Environmental Factors Item Development for Persons With Stroke, Traumatic Brain Injury, and Spinal Cord Injury

Arch Phys Med Rehabil, 2015 · DOI: 10.1016/j.apmr.2013.11.024 · Published: April 1, 2015

Simple Explanation

This research focuses on creating ways to measure how environmental factors affect the participation of people with disabilities, specifically those with stroke, traumatic brain injury (TBI), and spinal cord injury (SCI). The study uses a detailed process including reviewing existing research, categorizing items, writing new items, and testing them with individuals who have experienced stroke, TBI, or SCI. The goal is to develop reliable and valid tools that can help understand and address the environmental barriers that prevent people with disabilities from fully participating in their communities.

Study Duration

Not specified

Participants

Content area and outcome measurement experts (n=10), individuals with stroke, TBI, SCI (n=200), cognitive testing (n=15)

Evidence Level

Not specified

Key Findings

1
The study identified six key domains of environmental factors: assistive technology; built and natural environment; social environment; services, systems, and policies; access to information and technology; and economic quality of life.
2
Initial item reduction resulted in a pool of 291 items for cognitive testing, which was further refined to 274 items for pilot data collection.
3
Cognitive interviews with individuals with stroke, TBI, and SCI led to the revision of 57 items and the deletion of 17, improving clarity and relevance.

Research Summary

This study describes the methods used to develop measures of environmental factors that affect participation after stroke, traumatic brain injury, and spinal cord injury. The research involved extensive literature review, item classification and selection, item writing, and cognitive testing. The study concludes with an initial item set of facilitators and barriers to participation, categorized into six domains, ready for pilot data collection and further psychometric evaluation.

Practical Implications

Clinical Practice

Clinicians can use the developed items to identify modifiable environmental factors that limit participation and life satisfaction for patients with stroke, TBI, and SCI.

Research

Researchers can utilize the environmental factor measures to gain a fuller understanding of how these factors affect participation and quality of life.

Advocacy

Disability advocates can leverage the detailed information about environmental factors to advocate for the elimination of barriers and promotion of inclusive policies.

Study Limitations

1
Limited number of participants in focus groups and cognitive interviews.
2
Geographic sampling limited to Colorado, Illinois, and New Jersey, primarily from urban and suburban communities.
3
Reliance on focus groups conducted in earlier projects may have constrained the breadth of environmental factor information.

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