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Community Integration Questionnaire (CIQ)
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The Community Integration Questionnaire (CIQ) is intended as a brief, reliable measure of an individual¡¦s level of integration into the home and community. The CIQ was developed by a small group of experts interested in assessing community integration for persons who have experienced traumatic brain injury. These experts met together to establish a consensus on what characterizes an individual¡¦s experience in the community, especially after the acute rehabilitation phase. The CIQ is normally completed by the individual being assessed. In most cases an interviewer should be present to assist with interpretation of specific items. In certain instances, the individual being assessed may not be able to complete the questionnaire (e.g., due to expressive or receptive language deficits, memory impairment, physical disabilities, etc.). In these instances, a person who is familiar with the individual being assessed may complete the form, provided that the individual being assessed is present when the form is completed. Name:______________________________ ID Number:___________ 1. Who usually does shopping for groceries or other necessities in your household? The CIQ consists of a total of 15 questions. The overall score, which represents a summation of the scores from individual questions, can range from 0 to 29. A higher score indicates greater integration, and a lower score reflects less integration. The CIQ can be further divided into three subscores, corresponding to integration in the home, social integration, and productivity. Procedures for deriving the subscores are outlined on the scoring sheet. Subscales have been developed to allow an analysis of integration within specific domains of everyday life. Items have been grouped with respect to their association with: 1) activities primarily related to the home; 2) activities associated with socialization; and 3) educational or vocational activities. These groupings have been made both logically and on the basis of principal components analysis of items which cluster together. Separate home integration, social integration and productivity subscale scores are derived as follows: Willer, B., Linn, R. and Allen, K. (1993). Community Integration and Barriers to Integration for individuals with brain injury. In M.A.J. Finlayson and S.H. Garner (Eds.) Brain Injury Rehabilitation: Clinical Considerations. Baltimore, MD: Williams & Wilkins. pp.355-375. Copyright by OBIA©1991 Background and Rationale of the Community Integration Questionnaire (CIQ)
It is important to note that this questionnaire represents a finite set of indicators of community integration, and as such does not encompass all possible indicators of integration. Therefore, it is recommended that the CIQ be used in concert with similar assessments of impairment, disability, environmental barriers, and demographic descriptors.
Although the CIQ was designed specifically for individuals with traumatic brain injury, it is applicable to all individuals, disabled or not, living outside institutions.Administration
Most of the questions are directed at how the individual performs a specific activity within the household or the community. Responses usually indicate that the individual performs the activity alone, with another person, or that the activity is typically performed by someone else. For some responses, the individual being assessed may find it difficult to decide which response fits best with how a particular activity is performed. In these instances, the individual should be encouraged by the examiner to choose the response reflecting the usual or typical performance of that activity.
Education:__________________________ Sex:___________ Marital Status:___________
Occupation:_________________________
Address:____________________________ ___________________________________
Date of Birth: _____ / _____ / _____
Date of Test: _____ / _____ / _____
Age: ___________
Did a proxy complete the questionnaire? Yes:______ No:______
Relationship of proxy to respondent:___________
CIQ Score:
Home Integration Scale: ___________
Social Integration Scale: ___________
Productivity Scale: ___________
CIQ Total Score: ___________ Community Integration Questionnaire
___ yourself alone
___ yourself and someone else
___ someone else
2. Who usually prepares meals in your household?
___ yourself alone
___ yourself and someone else
___ someone else
3. In your home, who usually does normal everyday housework?
___ yourself alone
___ yourself and someone else
___ someone else
4. Who usually cares for the children in your home?
___ yourself alone
___ yourself and someone else
___ someone else
___ not applicable/ no children under 17 in the home.
5. Who usually plans social arrangements such as get-together's with family and friends?
___ yourself alone
___ yourself and someone else
___ someone else
6. Who usually looks after your personal finances, such as banking or paying bills?
___ yourself alone
___ yourself and someone else
___ someone else
Can you tell me approximately how many times a month you now usually participate in the following activities outside your home?
7. Shopping
___ Never
___ 1-4 times
___ 5 or more
8. Leisure activities such as movies, sports, restaurants, etc.
___ Never
___ 1-4 times
___ 5 or more
9. Visiting friends or relatives
___ Never
___ 1-4 times
___ 5 or more
10. When you participate in leisure activities, do you usually do this alone or with
others?
___ mostly alone
___ mostly with friends who have head injuries
___ mostly with family members
___ mostly with friends who do not have head injuries
___ with a combination of family and friends
11. Do you have a best friend with whom you confide?
___ yes
___ no
12. How often do you travel outside the home?
___ almost every day
___ almost every week
___ seldom/never (less than once per week)
13. Please choose the answer below that best corresponds to your current (during the past month) work situation:
___ full-time (more than 20 hours per week)
___ part-time (less than or equal to 20 hours per week)
___ not working, but actively looking for work
___ not working, not looking for work
___ not applicable, retired due to age
14. Please choose the answer below that best corresponds to your current (during the past month) school or training program situation:
___ full-time
___ part-time
___ not attending school or training program
15. In the past month, how often did you engage in volunteer activities?
___ Never
___ 1-4 times
___ 5 or more
Click here to print the Community Integration Questionnaire.
