Abstract
Objective
To compare the psychometric properties of 2 commonly used participation measures:
the Community Reintegration of Service Members (CRIS) and the Participation Assessment
with Recombined Tools-Objective (PART-O) in veterans with mild traumatic brain injury
(mTBI).
Design
Data were collected from 2 cross-sectional observation studies conducted in 2 Veterans
Affairs medical centers.
Setting
Questionnaires were completed in-person or by mail.
Participants
Veterans with mTBI (N=201) were recruited from the Michael E. DeBakey Veterans Affairs
Medical Center in Houston (n=94) and the Malcom Randall North Florida/South Georgia
Veterans Health System (n=107).
Interventions
Not applicable.
Main Outcome Measures
CRIS and PART-O.
Results
We conducted Rasch analysis on the PART-O and on 3 subscales of the CRIS (extent of
participation, perceived limitation, and satisfaction). For PART-O, results showed
PART-O has questionable unidimensionality. For both instruments, some rating categories
were underused, and rating scales did not advance accordingly. Compared with PART-O,
the CRIS was able to distinguish more categories of person's ability (>5 vs 2 for
PART-O) and had better internal consistency as indicated by higher Cronbach α (.96–.98
vs .65 for PART-O).
Conclusions
To capture participation unique to veterans with mTBI, CRIS has greater potential
to detect a change in participation and is therefore recommended over PART-O. Rating
scales of both instruments, however, need further refinement. We suggest future studies
examine collapsed rating categories and use qualitative methods to redefine categories.
Keywords
List of abbreviations:
CRIS (Community Reintegration of Service Members), mTBI (mild traumatic brain injury), PART-O (Participation Assessment with Recombined Tools-Objective), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model Systems)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery.RAND Corp, Santa Monica, CA2008
Bagalman E. Mental disorders among OEF/OIF veterans using VA health care: facts and figures. 2013. Available at: https://fas.org/sgp/crs/misc/R41921.pdf. Accessed July 28, 2017.
- Veterans using and uninsured veterans not using Veterans Affairs (VA) health care.Public Health Rep. 2007; 122: 93-100
- Defense and Veterans Brain Injury Center.(Available at:) (Accessed June 30, 2017)
- Executive functioning of combat mild traumatic brain injury.Appl Neuropsychol Adult. 2016; 23: 115-124
- Mild traumatic brain injury in U.S. soldiers returning from Iraq.N Engl J Med. 2008; 358: 453-463
- Neuropsychological outcomes of mild traumatic brain injury, post-traumatic stress disorder and depression in Iraq-deployed US army soldiers.Br J Psychiatry. 2012; 201: 186-192
- Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care.Psychiatr Serv. 2010; 61: 589-597
- International classification of functioning, disability and health.World Health Organization, Geneva2001
- What is community integration anyway?: defining meaning following traumatic brain injury.J Head Trauma Rehabil. 2010; 25: 121-127
- The definition of community integration: perspectives of people with brain injuries.Brain Inj. 1998; 12: 15-30
- Recommendations for the use of common outcome measures in traumatic brain injury research.Arch Phys Med Rehabil. 2010; 91: 1650-1660.e17
- Development of the participation assessment with recombined tools-objective for use after traumatic brain injury.Arch Phys Med Rehabil. 2011; 92: 542-551
- Comparison of scoring methods for the participation assessment with recombined tools-objective.Arch Phys Med Rehabil. 2011; 92: 552-563
- Another look at the PART-O using the traumatic brain injury model systems national database: scoring to optimize psychometrics.Arch Phys Med Rehabil. 2016; 97: 211-217
- Development of CRIS: measure of community reintegration of injured service members.J Rehabil Res Dev. 2009; 46: 469-480
- Measurement of community reintegration in sample of severely wounded servicemembers.J Rehabil Res Dev. 2011; 48: 89-101
- The community integration questionnaire: Factor structure across racial/ethnic groups in persons with traumatic brain injury.J Head Trauma Rehabil. 2013; 28: E14-E22
- Psychometric theory.3rd ed. McGraw-Hill, New York1994
- Sample size and item calibration stability.Rasch Measurement Transactions. 1994; 7: 328
- Item parameter recovery, standard error estimates, and fit statistics of the winsteps program for the family of rasch models.Educ Psychol Meas. 2005; 65: 376-404
- Reasonable mean-square fit values.Rasch Measurement Transactions. 1994; 8: 370
- Rating scale analysis. Rasch measurement.ERIC, Chicago, IL1982
- Reliability and separation of measures.(Available at:) (Accessed November 2016)
- Optimizing rating scale category effectiveness.J Appl Meas. 2002; 3: 85-106
- Winsteps® Rasch measurement computer program user's guide.Winsteps.com, Beaverton2016
- Variance in data explained by Rasch measures.Rasch Meas Trans. 2008; 22: 1164
- Issues in participation measurement in research and clinical applications.Arch Phys Med Rehabil. 2010; 91: S72-S76
- Utility of the mayo-portland adaptability inventory-4 for self-reported outcomes in a military sample with traumatic brain injury.Arch Phys Med Rehabil. 2013; 94: 2417-2424
Article info
Publication history
Published online: June 02, 2017
Footnotes
Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, as part of the Medical Rehabilitation Research Infrastructure Network (Boston Rehabilitation Outcome Center) (grant no. 5R24HD065688-05) and in part by the Department of Veterans Affairs Rehabilitation Research and Development (grant no. B0902-W).
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
