan help or improve a person’s participation in these activities while other factors can act as barriers and limit participation.First of all, do you think you have had the same opportunities as other people to participate in and take advantage of:

education ____yes ____noemployment ____yes ____norecreation/leisure ____yes ____no

First, please tell me how often each of the following has been a barrier to your own participation in the activities that matter toyou. Think about the past year, and tell me whether each item on the list below has been a problem daily, weekly, monthly,less than monthly, or never. If the item occurs, then answer the question as to how big a problem the item is with regard toyour participation in the activities that matter to you.

(Note: if a question asks specifically about school or work and you neither work nor attend school, check not applicable)D

aily

Weekly

Mon

thly

Less than

mon

thly

Never

Not

applicable

Big

problem

Littleproblem

1. In the past 12 months, how often has the availability oftransportation been a problem for you?

When this problem occurs has it been a bigproblem or a little problem?

2. In the past 12 months, how often has the design andlayout of your home made it difficult to do what you want orneed to do?


3. In the past 12 months, how often has the design andlayout of buildings and places you use at school or workmade it difficult to do what you want or need to do?


4. In the past 12 months, how often has the design andlayout of buildings and places you use in your communitymade it difficult to do what you want or need to do?


5. In the past 12 months, how often has the naturalenvironment – temperature, terrain, climate – made itdifficult to do what you want or need to do?


6. In the past 12 months, how often have other aspects ofyour surroundings – lighting, noise, crowds, etc – made itdifficult to do what you want or need to do?


30

Daily

Weekly

Mon

thly

Less than

mon

thly

Never

Not

applicable

Big

problem

Littleproblem

7. In the past 12 months, how often has the information youwanted or needed not been available in a format you can useor understand?


8. In the past 12 months, how often has the availability ofthe education and training you needed been a problem foryou?


9. In the past 12 months, how often has the availability ofhealth care services and medical care been a problem foryou?


10. In the past 12 months, how often has the lack ofpersonal equipment or special adapted devices been aproblem for you. Examples might include hearing aids,eyeglasses or wheelchairs.


11. In the past 12 months, how often has the lack ofcomputer technology been a problem for you?


12. In the past 12 months, how often did you need someoneelse’s help in your home and could not get it easily?


13. In the past 12 months, how often did you need someoneelse’s help at school or work and could not get it easily?


14. In the past 12 months, how often did you need someoneelse’s help in your community and could not get it easily?


15. In the past 12 months, how often have other people’sattitudes toward you been a problem at home?


16. In the past 12 months, how often have other people’sattitudes toward you been a problem at school or work?


17. In the past 12 months, how often have other people’sattitudes toward you been a problem in the community?


31

Daily

Weekly

Mon

thly

Less than

mon

thly

Never

Not

applicable

Big

problem

Littleproblem

18. In the past 12 months, how often has a lack of supportand encouragement from others in your home been aproblem?


19. In the past 12 months, how often has a lack of supportand encouragement from others at school or work been aproblem?


20. In the past 12 months, how often has a lack of supportand encouragement from others in your community been aproblem?


21. In the past 12 months, how often did you experienceprejudice or discrimination?


22. In the past 12 months, how often has the lack ofprograms and services in the community been a problem?


23. In the past 12 months, how often did the policies andrules of businesses and organizations make problems foryou?


24. In the past 12 months, how often did education andemployment programs and policies make it difficult to dowhat you want or need to do?


25. In the past 12 months, how often did governmentprograms and policies make it difficult to do what you wantor need to do?


32

Craig Hospital Inventory of Environmental FactorsShort Form

© (for information contact [email protected] or [email protected])

Being an active, productive member of society includes participating in such things as working, going to school, taking care ofyour home, and being involved with family and friends in social, recreational and civic activities in the community. Many factorscan help or improve a person’s participation in these activities while other factors can act as barriers and limit participation.

First, please tell me how often each of the following has been a barrier to your own participation in the activities that matter toyou. Think about the past year, and tell me whether each item on the list below has been a problem daily, weekly, monthly,less than monthly, or never. If the item occurs, then answer the question as to how big a problem the item is with regard toyour participation in the activities that matter to you.

(Note: if a question asks specifically about school or work and you neither work nor attend school, check not applicable)

Daily

Weekly

Mon

thly

Less than

mon

thly

Never

Not

applicable

Big

problem

Littleproblem

1. In the past 12 months, how often has the availability oftransportation been a problem for you?


2. In the past 12 months, how often has the naturalenvironment – temperature, terrain, climate – made itdifficult to do what you want or need to do?


3. In the past 12 months, how often have other aspects ofyour surroundings – lighting, noise, crowds, etc – made itdifficult to do what you want or need to do?


4. In the past 12 months, how often has the information youwanted or needed not been available in a format you can useor understand?


5. In the past 12 months, how often has the availability ofhealth care services and medical care been a problem foryou?


6. In the past 12 months, how often did you need someoneelse’s help in your home and could not get it easily?


7. In the past 12 months, how often did you need someoneelse’s help at school or work and could not get it easily?


33

Daily

Weekly

Mon

thly

Less than

mon

thly

Never

Not

applicable

Big

problem

Littleproblem

8. In the past 12 months, how often have other people’sattitudes toward you been a problem at home?


9. In the past 12 months, how often have other people’sattitudes toward you been a problem at school or work?


10. In the past 12 months, how often did you experienceprejudice or discrimination?


11. In the past 12 months, how often did the policies andrules of businesses and organizations make problems foryou?


12. In the past 12 months, how often did governmentprograms and policies make it difficult to do what you wantor need to do?


VERSION 3.0 Craig · PDF fileThe Creation of the Craig Hospital Inventory of Environmental...

Documents

Transcript of VERSION 3.0 Craig · PDF fileThe Creation of the Craig Hospital Inventory of Environmental...