Measuring enfranchisement: importance of and control over participation by people with disabilities

Arch Phys Med Rehabil. 2013 Nov;94(11):2157-65. doi: 10.1016/j.apmr.2013.05.017. Epub 2013 Jun 13.


Objective: To evaluate the psychometric properties and validity of an expanded set of community enfranchisement items that are suitable for computer adaptive testing.

Design: Survey.

Setting: Community setting.

Participants: Individuals with disabilities (N=1163) were recruited from an online panel generation company (51%), former rehabilitation inpatients (18%), disability community organizations (13%), a registry of rehabilitation patients (10%), and Traumatic Brain Injury and Spinal Cord Injury Model System facilities (8%). Inclusion criteria were a self-identified disability, aged ≥18 years, and the ability to read and speak English.

Interventions: None.

Main outcome measure: Community enfranchisement.

Results: Exploratory and confirmatory factor analyses of the 48 enfranchisement items suggested 2 distinct subsets of items: (1) importance of participation and (2) control over participation. Principal components analysis of the residuals suggested that the 2 item sets are unidimensional. Rating scale analysis provided evidence that the 2 item sets fit the Rasch model. Importance and control were moderately correlated with each other and with disability severity.

Conclusions: Importance of participation and control over participation define 2 distinct sets of participation enfranchisement. Preliminary evidence supports their validity.

Keywords: CFA; CFI; DIF; EFA; ICF; IRT; International Classification of Functioning, Disability and Health; PCA; Psychometrics; Quality of life; RMSEA; Rehabilitation; Social participation; comparative fit index; confirmatory factor analysis; differential item functioning; exploratory factor analysis; item response theory; principal components analysis; root mean square error of approximation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Disabled Persons* / rehabilitation
  • Factor Analysis, Statistical
  • Humans
  • Principal Component Analysis
  • Psychometrics
  • Reproducibility of Results
  • Self Report