• Originally designed as a measurement of community integration for individuals with traumatic brain injury (Willer et al. 1994).
  • Has three subscales:
    1. Home Integration (e.g. Who does the grocery shopping at home? Who does the normal everyday housework?)
    2. Social Integration (e.g. Who looks after your personal finances?)
    3. Productive Activities (e.g. Do you work/volunteer? How often?)
  • Scores for these domains are generated based on the frequency of engaging in roles and activities, and responses are weighted according to level of independence in performing roles and activities. The CIQ has recently been validated for use with SCI populations (Gontkovsky et al. 2009).

Clinical Considerations

  • Originally developed by 14 experts due to recognition that community integration is a priority during rehabilitation after a traumatic brain injury.
  • Scores on the CIQ indicate the level of community integration. Low scores would suggest a need for strategies to help with community integration.
  • Additional evaluations may be warranted to assess the subjective aspects of community integration, such as a person’s desire to engage in activities and how satisfied a person is with the activities they are engaged in.
  • The three domains of the CIQ parallel the Craig Handicap Assessment Reporting Technique – Short Form (CHART-SF), a common measure of community integration in the SCI population. If the individual is unable to answer the questions, a person close to the individual can complete the questionnaire on his/her behalf.
  • Respondent burden is minimal especially given the several ways to complete the questionnaire.
  • The CIQ has now been validated for use in the chronic spinal cord injured population.
  • Administration and scoring are done via established standardized procedures.

ICF Domain

Participation

Administration

  • Self-report measure that can be completed via a computer, on the phone, by mail, or in person.
  • May be completed in less than 15 minutes.

Number of Items

15

Equipment

None

Scoring

  • Subscales (Home Integration, Social Integration and Productivity) are summed to yield a total score for community integration ranging from 0-29, with higher scores indicating a greater degree of community integration.
  • Most items are scored on a 3 point scale from 0-2, 1 item is scored from 0-4 and 1 item is scored from 0-5.
  • Higher scores indicate higher levels of community integration (Willer et al. 1994).
  • Individual domain scores of the CIQ allow the clinician to determine where individuals are succeeding or struggling in re-integration after injury.
  • Published data for the SCI population is available for comparison (see the Interpretability section of the Research Summary).

Languages

English

Training Required

None

Availability

Worksheet can be found here.

More details found here.

Interpretability

MCID: not established for SCI
SEM: not established for SCI
MDC: not established for SCI

Typical Values

Mean (SD) Score:

  • Home integration = 3.5 (2.6)
  • Social integration = 6.7 (2.5)
  • Productive activity = 1.0 (1.6)
  • Total score = 11.2 (5.0)

(Gontkovsky et al. 2009: N=28, 21 males, 25 traumatic SCI, mixed injury types, chronic) 

Reliability

  • Low to High Internal Consistency:
    • Total Score: α = 0.71 – 0.75
    • Home integration: α = 0.79 – 0.81
    • Social integration: α = 0.62 – 0.63
    • Productive activity: α = 0.50 – 0.51

(Kratz et al. 2015: measured at 1 month and 12 months; mixed injury types; time 1: n = 727, 399 males, mean time since injury (SD) = 16.52 (12.67) years; time 2: n = 494, 301 males; mean time since injury (SD) = 16.15 (11.98) years)

  • Low to High Internal Consistency:
    • Total Score: α = 0.70
    • Home integration: α = 0.82
    • Social integration: α = 0.33 Productive activity: α = 0.42
  • High Test-Retest Correlation: r = 0.85

(Rintala et al. 2002: N = 99, mean duration (SD) = 7.0 (6.5), 29 traumatic SCI)

Validity

  • High correlation with CHART-SF: r = 0.79

(Gontkovsky et al. 2009: N=28, 21 males; 25 traumatic SCI, mixed injury types, chronic)

  • Low to Moderate correlation with Spinal Cord Lesion Coping Strategies Questionnaire subscales (SCL CSQ):
    • SCL CSQ – Acceptance: r = 0.289
    • SCL CSQ – Fighting spirit: r = 0.326
    • SCL CSQ – Social reliance: r = 0.272

(Saffari et al. 2015: CIQ Iranian version, N=220, 164 males, mixed injury types, mean time since injury (SD) = 50.96 (35.05) months)

  • Moderate correlation of CIQ (Spanish) with CHART (Spanish):
    r = 0.53
  • High correlation of CIQ (Spanish) with CIQ (English):
    r = 0.83

(Rintala et al. 2002: N=99, mean duration (SD): 7.0 (6.5), 29 traumatic SCI)

Responsiveness

There has been 1 study reporting values for the responsiveness of the CIQ in SCI.

Floor/Ceiling Effect

  • Patients at ceiling (time 1, time 2):
    • Total Score: 0, 5%
    • Home integration: 6.4, 7.7%
    • Social integration: 1.6, 2.0%
    • Productive integration: 25, 27.1%
  • Patients at floor (time 1, time 2):
    • Total Score: 0.2%
    • Home integration: 1.2, 1.3%
    • Social integration: 0.6%
    • Productive integration: 8.1, 8.6%

(Kratz et al. 2015: measured at 1 month and 12 months; mixed injury types; time 1: n = 727, 399 males, mean time since injury (SD) = 16.52 (12.67) years; time 2: n = 494, 301 males; mean time since injury (SD) = 16.15 (11.98) years)

Reviewers

Dr. Ben Mortenson, John Zhu, Jeremy Mak, Matthew Querée, Gita Manhas

Date Last Updated

20 July 2020

Gontkovsky ST, Russum P, Stokic DS. Comparison of the CIQ and CHART short form in assessing community integration in individuals with chronic spinal cord injury: A pilot study. NeuroRehabilitation 2009; 24:185-192.
http://www.ncbi.nlm.nih.gov/pubmed/19339757

Kratz AL, Chadd E, Jensen MP, Kehn M, Kroll T. An examination of the psychometric properties of the community integration questionnaire (CIQ) in spinal cord injury. J Spinal Cord Med. 2015;38(4):446-55.
http://www.ncbi.nlm.nih.gov/pubmed/24621050

Saffari M, Pakpour AH, Yaghobidoot M, Al zaben F, Koenige HG. Cross-cultural adaptation of the spinal cord lesion-related coping strategies questionnaire for use in Iran. Injury. 2015;46(8):1539-44.
http://www.ncbi.nlm.nih.gov/pubmed/26003680

Willer B, Ottenbacher KJ, Coad ML. The Community Integration Questionnaire: A comparative Examination. Am. J. Phys. Med. Rehabil. 1994 103-110.
http://www.ncbi.nlm.nih.gov/pubmed/8148099

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