Construct validity of the enfranchisement scale of the community participation indicators

Abstract

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.

Cut points and sensitivity to change of the Enfranchisement scale of the Community Participation Indicators in adults with traumatic brain injury

“…It is possible that these differences may be attributed to the experience of enfranchisement across diagnostic groups and their associated clinical presentations (eg, differences in age, physical function, communication, and social skills). However, previous studies have shown that there are few differences in enfranchisement scores across diagnostic groups (TBI, stroke, spinal cord injury) in samples larger than ours 5,6,7,36 . It is also possible that our results differed because of differences in sampling approaches.…”

“…However, previous studies have shown that there are few differences in enfranchisement scores across F I G U R E 2 Distribution of change scores: Importance subscale diagnostic groups (TBI, stroke, spinal cord injury) in samples larger than ours. 5,6,7,36 It is also possible that our results differed because of differences in sampling approaches. We specifically recruited people with recent brain injuries, or who were still undergoing rehabilitation therapies, whereas previous studies have intentionally sought participants in a more chronic or stable phase of recovery.…”

“…5,6 The content of this measure was developed using stakeholder perspectives and was refined using factor analysis and Rasch analysis. [4][5][6] Recent research by our team has also examined construct validity in a sample of adults with disability (stroke, spinal cord injury, and traumatic brain injury [TBI]) 7 and sensitivity to change in a sample of adults with stroke. 8 Each of these studies has revealed that disenfranchisement is widespread in people with disabilities, including people with TBI.…”

Risk prevention and early diagnosis of sports-related chronic brain injury

“…In 2011, a two-day evaluation of 100 professional American football players and 50 non-confrontational athletes was conducted in the United States, which included: sports history, history of previous brain injury; cognitive, emotional and behavioral testing; lumbar puncture for cerebrospinal fluid protein levels; EEG and neuroimaging, using DTI, fMRI, MRS and other technical means [8]. Another recent clinical prospective study of brain injury in athletes was conducted by American neuroscientists.…”

Assessing the role of sustainable strategies in alleviating energy poverty: an environmental sustainability paradigm

“…Convergent and discriminant validity are established to evaluate construct validity (Kersey et al 2022). Convergent validity occurs when measured items converge on the underlying construct; AVE > 0.50 indicates convergent statistical validity (Hair et al 2021).…”