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Development of a Proxy Measure of Veteran Community Integration: A Preliminary Report

Background: The Community Reintegration Measure for Injured Service Members (CRIS) assesses issues in community participation specific to injured service members. The CRIS may have limited usefulness where illness or disability prevents completion, patients have limited insight, or symptoms/stigma distort self-report. Thus, an alternative approach to measurement using proxies is needed.

Purpose: The objectives were to 1) create and pilot test a proxy version the CRIS, which we called the CRIS/P; 2) create and pilot test a measure of proxy satisfaction with veteran community integration.

Methods: The study involved cognitive testing and a reliability study. Participants were caregivers of Veterans. Cognitive testing was conducted with 10 caregivers. The refined measures were administered to 24 caregivers, 23 completed measures twice within a week. Analyses of scale internal consistency led to refinements. Test-retest reliability was examined using ICC. Differences between CRIS/P Satisfaction and Proxy Satisfaction were examined.

Results: ICCs of CRIS/P were 0.96, 0.95, 0.91 and Cronbach’s alphas were 0.95, 0.95 and 0.96 for Extent, Perceived Limitation and Satisfaction, respectively. The final Proxy Satisfaction scale consists had an ICC of 0.97 and a Cronbach alpha of 0.97. CRIS/P satisfaction scale was strongly correlated with the Proxy Satisfaction (r=0.78), CRIS/P scores were significantly higher than Proxy Satisfaction for the full measure and for 11 items.

Conclusion: Preliminary analyses support internal consistency and test-retest reliability of the CRIS/P and Proxy Satisfaction scales and suggest that proxies are less satisfied with veteran participation then their ratings of Veteran’s satisfaction with participation.


Linda Resnik, Pam Steager and Matthew Borgia

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