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Rasch Analysis of Social Attitude Barriers and Facilitators to Participation for Individuals with Disabilities

Published:October 21, 2020DOI:https://doi.org/10.1016/j.apmr.2020.09.390

      Abstract

      Objectives

      To develop item banks of social attitude barriers and facilitators to participation and validate them with established instruments.

      Design

      We used the Rasch model to identify misfitting items and rating scale problems, calibrate items, and develop KeyForms and short forms. Correlations between the Social Attitude Barriers and Facilitators item banks with the Patient-Reported Outcomes Measurement Information System (PROMIS) Social Health domain and National Institutes of Health Toolbox Emotional Battery Social Relationships domain were computed to evaluate convergent and divergent validity.

      Setting

      Community-dwelling individuals traveled to 3 academic medical centers for testing.

      Participants

      Participants (N=558) who had a primary impairment of stroke, spinal cord injury, or traumatic brain injury (mean age, 47.0±16.0y) completed 31 social attitude facilitator and 51 barrier items using a 5-point rating scale.

      Interventions

      Not applicable.

      Main Outcome Measures

      Item banks to measure social attitude barriers and facilitators for individuals with disabilities.

      Results

      After combining the “never” and “rarely” rating scale categories, 30 Facilitator items fit the Rasch model and demonstrated person reliability of 0.93. After collapsing the “never” and “rarely” rating scale categories, 45 Barrier items fit the Rasch model and demonstrated person reliability of 0.95. Ceiling and floor effects were negligible for both item banks. Facilitators and Barriers item banks were negatively correlated, and these banks were moderately correlated with PROMIS and Toolbox measures, providing evidence of convergent and divergent validity.

      Conclusions

      Findings support the reliability and validity of the Social Attitude Facilitators and Barriers item banks. These item banks allow investigators and clinicians to measure perceptions of social attitudes, providing information that can guide individual interventions to reduce barriers and promote facilitators. Moderate correlations between the Social Attitude banks and PROMIS and Toolbox variables provide support for the measurement and theory of environmental influences on social health and participation.

      Keywords

      List of abbreviations:

      CAT (computer adaptive testing), DIF (differential item functioning), EF (environmental factor), PROMIS (Patient-Reported Outcomes Measurement Information System), NIHTB-EB (National Institutes of Health Toolbox – Emotion Battery), SCI (spinal cord injury), SF (short form), TBI (traumatic brain injury)
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      References

