title: An Item Bank to Measure Systems, Services, and Policies: Environmental Factors Affecting People With Disabilities.
abstract: To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life.
  
  
  
  Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity.
  
  
  
  Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place.
  
  
  
  Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking.
  
  
  
  Not applicable.
  
  
  
  An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities.
  
  
  
  We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation.
  
  
  
  The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure perceptions of systems, services, and policies resources reliably with the items described here. Moderate relations between systems, services, and policies facilitators and PROMIS and CPI variables provide support for the measurement and theory of environmental effects on social functioning related to participation.
authors.affiliation: Department of Medical Social Sciences and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: js-lai@northwestern.edu.
authors.forename: Jin-Shei
authors.initials: JS
authors.lastname: Lai
authors.affiliation: Department of Occupational Therapy, University of Illinois, Chicago, Chicago, IL.
authors.forename: Joy
authors.initials: J
authors.lastname: Hammel
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
authors.forename: Sara
authors.initials: S
authors.lastname: Jerousek
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
authors.forename: Arielle
authors.initials: A
authors.lastname: Goldsmith
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
authors.forename: Ana
authors.initials: A
authors.lastname: Miskovic
authors.affiliation: Program in Occupational Therapy, Washington University, St Louis, MO.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Baum
authors.affiliation: Program in Occupational Therapy, Washington University, St Louis, MO.
authors.forename: Alex W
authors.initials: AW
authors.lastname: Wong
authors.affiliation: Program in Occupational Therapy, Washington University, St Louis, MO.
authors.forename: Jessica
authors.initials: J
authors.lastname: Dashner
authors.affiliation: Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
mesh_terms: D000328:Adult; D000368:Aged; D001107:Architectural Accessibility / Q000592:standards; D001930:Brain Injuries / Q000534:rehabilitation; D003153:Community Health Services / Q000458:organization & administration* / Q000592:standards; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D005163:Factor Analysis, Statistical; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D064702:International Classification of Functioning, Disability and Health / Q000458:organization & administration* / Q000592:standards; D008875:Middle Aged; D017060:Patient Satisfaction; D057766:Policy; D011594:Psychometrics; D036301:Qualitative Research; D011788:Quality of Life; D058992:Social Participation; D012944:Social Support; D012947:Social Work / Q000458:organization & administration* / Q000592:standards; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation; D000071939:Stroke Rehabilitation
keywords: Environment; International Classification of Functioning, Disability and Health; Patient outcome assessment; Quality of life; Rehabilitation; Surveys and questionnaires