Scoring Guidelines
The following guidelines provide scoring information for specific items or groups of items.
Items 1 to 6:
Score:
2 = The activity is performed alone
1 = The activity is performed with someone else
0 = The activity is performed by someone else
Note: For item 4, if there are no children under 17 in the home, the average (mean) score for items 1 through 3 and item 5 should be substituted.
Items 7 to 9:
Score:
2 = The activity was performed 5 or more times in the past month
1 = The activity was performed 1 - 4 times in the past month
0 = The activity was not performed in the past month
Item 10
Score:
2 = Mostly with friends without head injury or combination of family and friends
1 = Mostly with friends who have head injuries or with family
0 = Mostly alone
Item 11
Score:
2 = Yes response
0 = No response
Item 12
Score:
2 = Almost every day
1 = Almost every week
0 = Seldom/never (less than once per week)
Items 13 to 15
Although these items are collected individually, they will be combined to form one variable, Productivity. The scoring of this variable is dependent on the combination of answers to questions 13, 14 and 15. On page 4, is a listing of answer sets to these questions and their associated score.
Scoring of the Productivity Variable
Question#13
Work
Question #14 School
Question#15
Volunteer WorkScore
Not working/not looking
+
No school
+
No Volunteering
= 0
Not working/not looking
+
No school
+
1-4 times/month
= 1
Not working/not looking
+
No school
+
5 or more times/month
= 1
Not working/looking
+
No school
+
No Volunteering
= 0
Not working/looking
+
No school
+
1-4 times/month
= 2
Not working/looking
+
No school
+
5 or more times/month
= 2
Retired due to age
+
No school
+
No Volunteering
= 0
Retired due to age
+
No school
+
1-4 times/month
= 2
Retired due to age
+
No school
+
5 or more times/month
= 3
Retired due to age
+
Part-time
+
No Volunteering
= 4
Retired due to age
+
Part-time
+
1-4 times/month
= 5
Retired due to age
+
Part-time
+
5 or more times/month
= 5
Retired due to age
+
Full-time
+
Any answer
= 5
Not working
+
Full-time
+
Any answer
= 3
Not working
+
Part-time
+
Any answer
= 4
Part-time
+
No school
+
Any answer
= 3
Part-time
+
Part-time
+
Any answer
= 4
Part-time
+
Full-time
+
Any answer
= 5
Full time
+
No school
+
Any answer
= 4
Full time
+
Part-time
+
Any answer
= 5
Subscales
Home Integration: Summation of items 1 through 5
Social Integration: Summation of items 6 through 11
Productivity: Summation of item 12 and the Productivity variable
The overall CIQ score is the additive sum of items 1 through 12 and the Productivity variable.
CIQ Scoring Sheet
Item Number
Description
Sub-Score
Score
1
Shopping
__________
2
Prepare Meals
__________
3
Housework
__________
4
Caring for Children
__________
5
Social Arrangements
__________
HOME INTEGRATION SUBSCALE
__________
6
Personal Finances
__________
7
Shopping (times/month)
__________
8
Leisure activities (times/month)
__________
9
Visiting friends or relatives
__________
10
Leisure activities (with whom)
__________
11
Having a best friend
__________
SOCIAL INTEGRATION SUBSCALE
__________
12
Travel outside of home
__________
13, 14, 15
Productivity
__________
PRODUCTIVITY SUBSCALE
__________
CIQ TOTAL SCORE
__________
Click here to print a CIQ Score Sheet.
The following publications contain development procedures and psychometric properties of the scale.
Willer, B. S., Ottenbacher, K.J., and Coad, M. L. (1994). The Community Integration Questionnaire: A comparative examination. American Journal of Physical Medicine and Rehabilitation, 73(2), 103-111.
Willer, B. S., Rosenthal, M., Kreutzer, J., Gordon, W., and Rempel, R. (1993). Assessment of the community integration following rehabilitation for traumatic brain injury. Journal of Head Trauma & Rehabilitation, 8(2), 75-87.
Corrigan, J. D., Deming, R. (1995). Psychometric characteristics of the Community Integration Questionnaire: Replication and extension. Journal of Head Trauma Rehabilitation, 10(4), 41-53.
Heineman, A. W., & Whiteneck, G. G. (1995). Relationships among impairment, disability, handicap, and life satisfaction in persons with traumatic brain injury. The Journal of Head Trauma Rehabilitation, 10(4), 54-63.
Schmidt, M. F., Garvin, L. J., Heineman, A. W., & Kelly, J. P. (1995). Gender- and age-related role changes following traumatic brain injury. The Journal of Head Trauma Rehabilitation, 10(4), 14-27.
Hall, K. M., Mann, N., High, W. M., Wright, J., Kreutzer, J. S., & Wood, D. (1996). Functional measure after traumatic brain injury: Ceiling effect of FIM, FIM+FAM, DRS, and CIQ. Journal of Head Trauma Rehabilitation, 11(5), 27-39
Rosenthal, M., Dijkers, M., Harrison-Felix, C., Nabors, N., Witol, A., D., Young, M., E., & Englander, J., S. (1996). Impact of minority status on functional outcome and community integration following traumatic brain injury. Journal of Head Trauma Rehabilitation, 11(5), 40-57.
Sander, A. M., Kreutzer, J. S., Rosenthal, M., Delmonico, R., & Young, M. E. (1996). A multicenter longitudinal investigation of return to work and community integration following traumatic brain injury. Journal of Head Trauma Rehabilitation, 11(5), 70-84.
Sander A.M.; Seel R.T.; Kreutzer J.S.; Hall K.M.; High W.M. Jr; Rosenthal M. (1997). Agreement between persons with traumatic brain injury and their relative regarding psychosocial outcome using the Community Integration Questionnaire. Archives of Physical Medicine and Rehabilitation ; 78 (4), 353-7
Tepper S.; Beatty P.; DeJong G. (1996). Outcomes in traumatic brain injury: self-report versus report of significant others. Brain Injury; 10 (8), 575-8
Millis S. R.; Rosenthal M.; Lourie I.F. (1994). Predicting community integration after traumatic brain injury with neuropsychological measures. International Journal of Neuroscience, 79 (3-4), 165-7.
Dijkers, M. (1997). Measuring the Long-Term Outcomes of Traumatic Brain Injury: A Review of thte Community Integration Questionnaire. Journal of Head Trauma Rehabilitation, 12 (6), 74-91.
Cattelani, R.; Lombardi, F.; Brianti, R.; Mazzucchi, A. (1998). Traumatic brain injury in childhood: intellectual, behavioural and social outcome into childhood. Journal of Brain Injury, 12 (4), 283-296.
Colantonio, A.; Dawson, D.; McLellan, B.A. (1998). Head Injury in Young Adults: Long-Term Outcome. Journal of Archives of Physical Medicine and Rehabilitation, 79, 550-558.
Corrigan, J.; Smith-Knap, K.; Granger, C., (1998). Outcomes in the First 5 Years After Traumatic Brain Injury. Journal of Archives of Physical Medicine and Rehabilitation, 79, 298-305.
Bryant, R.; Marosszeky, J.; Crooks, J.; Baguley, I.; Gurka, J. (1999). Interaction of Posttraumatic Stress Disorder and Chronic Pain Following Traumatic Brain injury. Journal of Head Trauma Rehabilitation, 14, (6), 588-594.
Callaban, C.; Hinkebein, J. (1999). Neuropsychological Significance of Anosmia following Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 14, (6), 581-587.
Gurka, J.; Felmingham, K.; Baguley, I.; Schotte, D.; Crooks, J.; Marosszeky, J. (1999). Utility of the Funxtional Assessment Measure after Discharge from Inpatient Rehabilitation. Journal of Head Trauma Rehabilitation, 14, (3), 247-256.
Hanks, R.; Rapport, L.; Millis, S.; Deshpande, S. (1999). Measures of Executive Functioning as Predictors of Functional Ability and Social Integration in a Rehabilitation Sample. Journal of Archives of Physical Medicine and Rehabilitation, 80, 1030-1037.
Paniak, C.; Phillips, K.; Toller-Lobe, G.; Durand, A.; Nagy, J. (1999). Sensitivity of Three Recent Questionnaires to Mild Traumatic Brain Injury-Related Effects. Journal of Head Trauma Rehabilitation, 14, (3), 211-219.
Sander, A.; Fuchs, K.; High, W.; Hall, K.; Kreutzer, J.; Rosenthal, M. (1999). The Community Integration Qestionnaire Revisited: An Assessment of Factor Structure and Validity. Journal of Archives of Physical Medicine and Rehabilitation, 80, 1303-1308.
Willer, B.; Button, J.; Remple, R. (1999). Residential and home-based postacute rehabilitation of indiviiduals with traumatic brain injury: a case control study. Journal of Archives of Physical Medicine and Rehabilitation, 80, (4), 399-406
Cusick, C.; Gerbart, K.; Mellick, D. (2000). Participant-Proxy Reliability in Traumatic Brain Injury Outcome Research. Journal of Head Trauma Rehabilitation, 15, (1), 739-749.
Ontario Brain Injury Association
P.O. Box 2338
St. Catharines, ON L2R 7R9
Ph: (905) 641-8877 Fax: (905) 641-0323
Website: www.obia.on.ca or Email: dspauld@obia.on.ca