Background:
The Computer Adaptive Test version of the Community Reintegration of Injured ServiceMembers measure (CRIS-CAT) consists of three scales measuring Extent of, PerceivedLimitations in, and Satisfaction with community integration.The CRIS-CAT was developed using item response theory methods. The purposes of thisstudy were to assess the reliability, concurrent, known group and predictive validity andrespondent burden of the CRIS-CAT.
Methods:
This was a three-part study that included a 1) a cross-sectional field study of 517 homeless,employed, and Operation Enduring Freedom / Operation Iraqi Freedom (OEF/OIF) veterans;who completed all items in the CRIS item set, 2) a cohort study with one year follow-upstudy of 135 OEF/OIF veterans, and 3) a 50-person study of CRIS-CAT administration.Conditional reliability of simulated CAT scores was calculated from the field study data, andconcurrent validity and known group validity were examined using Pearson productcorrelations and ANOVAs. Data from the cohort were used to examine the ability of theCRIS-CAT to predict key one year outcomes. Data from the CRIS-CAT administration studywere used to calculate ICC (2,1) minimum detectable change (MDC), and average number ofitems used during CAT administration.
Results:
Reliability scores for all scales were above 0.75, but decreased at both ends of the scorecontinuum. CRIS-CAT scores were correlated with concurrent validity indicators anddiffered significantly between the three veteran groups (P < .001). The odds of having anyEmergency Room visits were reduced for veterans with better CRIS-CAT scores, (Extent,Perceived Satisfaction respectively: OR = 0.94, 0.93, 0.95; P < .05). CRIS-CAT scores werepredictive of SF-12 physical and mental health related quality of life scores at the 1 yearfollow-up. Scales had ICCs >0.9. MDCs were 5.9, 6.2, and 3.6, respectively for Extent,Perceived and Satisfaction subscales. Number of items (mn, SD) administered at Visit 1 were14.6 (3.8) 10.9 (2.7) and 10.4 (1.7) respectively for Extent, Perceived and Satisfactionsubscales.
Conclusion:
The CRIS-CAT demonstrated sound measurement properties including reliability, construct,known group and predictive validity, and it was administered with minimal respondentburden. These findings support the use of this measure in assessing community reintegration.