Measuring Environmental Factors: Unique and Overlapping ICF Coverage of Five Instruments

Publication date: Available online 23 June 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Allen W. Heinemann, Ana Miskovic, Patrick Semik, Alex Wong, Jessica Dashner, Carolyn Baum, Susan Magasi, Joy Hammel, David S. Tulsky, Sofia F. Garcia, Sara Jerousek, Jin-Shei Lai, Noelle E. Carlozzi, David B. Gray
ObjectivesTo describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and evaluate the EFIB's construct validity by examining associations with legacy instruments.DesignCross-sectional, observational cohort.SettingCommunity.ParticipantsA sample of 597 community-dwelling adults with stroke, spinal cord injury, and traumatic brain injury.InterventionsNoneMain Outcome MeasuresEFIB covering domains of the Built and Natural Environment; Systems, Services, and Policies; Social Environment; and Access to Information and Technology; the Craig Hospital Inventory of Environmental Factors (CHIEF) short form; the Facilitators and Barriers Survey (FABS/M) short form; the Home and Community Environment Instrument (HACE); the Measure of the Quality of Environment (MQE) short form; 3 of PROMIS' Quality of Social Support measures.ResultsThe EFIB and legacy instruments assess most of the International Classification of Functioning, Disability, and Health (ICF) environmental factors chapters, including Chapter 1 (products and technology, 75 items corresponding to 11 codes), Chapter 2 (natural environment and human-made changes, 31 items, 7 codes), Chapter 3 (support and relationships, 74 items, 7 codes), Chapter 4 (attitudes, 83 items, 8 codes), and Chapter 5 (services, systems, policies, 72 items, 16 codes). Construct validity is provided by moderate correlations between EFIB measures and the CHIEF, MQE Barriers, HACE Technology Mobility, FABS/M Community Built Features, PROMIS item banks, and small correlations with other legacy instruments. Only 5 of the 66 legacy instrument correlation coefficients are moderate, suggesting they measure unique aspects of the environment, while all intra-EFIB correlations were at least moderate.ConclusionsThe EFIB measures provide a brief and focused assessment of ICF Environmental Factor chapters. The pattern of correlations with legacy instruments provides initial evidence of construct validity.



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