Measuring participation enfranchisement

Arch Phys Med Rehabil. 2011 Apr;92(4):564-71. doi: 10.1016/j.apmr.2010.07.220. Epub 2011 Mar 2.


Objective: To reflect the perspectives of rehabilitation stakeholders in a measure of participation enfranchisement that can be used by people with and without disabilities.

Design: Survey.

Setting: Community settings.

Participants: We pilot-tested a draft instrument with 326 adults who had sustained stroke, spinal cord injury, traumatic brain injury, or other disabling condition, as well as a general population sample. We administered a revised version of the instrument to a statewide sample drawn from the 2006 Colorado Behavioral Risk Factors Surveillance System that included persons with (N=461) and without (N=451) self-identified activity limitations.

Interventions: None.

Main outcome measure: Participation enfranchisement.

Results: We used multidimensional scaling, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), followed by rating scale analysis to evaluate the psychometric properties of the instrument. EFA identified 3 participation enfranchisement factors that describe perceived choice and control, contributing to one's community, and feeling valued; the factors were supported marginally by CFA. Rating scale analysis revealed marginal person separation and no misfitting items.

Conclusions: Participation enfranchisement constitutes a new, previously unmeasured aspect of participation-one that addresses subjective perceptions rather than objective performance-with items that are clearly distinct from more generalized satisfaction with participation. The 19 enfranchisement items describe aspects of participation that may prove useful in characterizing longer-term rehabilitation outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Brain Injuries / rehabilitation*
  • Disability Evaluation
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Patient Participation*
  • Psychometrics
  • Risk Factors
  • Social Adjustment
  • Spinal Cord Injuries / rehabilitation*
  • Stroke Rehabilitation*
  • Surveys and Questionnaires