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Developing a Barriers Scale in the Context of Travel: TRIP

Published:August 14, 2018DOI:https://doi.org/10.1016/j.apmr.2018.07.424

      Abstract

      Objective

      To develop an environmental-barriers scale, Travel Restrictions Influencing Participation (TRIP), in the context of travel for people living with spinal cord injury (SCI).

      Design

      A mixed-method approach where, in the qualitative phase, items were developed and written based on results of interviewers with different stakeholder groups and, in the quantitative phase, survey data were collected to examine the psychometric properties of the scale.

      Setting

      Home, work, and community settings.

      Participants

      People living with SCI, caregivers/family members, therapists, and travel professionals (N=333).

      Interventions

      None.

      Main Outcome Measures

      A 19-item TRIP scale that measures the travel barriers encountered by people with SCI.

      Results

      Results from 83 semi-structured in-depth interviews with 4 stakeholder groups guided the writing of items in the TRIP scale. Seven cognitive interviews and an expert panel conducted reviews for content validity of the scale, and 19 items were included in the quantitative assessment of the scale. A total of 250 patients enrolled in the Rocky Mountain Regional Spinal Injury System was systematically selected to report their experience with each travel barrier. Item-response theory–based Rasch analysis revealed that TRIP has acceptable psychometric properties.

      Conclusions

      The 19-item TRIP scale demonstrates promising psychometric properties for the scale to be used in clinical settings to quickly identify environmental barriers individuals with SCI encounter when traveling. It has the potential to assist with developing interventions that will improve the travel experience of individuals with SCI or to assist with strategies to overcome travel barriers.

      Keywords

      List of abbreviations:

      CFA (confirmatory factor analysis), DIF (differential item functioning), EFA (exploratory factor analysis), ICF (International Classification of Functioning, Disability and Health), RSM (Rasch-Andrich Ratings Scale Model), SCI (spinal cord injury), TRIP (Travel Restrictions Influencing Participation)
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