People at picnic

What is the study about?

One measurement used to assess the level of community integration of people who have incurred traumatic brain injury (TBI) is the Community Integration Questionnaire (CIQ). This questionnaire has 15 elements, which are grouped into three subscales: home integration, social activity, and productive activity. The purpose of this study was to investigate whether this categorization can be used to accurately assess the degree of community integration for people who selfidentify as White, Black, or Hispanic. Some have argued that disparity in outcome may be caused by the use of measures that may not be applicable to racial and ethnic minorities.

What did the study find?

Results showed that the grouping of the subscales best matched the sample of Whites. The fit was poorer for Blacks and worst for Hispanics. These results indicate that community participation has cultural elements in addition to level of impairment. This study identified that the CIQ subscale grouping may not fit all racial/ethnic minorities similarly. However, more research is needed to identify why these differences exist and to test whether factors in addition to race and ethnicity, such as education and employment, play a role.

Who participated in the study?

The CIQ was administered as a 1-year followup for participants from the Traumatic Brain Injury Model System National Database, which has medical records for patients from various Model Systems (i.e., Federally funded medical centers). Survey responses were successfully collected from 2,315 participants. After excluding the survey results with missing values and responses from those who had retired at the time of followup, the final sample included 1,756 participants (1,192 White, 450 Black, and 114 Hispanic).

How was the study conducted?

The questionnaire was tested using statistical analysis to examine whether the three subscales fit the characteristics of the three ethnic groups—White, Black, and Hispanic.


1 Lequerica, A. H., Chiaravalloti, N. D., Sander, A. M., Pappadis, M. R., Arango-Lasprilla, J. C., Hart, T., … Sherman, T. E. (2013). The Community Integration Questionnaire: Factor structure across racial/ethnic groups in persons with traumatic brain injury. Journal of Head Trauma Rehabilitation, 93, 2237–2243.

2 Sanders, A. M., Clark A., & Pappadis, M. R. (2010). What is community integration anyway? Defining meaning following traumatic brain injury. Journal of Head Trauma Rehabilitation, 25, 121–127.

The contents of this quick review were developed under a grant from the Department of Education, NIDRR grant number H133A110004. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.