Rasch Analysis of Social Attitude Barriers and Facilitators to Participation for Individuals with Disabilities

Alex W.K. Wong*, Sofia F. Garcia, Elizabeth A. Hahn, Patrick Semik, Jin Shei Lai, Susan Magasi, Joy Hammel, Kristian P. Nitsch, Ana Miskovic, Allen W. Heinemann

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: To develop item banks of social attitude barriers and facilitators to participation and validate them with established instruments. Design: We used the Rasch model to identify misfitting items and rating scale problems, calibrate items, and develop KeyForms and short forms. Correlations between the Social Attitude Barriers and Facilitators item banks with the Patient-Reported Outcomes Measurement Information System (PROMIS) Social Health domain and National Institutes of Health Toolbox Emotional Battery Social Relationships domain were computed to evaluate convergent and divergent validity. Setting: Community-dwelling individuals traveled to 3 academic medical centers for testing. Participants: Participants (N=558) who had a primary impairment of stroke, spinal cord injury, or traumatic brain injury (mean age, 47.0±16.0y) completed 31 social attitude facilitator and 51 barrier items using a 5-point rating scale. Interventions: Not applicable. Main Outcome Measures: Item banks to measure social attitude barriers and facilitators for individuals with disabilities. Results: After combining the “never” and “rarely” rating scale categories, 30 Facilitator items fit the Rasch model and demonstrated person reliability of 0.93. After collapsing the “never” and “rarely” rating scale categories, 45 Barrier items fit the Rasch model and demonstrated person reliability of 0.95. Ceiling and floor effects were negligible for both item banks. Facilitators and Barriers item banks were negatively correlated, and these banks were moderately correlated with PROMIS and Toolbox measures, providing evidence of convergent and divergent validity. Conclusions: Findings support the reliability and validity of the Social Attitude Facilitators and Barriers item banks. These item banks allow investigators and clinicians to measure perceptions of social attitudes, providing information that can guide individual interventions to reduce barriers and promote facilitators. Moderate correlations between the Social Attitude banks and PROMIS and Toolbox variables provide support for the measurement and theory of environmental influences on social health and participation.

Original languageEnglish (US)
Pages (from-to)675-686
Number of pages12
JournalArchives of physical medicine and rehabilitation
Volume102
Issue number4
DOIs
StatePublished - Apr 2021

Funding

Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research through a Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes grant awarded to the Shirley Ryan AbilityLab (formerly the Rehabilitation Institute of Chicago) (grant no. H133B090024 ). The National Institutes of Health (grant no. K01HD095388 ) and Craig H. Neilsen Foundation (grant no. 542448 ) supported a portion of Dr Wong’s effort for developing this manuscript. The contents do not necessarily represent the policy of the funding agencies. We certify that all financial and material support for this research and work are clearly identified in the manuscript.

Keywords

  • Attitude
  • Brain injuries, traumatic
  • Community participation
  • Environment
  • Patient reported outcome measures
  • Rehabilitation
  • Spinal cord injuries
  • Stroke

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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