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

Arch Phys Med Rehabil, 2021 · DOI: 10.1016/j.apmr.2020.09.390 · Published: April 1, 2021

Simple Explanation

This study focuses on understanding how social attitudes can either help or hinder people with disabilities from participating fully in their communities. It aims to create and test tools that measure these social attitudes. The researchers developed 'item banks' to measure social attitude barriers and facilitators. These item banks were tested to ensure they are reliable and valid measures. The findings support that the developed tools are reliable and valid, allowing clinicians and researchers to measure perceptions of social attitudes. This information can then be used to design interventions that reduce barriers and enhance facilitators for people with disabilities.

Study Duration

Not specified

Participants

558 community-dwelling adults with stroke, spinal cord injury, or traumatic brain injury

Evidence Level

Not specified

Key Findings

1
The Social Attitude Facilitators item bank, after combining some response categories, consisted of 30 items and showed high reliability (0.93).
2
The Social Attitude Barriers item bank, after adjustments, included 45 items with a reliability of 0.95, indicating the items consistently distinguished between levels of perceived barriers.
3
Both item banks demonstrated negligible ceiling and floor effects, and showed moderate correlations with other established measures of social health, supporting their validity.

Research Summary

The study developed and validated item banks to measure social attitude barriers and facilitators for people with disabilities using the Rasch model. The resulting item banks demonstrated good reliability and validity, with negligible ceiling and floor effects, and moderate correlations with other measures of social health. The findings support the use of these item banks by investigators and clinicians to measure perceptions of social attitudes, inform interventions, and promote the health and participation of people with disabilities.

Practical Implications

Clinical Assessment

Clinicians can use the item banks to assess social attitudes experienced by persons with disabilities.

Intervention Planning

Understanding perceived barriers can help identify targets for intervention and design therapy goals.

Policy and Systems Change

The item banks' hierarchy can inform policy- or systems-level interventions.

Study Limitations

1
The sample included people with only three types of impairments from three metropolitan areas in the Midwestern United States.
2
The 2-day assessment period might have created a selection bias toward persons who were able to travel to the testing sites and with better health statuses.
3
The item banks primarily measure self-perceived social attitudes. Some individuals may be unaware of structural forms of discrimination.

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