Understanding Health-Related Quality of Life of Caregivers of Civilians and Service Members/Veterans With Traumatic Brain Injury: Establishing the Reliability and Validity of PROMIS Social Health Measures

Published:August 01, 2018DOI:


      • Patient-Reported Outcomes Measurement Information System (PROMIS) social health measures are both reliable and valid in caregivers.
      • PROMIS social health measures are brief (<45s for each measure).
      • Caring for an individual with a brain injury can significantly affect social health.



      To examine the reliability and validity of the short form (SF) and computer adaptive test (CAT) versions of the Patient-Reported Outcomes Measurement Information System (PROMIS) measures of social health of caregivers of civilians and service members/veterans (SMVs) with traumatic brain injury (TBI).


      Self-report questionnaires administered through an online data collection platform.


      Hospital and community-based outreach at 3 TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility.


      Caregivers (N=560) (344 civilians and 216 military) of individuals with a documented TBI.


      Not applicable.

      Main Outcome Measures

      A total of 5 PROMIS social health measures.


      All 5 PROMIS social health measures exceeded the a priori criterion for internal consistency reliability (≥0.70); most PROMIS measures met the criterion for test-retest reliability (≥0.70) in the civilian sample; in the SMV sample, test-retest reliability was generally below this criterion, except for social isolation. For both samples, convergent validity was supported by moderate correlations between the 5 PROMIS social health measures and related measures, and discriminant validity was supported by low correlations between PROMIS social health measures and measures of dissimilar constructs. Most PROMIS scores indicated significantly worse social health in both samples of those caring for individuals who were low functioning. Finally, impairment rates in social health were elevated for those caring for low-functioning individuals, especially in the SMV sample.


      The PROMIS CAT and SF social health measures have potential clinical utility for use in caregivers of civilians and SMVs with TBI.


      List of abbreviations:

      CAT (computer adaptive test), CAS (Caregiver Appraisal Scale), HRQOL (health-related quality of life), MPAI-4 (Mayo-Portland Adaptability Inventory-Fourth Edition), PROMIS (Patient-Reported Outcomes Measurement Information System), SF (short form), SRA (social roles and activities), SMV (service member/veteran), TBI (traumatic brain injury), UM (University of Michigan), ZBI (Zarit Burden Interview)
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