Using the ICF’s environmental factors framework to develop an item bank measuring built and natural environmental features affecting persons with disabilities

Allen Walter Heinemann*, Jin-Shei Lai, Alex Wong, Jessica Dashner, Susan Magasi, Elizabeth A Hahn, Noelle E. Carlozzi, David S. Tulsky, Sara Jerousek, Patrick Semik, Ana Miskovic, David B. Gray

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: To develop a measure of natural environment and human-made change features (Chapter 2 of the international classification of functioning, disability, and health) and evaluate the influence of perceived barriers on health-related quality of life. Methods: A sample of 570 adults with stroke, spinal cord injury, and traumatic brain injury residing in community settings reported their functioning in home, outdoor, and community settings (mean age = 47.0 years, SD = 16.1). They rated 18 items with a 5-point rating scale to describe the influence of barriers to moving around, seeing objects, hearing sounds, hearing conversations, feeling safe, and regulating temperature and indicated whether any difficulties were due to environmental features. We used Rasch analysis to identify misfitting items and evaluate differential item functioning (DIF) across impairment groups. We computed correlations between barriers and patient-reported outcomes measurement information system (PROMIS) social domain measures and community participation indicators (CPI) measures. Results: The 18 items demonstrated person reliability of.70, discriminating nearly three levels of barriers. All items fit the Rasch model; impairment-related DIF was negligible. Ceiling effects were negligible, but 25 % of the respondents were at the floor, indicating that they did not experience barriers that they attributed to the built and natural environment. As anticipated, barriers correlated moderately with PROMIS and CPI variables, suggesting that although this new item bank measures a construct that is related to participation and health-related quality of life, it also captures something unique. Known-groups validity was supported by wheelchair users reporting a higher level of barriers than did ambulatory respondents. Conclusions: Preliminary evidence supports the reliability and validity of this new measure of barriers to the built and natural environment. This measure allows investigators and clinicians to measure perceptions of the natural environment and human-made changes, providing information that can guide interventions to reduce barriers. Moderate relationships between barriers and PROMIS and CPI variables provide support for the measurement and theory of environmental influences on social health and participation.

Original languageEnglish (US)
Pages (from-to)2775-2786
Number of pages12
JournalQuality of Life Research
Volume25
Issue number11
DOIs
StatePublished - Nov 1 2016

Fingerprint

Disabled Persons
Information Systems
Hearing
Quality of Life
International Classification of Functioning, Disability and Health
Social Participation
Wheelchairs
Spinal Cord Injuries
Reproducibility of Results
Emotions
Stroke
Research Personnel
Temperature
Health
Patient Reported Outcome Measures
Community Participation
Surveys and Questionnaires

Keywords

  • Disability populations
  • Environment
  • Health-related quality of life
  • Patient-reported outcomes
  • Questionnaires

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Heinemann, Allen Walter ; Lai, Jin-Shei ; Wong, Alex ; Dashner, Jessica ; Magasi, Susan ; Hahn, Elizabeth A ; Carlozzi, Noelle E. ; Tulsky, David S. ; Jerousek, Sara ; Semik, Patrick ; Miskovic, Ana ; Gray, David B. / Using the ICF’s environmental factors framework to develop an item bank measuring built and natural environmental features affecting persons with disabilities. In: Quality of Life Research. 2016 ; Vol. 25, No. 11. pp. 2775-2786.
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Using the ICF’s environmental factors framework to develop an item bank measuring built and natural environmental features affecting persons with disabilities. / Heinemann, Allen Walter; Lai, Jin-Shei; Wong, Alex; Dashner, Jessica; Magasi, Susan; Hahn, Elizabeth A; Carlozzi, Noelle E.; Tulsky, David S.; Jerousek, Sara; Semik, Patrick; Miskovic, Ana; Gray, David B.