        • Haddock G.
        • Maio G.R.
        Contemporary perspectives on the psychology of attitudes.
        Psychology Press, New York2004
        • Commission on Social Determinants of Health
        Closing the gap in a generation: health equity through action on the social determinants of health.
        World Health Organization, Geneva2008
        • Field M.J.
        • Jette A.M.
        • Institute of Medicine
        The future of disability in America.
        National Academies Press, Washington, DC2007
        • Fougeyrollas P.
        • Cloutier R.
        • Bergeron H.
        • Côté J.
        • St Michel G.
        The Quebec classification disability creation process international network on disability creation process 1988.
        (Available at:) (Accessed October 15, 2013)
        • Oliver M.
        The politics of disablement.
        Macmillan Education, London1990
        • Whiteneck G.
        • Dijkers M.P.
        Difficult to measure constructs: conceptual and methodological issues concerning participation and environmental factors.
        Arch Phys Med Rehabil. 2009; 90: S22-S35
        • United Nations
        Convention on the Rights of Persons with Disabilities 2006.
        (Available at:) (Accessed July 30, 2019)
        • Hammel J.
        • Magasi S.
        • Heinemann A.
        • et al.
        Environmental barriers and supports to everyday participation: a qualitative insider perspective from people with disabilities.
        Arch Phys Med Rehabil. 2015; 96: 578-588
        • Hammel J.
        • Magasi S.
        • Heinemann A.
        • Whiteneck G.
        • Bogner J.
        • Rodriguez E.
        What does participation mean? An insider perspective from people with disabilities.
        Disabil Rehabil. 2008; 30: 1445-1460
        • Yuker H.E.
        • Block J.R.
        • Campbell W.J.
        A scale to measure attitudes toward disabled persons.
        Human Resources Foundation, Division of Abilities, Albertson, NY1960
        • Whiteneck G.G.
        • Harrison-Felix C.L.
        • Mellick D.C.
        • Brooks C.A.
        • Charlifue S.B.
        • Gerhart K.A.
        Quantifying environmental factors: a measure of physical, attitudinal, service, productivity, and policy barriers.
        Arch Phys Med Rehabil. 2004; 85: 1324-1335
        • Heinemann A.W.
        • Magasi S.
        • Hammel J.
        • et al.
        Environmental factors item development for persons with stroke, traumatic brain injury, and spinal cord injury.
        Arch Phys Med Rehabil. 2015; 96: 589-595
        • Keller C.
        • Siegrist M.
        Psychological resources and attitudes toward people with physical disabilities.
        J Appl Soc Psychol. 2010; 40: 389-401
        • Garcia S.F.
        • Hahn E.A.
        • Magasi S.
        • et al.
        Development of self-report measures of social attitudes that act as environmental barriers and facilitators for people with disabilities.
        Arch Phys Med Rehabil. 2015; 96: 596-603
        • Bailey I.L.
        • Lovie J.E.
        New design principles for visual acuity letter charts.
        Am J Optom Physiol Opt. 1976; 53: 740-745
        • Wilkinson G.S.
        • Robertson G.J.
        WRAT4: Wide Range Achievement Test.
        Psychological Assessment Resources, Lutz, FL2006
        • Enderby P.M.
        • Wood V.A.
        • Wade D.T.
        • Hewer R.L.
        The Frenchay Aphasia Screening Test: a short, simple test for aphasia appropriate for non-specialists.
        Disabil Rehabil. 1986; 8: 166-170
        • DeWalt D.A.
        • Rothrock N.
        • Yount S.
        • Stone A.A.
        • Group P.C.
        Evaluation of item candidates: the PROMIS qualitative item review.
        Med Care. 2007; 45: S12-S21
        • World Health Organization
        Towards a common language for functioning, disability and health: ICF.
        World Health Organization, Geneva2002
        • Castel L.D.
        • Williams K.A.
        • Bosworth H.B.
        • et al.
        Content validity in the PROMIS social-health domain: a qualitative analysis of focus-group data.
        Qual Life Res. 2008; 17: 737-749
        • Hahn E.A.
        • DeWalt D.A.
        • Bode R.K.
        • et al.
        New English and Spanish social health measures will facilitate evaluating health determinants.
        Health Psychol. 2014; 33: 490-499
        • Babakhanyan I.
        • McKenna B.S.
        • Casaletto K.B.
        • Nowinski C.J.
        • Heaton R.K.
        National Institutes of Health Toolbox Emotion Battery for English- and Spanish-speaking adults: normative data and factor-based summary scores.
        Patient Relat Outcome Meas. 2018; 9: 115-127
        • Wright B.D.
        Model selection: rating scale model (RSM) or partial credit model (PCM).
        Rasch Meas Trans. 1998; 12: 641-642
        • Linacre J.M.
        Optimizing rating scale category effectiveness.
        J Appl Meas. 2002; 3: 85-106
        • Charles E.P.
        The correction for attenuation due to measurement error: clarifying concepts and creating confidence sets.
        Psychol Methods. 2005; 10: 206-226
        • Schmidt F.L.
        • Hunter J.E.
        Theory testing and measurement error.
        Intelligence. 1999; 27: 183-198
        • Boone W.J.
        • Staver J.R.
        • Yale M.S.
        Rasch analysis in the human sciences.
        Springer, New York2013
        • Linacre J.M.
        Reliability, separation and strata: percentage of sample in each level.
        Rasch Meas Transact. 2013; 26: 1399
        • Dunn D.S.
        • Burcaw S.
        Disability identity: exploring narrative accounts of disability.
        Rehabil Psychol. 2013; 58: 148-157
        • Gill C.J.
        Four types of integration in disability identity development.
        J Vocat Rehabil. 1997; 9: 39-46
        • Olkin R.
        • Pledger C.
        Can disability studies and psychology join hands?.
        Am Psychol. 2003; 58: 296-304
        • Daruwalla P.
        • Darcy S.
        Personal and societal attitudes to disability.
        Ann Tour Res. 2005; 32: 549-570
        • Keller R.M.
        • Galgay C.E.
        Microaggressive experiences of people with disabilities.
        John Wiley & Sons, Hoboken, NH2010
        • Sue D.W.
        Microaggressions in everyday life: race, gender, and sexual orientation.
        John Wiley & Sons, Hoboken, NJ2010
        • Velozo C.A.
        • Woodbury M.L.
        Translating measurement findings into rehabilitation practice: an example using Fugl-Meyer Assessment-Upper Extremity with patients following stroke.
        J Rehab Res Dev. 2011; 48: 1211-1222
        • Kimberlin S.E.
        Political science theory and disability.
        J Hum Behav Soc Environ. 2009; 19: 26-43
        • Commission on Social Determinants of Health
        Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health.
        World Health Organization, Geneva2008
        • Office of Disease Prevention and Health Promotion
        Healthy People 2020.
        (Available at:)
        https://www.healthypeople.gov/2020/
        Date accessed: April 28, 2019
        • Magasi S.
        • Wong A.
        • Gray D.B.
        • et al.
        Theoretical foundations for the measurement of environmental factors and their impact on participation among people with disabilities.
        Arch Phys Med Rehabil. 2015; 96: 569-577
        • Wong A.W.
        • Ng S.
        • Dashner J.
        • et al.
        Relationships between environmental factors and participation in adults with traumatic brain injury, stroke, and spinal cord injury: a cross-sectional multi-center study.
        Qual Life Res. 2017; 26: 2633-2645