4.5 Article

Construct validity of the enfranchisement scale of the community participation indicators

Journal

CLINICAL REHABILITATION
Volume 36, Issue 2, Pages 263-271

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/02692155211040930

Keywords

Validity; patient-centred outcome measure; community participation

Categories

Funding

  1. National Institute of Disability, Independent Living, and Rehabilitation Research through a Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes grant [H133B090024]
  2. National Institute on Disability and Rehabilitation Research [H133F140037]
  3. University of Pittsburgh School of Health and Rehabilitation Sciences Dissertation Fund

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This study examined the construct validity of the Enfranchisement scale from the Community Participation Indicators, demonstrating a strong association with measures of participation and a weaker association with cognition. The Importance subscale showed close relationships with factors like depression, systems, services, and policies. Both subscales were linked to social attitudes and social support, emphasizing the importance of the environment in enfranchisement outcomes.
Objective: This study examined the construct validity of the Enfranchisement scale of the Community Participation Indicators. Design: We conducted a secondary analysis of data collected in a cross-sectional study of rehabilitation outcomes. Subjects: The parent study included 604 community-dwelling adults with chronic traumatic brain injury, stroke, or spinal cord injury. The sample had a mean age of 64.1 years, was two-thirds male, and included a high proportion of racial minorities (n = 250, 41.4%). Main measures: The Enfranchisement scale contains two subscales: the Control subscale and the Importance subscale. We examined correlations between each Enfranchisement subscale and measures of participation, environment, and impairments. The current analyses included cases with at least 80% of items completed on each subscale (Control subscale: n = 391; Importance subscale: n = 219). Missing values were imputed using multiple imputation. Results: The sample demonstrated high scores, indicating poor enfranchisement (Control subscale: M = 51.7; Importance subscale: M = 43.0). Both subscales were most strongly associated with measures of participation (Control subscale: r = 0.56; Importance subscale: r = 0.52), and least strongly associated with measures of cognition (Control subscale: r = 0.03; Importance subscale: r = 0.03). The Importance subscale was closely associated with depression (r = 0.54), and systems, services, and policies (r = 0.50). Both subscales were associated with social attitudes (Control subscale: r = 0.44; Importance subscale: r = 0.44) and social support (Control subscale: r = 0.49; Importance subscale: r = 0.41). Conclusions: We found evidence of convergent validity between the Enfranchisement scale and measures of participation, and discriminant validity between the Enfranchisement scale and measures of disability-related impairments. The analyses also revealed the importance of the environment to enfranchisement outcomes.

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