In: Quality of Life Research, Vol. 25, No. 11, 01.11.2016, p. 2775-2786.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Using the ICF’s environmental factors framework to develop an item bank measuring built and natural environmental features affecting persons with disabilities

AU - Heinemann, Allen Walter

AU - Lai, Jin-Shei

AU - Wong, Alex

AU - Dashner, Jessica

AU - Magasi, Susan

AU - Hahn, Elizabeth A

AU - Carlozzi, Noelle E.

AU - Tulsky, David S.

AU - Jerousek, Sara

AU - Semik, Patrick

AU - Miskovic, Ana

AU - Gray, David B.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objectives: To develop a measure of natural environment and human-made change features (Chapter 2 of the international classification of functioning, disability, and health) and evaluate the influence of perceived barriers on health-related quality of life. Methods: A sample of 570 adults with stroke, spinal cord injury, and traumatic brain injury residing in community settings reported their functioning in home, outdoor, and community settings (mean age = 47.0 years, SD = 16.1). They rated 18 items with a 5-point rating scale to describe the influence of barriers to moving around, seeing objects, hearing sounds, hearing conversations, feeling safe, and regulating temperature and indicated whether any difficulties were due to environmental features. We used Rasch analysis to identify misfitting items and evaluate differential item functioning (DIF) across impairment groups. We computed correlations between barriers and patient-reported outcomes measurement information system (PROMIS) social domain measures and community participation indicators (CPI) measures. Results: The 18 items demonstrated person reliability of.70, discriminating nearly three levels of barriers. All items fit the Rasch model; impairment-related DIF was negligible. Ceiling effects were negligible, but 25 % of the respondents were at the floor, indicating that they did not experience barriers that they attributed to the built and natural environment. As anticipated, barriers correlated moderately with PROMIS and CPI variables, suggesting that although this new item bank measures a construct that is related to participation and health-related quality of life, it also captures something unique. Known-groups validity was supported by wheelchair users reporting a higher level of barriers than did ambulatory respondents. Conclusions: Preliminary evidence supports the reliability and validity of this new measure of barriers to the built and natural environment. This measure allows investigators and clinicians to measure perceptions of the natural environment and human-made changes, providing information that can guide interventions to reduce barriers. Moderate relationships between barriers and PROMIS and CPI variables provide support for the measurement and theory of environmental influences on social health and participation.

AB - Objectives: To develop a measure of natural environment and human-made change features (Chapter 2 of the international classification of functioning, disability, and health) and evaluate the influence of perceived barriers on health-related quality of life. Methods: A sample of 570 adults with stroke, spinal cord injury, and traumatic brain injury residing in community settings reported their functioning in home, outdoor, and community settings (mean age = 47.0 years, SD = 16.1). They rated 18 items with a 5-point rating scale to describe the influence of barriers to moving around, seeing objects, hearing sounds, hearing conversations, feeling safe, and regulating temperature and indicated whether any difficulties were due to environmental features. We used Rasch analysis to identify misfitting items and evaluate differential item functioning (DIF) across impairment groups. We computed correlations between barriers and patient-reported outcomes measurement information system (PROMIS) social domain measures and community participation indicators (CPI) measures. Results: The 18 items demonstrated person reliability of.70, discriminating nearly three levels of barriers. All items fit the Rasch model; impairment-related DIF was negligible. Ceiling effects were negligible, but 25 % of the respondents were at the floor, indicating that they did not experience barriers that they attributed to the built and natural environment. As anticipated, barriers correlated moderately with PROMIS and CPI variables, suggesting that although this new item bank measures a construct that is related to participation and health-related quality of life, it also captures something unique. Known-groups validity was supported by wheelchair users reporting a higher level of barriers than did ambulatory respondents. Conclusions: Preliminary evidence supports the reliability and validity of this new measure of barriers to the built and natural environment. This measure allows investigators and clinicians to measure perceptions of the natural environment and human-made changes, providing information that can guide interventions to reduce barriers. Moderate relationships between barriers and PROMIS and CPI variables provide support for the measurement and theory of environmental influences on social health and participation.

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KW - Health-related quality of life

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