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.
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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
Physical/StructuralSubscale
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
Attitudes/SupportSubscale
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
Services/AssistanceSubscale
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
Physical/StructuralSubscale
Work/SchoolSubscale
Attitudes/SupportSubscale
Services/AssistanceSubscale
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?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
8. In the past 12 months, how often has the availability ofthe education and training you needed been a problem foryou?
When this problem occurs has it been a bigproblem or a little problem?
9. In the past 12 months, how often has the availability ofhealth care services and medical care been a problem foryou?
When this problem occurs has it been a bigproblem or a little problem?
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.
When this problem occurs has it been a bigproblem or a little problem?
11. In the past 12 months, how often has the lack ofcomputer technology been a problem for you?
When this problem occurs has it been a bigproblem or a little problem?
12. In the past 12 months, how often did you need someoneelse’s help in your home and could not get it easily?
When this problem occurs has it been a bigproblem or a little problem?
13. In the past 12 months, how often did you need someoneelse’s help at school or work and could not get it easily?
When this problem occurs has it been a bigproblem or a little problem?
14. In the past 12 months, how often did you need someoneelse’s help in your community and could not get it easily?
When this problem occurs has it been a bigproblem or a little problem?
15. In the past 12 months, how often have other people’sattitudes toward you been a problem at home?
When this problem occurs has it been a bigproblem or a little problem?
16. In the past 12 months, how often have other people’sattitudes toward you been a problem at school or work?
When this problem occurs has it been a bigproblem or a little problem?
17. In the past 12 months, how often have other people’sattitudes toward you been a problem in the community?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
19. In the past 12 months, how often has a lack of supportand encouragement from others at school or work been aproblem?
When this problem occurs has it been a bigproblem or a little problem?
20. In the past 12 months, how often has a lack of supportand encouragement from others in your community been aproblem?
When this problem occurs has it been a bigproblem or a little problem?
21. In the past 12 months, how often did you experienceprejudice or discrimination?
When this problem occurs has it been a bigproblem or a little problem?
22. In the past 12 months, how often has the lack ofprograms and services in the community been a problem?
When this problem occurs has it been a bigproblem or a little problem?
23. In the past 12 months, how often did the policies andrules of businesses and organizations make problems foryou?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
25. In the past 12 months, how often did governmentprograms and policies make it difficult to do what you wantor need to do?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
4. In the past 12 months, how often has the information youwanted or needed not been available in a format you can useor understand?
When this problem occurs has it been a bigproblem or a little problem?
5. In the past 12 months, how often has the availability ofhealth care services and medical care been a problem foryou?
When this problem occurs has it been a bigproblem or a little problem?
6. In the past 12 months, how often did you need someoneelse’s help in your home and could not get it easily?
When this problem occurs has it been a bigproblem or a little problem?
7. In the past 12 months, how often did you need someoneelse’s help at school or work and could not get it easily?
When this problem occurs has it been a bigproblem or a little problem?
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?
When this problem occurs has it been a bigproblem or a little problem?
9. In the past 12 months, how often have other people’sattitudes toward you been a problem at school or work?
When this problem occurs has it been a bigproblem or a little problem?
10. In the past 12 months, how often did you experienceprejudice or discrimination?
When this problem occurs has it been a bigproblem or a little problem?
11. In the past 12 months, how often did the policies andrules of businesses and organizations make problems foryou?
When this problem occurs has it been a bigproblem or a little problem?
12. In the past 12 months, how often did governmentprograms and policies make it difficult to do what you wantor need to do?
When this problem occurs has it been a bigproblem or a little problem?