title: Measuring Environmental Factors: Unique and Overlapping International Classification of Functioning, Disability and Health Coverage of 5 Instruments.
abstract: To describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and to evaluate the EFIB's construct validity by examining associations with legacy instruments.
  
  
  
  Cross-sectional, observational cohort.
  
  
  
  Community.
  
  
  
  A sample of community-dwelling adults with stroke, spinal cord injury, and traumatic brain injury (N=568).
  
  
  
  None.
  
  
  
  EFIB covering domains of the built and natural environment; systems, services, and policies; social environment; and access to information and technology; the Craig Hospital Inventory of Environmental Factors (CHIEF) short form; the Facilitators and Barriers Survey/Mobility (FABS/M) short form; the Home and Community Environment Instrument (HACE); the Measure of the Quality of the Environment (MQE) short form; and 3 of the Patient Reported Outcomes Measurement Information System's (PROMIS) Quality of Social Support measures.
  
  
  
  The EFIB and legacy instruments assess most of the International Classification of Functioning, Disability and Health (ICF) environmental factors chapters, including chapter 1 (products and technology; 75 items corresponding to 11 codes), chapter 2 (natural environment and human-made changes; 31 items corresponding to 7 codes), chapter 3 (support and relationships; 74 items corresponding to 7 codes), chapter 4 (attitudes; 83 items corresponding to 8 codes), and chapter 5 (services, systems, and policies; 72 items corresponding to 16 codes). Construct validity is provided by moderate correlations between EFIB measures and the CHIEF, MQE barriers, HACE technology mobility, FABS/M community built features, and PROMIS item banks and by small correlations with other legacy instruments. Only 5 of the 66 legacy instrument correlation coefficients are moderate, suggesting they measure unique aspects of the environment, whereas all intra-EFIB correlations were at least moderate.
  
  
  
  The EFIB measures provide a brief and focused assessment of ICF environmental factor chapters. The pattern of correlations with legacy instruments provides initial evidence of construct validity.
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: a-heinemann@northwestern.edu.
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
authors.forename: Ana
authors.initials: A
authors.lastname: Miskovic
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
authors.forename: Patrick
authors.initials: P
authors.lastname: Semik
authors.affiliation: Program in Occupational Therapy, Washington University in St Louis, St Louis, MO; Department of Neurology, Washington University in St Louis, St Louis, MO.
authors.forename: Alex
authors.initials: A
authors.lastname: Wong
authors.affiliation: Program in Occupational Therapy, Washington University in St Louis, St Louis, MO; Department of Neurology, Washington University in St Louis, St Louis, MO.
authors.forename: Jessica
authors.initials: J
authors.lastname: Dashner
authors.affiliation: Program in Occupational Therapy, Washington University in St Louis, St Louis, MO; Department of Neurology, Washington University in St Louis, St Louis, MO; Brown School of Social Work, Washington University in St Louis, St Louis, MO.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Baum
authors.affiliation: Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL.
authors.forename: Susan
authors.initials: S
authors.lastname: Magasi
authors.affiliation: Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL; Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL.
authors.forename: Joy
authors.initials: J
authors.lastname: Hammel
authors.affiliation: The Center for Assessment Research and Translation, University of Delaware, Newark, DE; Department of Physical Therapy, University of Delaware, Newark, DE; Department of Psychological and Brain Sciences, University of Delaware, Newark, DE.
authors.forename: David S
authors.initials: DS
authors.lastname: Tulsky
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Sofia F
authors.initials: SF
authors.lastname: Garcia
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
authors.forename: Sara
authors.initials: S
authors.lastname: Jerousek
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Jin-Shei
authors.initials: JS
authors.lastname: Lai
authors.affiliation: Center for Clinical Outcomes Development and Application, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
authors.forename: Noelle E
authors.initials: NE
authors.lastname: Carlozzi
authors.affiliation: Program in Occupational Therapy, Washington University in St Louis, St Louis, MO.
authors.forename: David B
authors.initials: DB
authors.lastname: Gray
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation; D003153:Community Health Services / Q000458:organization & administration* / Q000592:standards; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D004777:Environment; D005260:Female; D006801:Humans; D064702:International Classification of Functioning, Disability and Health / Q000458:organization & administration* / Q000592:standards; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D012931:Social Environment; D012947:Social Work / Q000458:organization & administration* / Q000592:standards; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000523:psychology / Q000534:rehabilitation; D000071939:Stroke Rehabilitation / Q000523:psychology
keywords: Attitude; Environment; Rehabilitation