title: Development of a community health inclusion index: an evaluation tool for improving inclusion of people with disabilities in community health initiatives.
abstract: BACKGROUND
  Community health initiatives often do not provide enough supports for people with disabilities to fully participate in healthy, active living opportunities. The purpose of this study was to design an instrument that focused on integrating disability-related items into a multi-level survey tool that assessed healthy, active living initiatives.
  
  
  METHODS
  The development and testing of the Community Health Inclusion Index (CHII) involved four components: (a) literature review of studies that examined barriers and facilitators to healthy, active living; (b) focus groups with persons with disabilities and professionals living in geographically diverse settings; (c) expert panel to establish a final set of critical items; and (d) field testing the CHII in 164 sites across 15 communities in 5 states to assess the instrument's reliability.
  
  
  RESULTS
  Results from initial analysis of these data indicated that the CHII has good reliability. Depending on the subscale, Cronbach's alpha ranged from 0.700 to 0.965. The CHII's inter-rater agreement showed that 14 of the 15 venues for physical activity or healthy eating throughout a community had strong agreement (0.81 - 1.00), while one venue had substantial agreement (0.61 - 0.80).
  
  
  CONCLUSIONS
  The CHII is the first instrument to operationalize community health inclusion into a comprehensive assessment tool that can be used by public health professionals and community coalitions to examine the critical supports needed for improving healthy, active living among people with disabilities.
authors.affiliation: Institute on Disability and Human Development, 1640 W. Roosevelt Rd. M/C 626, Chicago, IL, 60608, USA. yeisen2@uic.edu.
authors.forename: Yochai
authors.initials: Y
authors.lastname: Eisenberg
authors.affiliation: University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, 4000 Ridgeway Dr., Birmingham, 35209, AL, USA. jrimmer@uab.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Rimmer
authors.affiliation: University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, 4000 Ridgeway Dr., Birmingham, 35209, AL, USA. tapan@uab.edu.
authors.forename: Tapan
authors.initials: T
authors.lastname: Mehta
authors.affiliation: Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E88, Atlanta, GA, 30333, USA. imv9@cdc.gov.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003153:Community Health Services / Q000458:organization & administration*; D006233:Persons with Disabilities / Q000523:psychology*; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D011633:Public Facilities; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012574:Schools; D058992:Social Participation; D011795:Surveys and Questionnaires; D017132:Workplace; D055815:Young Adult