Quantifying environmental factors: a measure of physical, attitudinal, service, productivity, and policy barriers.
OBJECTIVE
To develop and test a new instrument to assess environmental barriers encountered by people with and without disabilities by using a questionnaire format.


METHODS
New instrument development.


METHODS
A rehabilitation hospital and community.


METHODS
Two convenience samples: (1) 97 subjects, 50 with disabilities and 47 without disability, and (2) 409 subjects with disabilities from spinal cord injury, traumatic brain injury, multiple sclerosis, amputation, or auditory or visual impairments. In addition, a population-based sample in Colorado of 2269 people (mean age, 44 y; 57% men) with and without disabilities.


METHODS
Not applicable.


METHODS
Item development; factor structure; test-retest, subject-proxy and internal consistency reliability; content, construct, and discriminant validity; and subscale and abbreviated version development.


RESULTS
Panels of experts on disability developed items for the Craig Hospital Inventory of Environmental Factors (CHIEF). The instrument measured the frequency and magnitude of environmental barriers reported by individuals. Five subscales were derived from factor analysis measuring (1) attitudes and support, (2) services and assistance, (3) physical and structural, (4) policy, and (5) work and school environmental barriers. The CHIEF total score had high test-retest reliability (intraclass correlation coefficient [ICC]=.93) and high internal consistency (Cronbach alpha=.93), but lower participant-proxy agreement (ICC=.62). Significant differences were found in CHIEF scores among groups of people with known differences in disability levels and disability categories.


CONCLUSIONS
The CHIEF has good test-retest and internal consistency reliability with evidence of content, construct, and discriminant validity resulting from its development strategy and psychometric assessments in samples of the general population and among people with a variety of disabilities.
Research Department, Craig Hospital, Englewood, CO 80113, USA.
Gale G
GG
Whiteneck
Cynthia L
CL
Harrison-Felix
David C
DC
Mellick
C A
CA
Brooks
Susan B
SB
Charlifue
Ken A
KA
Gerhart
D000203:Activities of Daily Living; D000328:Adult; D001107:Architectural Accessibility / Q000592:standards; D001294:Attitude to Health; D016022:Case-Control Studies; D003120:Colorado; D018672:Community Health Planning; D006233:Persons with Disabilities / Q000523:psychology*; D016002:Discriminant Analysis; D017598:Efficiency, Organizational; D004777:Environment; D005163:Factor Analysis, Statistical; D005260:Female; D006272:Health Facility Environment / Q000592:standards*; D006291:Health Policy; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008297:Male; D017146:Models, Organizational; D020380:Needs Assessment; D011594:Psychometrics; D012944:Social Support; D011795:Surveys and Questionnaires / Q000592:standards*