title: Field-testing of the rapid assessment of disability questionnaire.
abstract: BACKGROUND
  The Rapid Assessment of Disability (RAD) questionnaire measures the magnitude and impact of disability and aims to inform the design of disability inclusive development programs. This paper reports the psychometric evaluation of the RAD.
  
  
  METHODS
  The initial version of the RAD comprised five sections: 1) demographics, 2) functioning, 3) rights awareness, 4) well-being, and 5) access to the community. Item functioning and construct validity were assessed in a population-based study in Bangladesh. Data were analysed using descriptive statistics (sections 2 and 5) and Rasch modelling (sections 3 and 4). A subsequent case-control study in Fiji tested the refined questionnaire in a cross-cultural setting and assessed the sensitivity and specificity of the RAD section 2 to identify people with disability.
  
  
  RESULTS
  2,057 adults took part in the study (1,855 in Bangladesh and 202 in Fiji). The prevalence of disability estimated using RAD section 2 in Bangladesh was 10.5% (95% CI 8.8-12.2), with satisfactory sensitivity and specificity (62.4% and 81.2%, respectively). Section 3 exhibited multidimensionality and poor differentiation between levels of rights awareness in both Bangladesh (person separation index [PSI] = 0.71) and Fiji (PSI = 0.0), and was unable to distinguish between people with and without disability (Bangladesh p = 0.786, Fiji p = 0.43). This section was subsequently removed from the questionnaire pending re-development. Section 4 had good ability to differentiate between levels of well-being (PSI = 0.82). In both countries, people with disability had significantly worse well-being scores than people without disability (p < 0.001) and also access to all sectors of community except legal assistance, drinking water and toilets (p < 0.001).
  
  
  CONCLUSIONS
  Filed-testing in Bangladesh and Fiji confirmed the psychometric robustness of functioning, well-being, and community access sections of the RAD. Information from the questionnaire can be used to inform and evaluate disability inclusive development programs.
authors.affiliation: Nossal Institute for Global Health, University of Melbourne, Level 4, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3010, Australia. marella.m@unimelb.edu.au.
authors.forename: Manjula
authors.initials: M
authors.lastname: Marella
authors.forename: Lucy
authors.initials: L
authors.lastname: Busija
authors.forename: Fakir M Amirul
authors.initials: FM
authors.lastname: Islam
authors.forename: Alexandra
authors.initials: A
authors.lastname: Devine
authors.forename: Kathy
authors.initials: K
authors.lastname: Fotis
authors.forename: Sally M
authors.initials: SM
authors.lastname: Baker
authors.forename: Beth
authors.initials: B
authors.lastname: Sprunt
authors.forename: Tanya J
authors.initials: TJ
authors.lastname: Edmonds
authors.forename: Nafisa Lira
authors.initials: NL
authors.lastname: Huq
authors.forename: Anaseini
authors.initials: A
authors.lastname: Cama
authors.forename: Jill E
authors.initials: JE
authors.lastname: Keeffe
mesh_terms: D000328:Adult; D000368:Aged; D001364:Awareness; D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D005367:Fiji; D006262:Health; D006806:Human Rights; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult