BI Asessment Tools
Craig Hospital Inventory of Environmental Factors (CHIEF)
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The CHIEF is designed to assess the frequency and magnitude of perceived physical, attitudinal, and policy barriers that keep people with disabilities from doing what they want or need to do. In 2000, the developers of CHART (Craig Handicap Assessment and Reporting Technique), designed and tested the CHART Short Form (SF). To reduce the number of questions in CHART a multi-dimensional analysis plan was designed. First, using data already gathered from a previous study, item-scale and item-total correlation coefficients were calculated for each scale. Second, regression analysis was performed on each subscale with the dependent measure being the scale score and the variables contributing to the subscale acting as the predictor variables. It was hypothesized that each subscale score could be accurately be predicted by fewer items. With two exceptions, the only variables that were selected to be in a subscale were those that entered into a stepwise regression model together explaining over 90% of the variance. Third, once the items had been selected for each subscale, the items were re-scored. Each subscale was computed to have a maximum score of 100, which indicates no handicap in that domain. Furthermore, efforts were made to keep all of the score weightings of the variables proportionate to the original weightings. Fourth, the CHART Short Form items and scoring were evaluated on 1800 persons that contributed to the Behavioral Risk Factor Surveillance System's survey of Colorado residents. As a result, the CHART SF has 19 items that yield the same subscales as the original CHART (32 items). 1. The instrument can be self-administered, or administered by interview, either in person or by telephone. 2. If self-administered, it takes approximately 10 minutes to complete the 25-item CHIEF and five minutes to complete the CHIEF-SF; add five minutes to each if administered by interview. 3. It is NOT recommended to use proxy respondents in the absence of the primary respondent. 4. The CHIEF was developed and tested with individuals aged 16 to 95, thus it is recommended for use within this age range. It has not been tested or used for children or adolescents less than 16 years of age. 5. It can be used with individuals with or without any type of disability. 6. There is no set time period for administering the CHIEF; however, it is recommended that multiple measurements be taken over the course of a person's lifetime to assess changes with adaptation to the disability and to gain insight into changes in environmental barriers which may occur over time. 1. Each of the 25 items on the CHIEF or 12 items on the CHIEF-SF are composed of two questions: • Respondents are first asked to rate the frequency with which they encounter barriers (4=daily, 3=weekly, 2=monthly, 1=less than monthly, or 0=never). 2. Scoring of each CHIEF item is the product of the frequency score (from never=0 to daily=4) and the magnitude of impact score (from no problem=0 to big problem=2) to produce an item score that ranges from 0-8. 3. A valid rating must be entered for all items, with the exception of the Work and School items which can be scored as not applicable=8, if the respondent does not work or attend school. 4. The Work/School items can then be re-coded to missing so as not to be included in the calculating of domain/sub-scale scores or a total CHIEF score. However, depending on the type of analysis, if missing data is an issue (e.g., multivariate analysis), these items can be re-coded to zero (0) for both frequency and magnitude, indicating "no environmental barrier". 5. A score for each of the five domains or subscales (1-Attitudes and Support, 2-Services and Assistance, 3-Physical and Structural, 4-Policies and 5-Work and School) is calculated as the average frequency-magnitude product score across all of the non-missing sub-scale items. A total CHIEF score across all 25 CHIEF items or 12 CHIEF-SF items is calculated the same way, as the average frequency-magnitude product score across all of the non-missing scale items. 6. The higher the item, sub-scale or total CHIEF score indicates a greater frequency and/or magnitude of environmental barriers. Source Material provided by Craig Hospital. For more information, contact Cindy Harrison-Felix, Ph. D. Harrison-Felix, C. (2001). The Craig Hospital Inventory of Environmental Factors. The Center for Outcome Measurement in Brain Injury. Whiteneck GG, Fougeyrolles P, Gerhart KA. "Elaborating the Model of Disablement." In, Assessing Medical Rehabilitation Practices: The Promise of Outcomes Research. Fuhrer M, editor. Paul H. Brooks Publishing Co., 1997. World Health Organization. International classification of impairments, disabilities, and handicaps: A manual of classification relating to the consequences of disease. Geneva: World Health Organization, 1980, 1993 reprint. World Health Organization. International classification of functioning and disability (ICIDH-2): Geneva: World Health Organization, 1999, 2000. 
Craig Hospital Inventory of Environmental Factors (CHIEF Form)
Craig Hospital Inventory of Environmental Factors Short Form (CHIEF-SF Form)Rater's Instructions
Scoring
• When respondents indicate that they encounter environmental barriers at any frequency other than never, a follow-up question is asked about whether they consider the barrier to be 2=a big problem or 1=a little problem (a score of 0=no problem is automatically entered for this item if the first question regarding the frequency of encountering barriers is 0=never). Contact
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