• Craig Hospital Inventory of Environmental Factors (CHIEF) assesses the perceived impact of various types of environmental barriers. The CHIEF takes into account the type, frequency, and magnitude of problem resulting from these barriers.
  • The CHIEF contains 5 subscales: physical and structural barriers, attitudinal and support barriers, barriers to services and assistance, policy barriers, and barriers at work and school. A CHIEF short-form (CHIEF-SF) is also available, with 12 items.

ICF Domain

Environmental Factors ▶ Multiple


  • Self-report or interviewer.
  • Contains 25 items.
  • There is also a short-form version with 12 items.

Number of Items

10-15 minutes, 25 items




For each item, a frequency score (0-4), a magnitude score (1-2), and an impact score (product of the former two, 0-8) is obtained. Overall or subscale scores are the means of respective item impact scores


English, Hindi

Training Required

Does not require advanced training.


Can be found here.

Information regarding the CHIEF was provided by Craig Hospital. Please contact Cindy Harrison-Felix, PhD, at charrison-felix@craighospital.org  for more information.

# of studies reporting psychometric properties: 2


MCID: not established in SCI
SEM: not established in SCI

  • Standard Error of Measurement: 0.36
  • Minimal Detectable Change: 0.99

(Soni et al. 2016)

MDC: not established in SCI

  • Mean (SD) Scores:
    • Physical and structural: 1.51 (0.92)
    • Attitude and support: 1.91 (0.95)
    • Services and assistance: 0.91 (0.68)
    • Policy: 1.17 (0.70)
    • Work and school: 1.50 (0.90)
    • Overall: 1.44 (0.82)

(Soni et al. 2016)


  • Test-retest reliability overall is High (ICC = 0.930).
  • Internal consistency overall is Moderate to High (Chronbach’s alpha = 0.77-0.93).

(Whiteneck et al. 2004a, Soni et al. 2016)


    • Discriminant Validity: Total score, all items and subscales produced statistically significant differences across impairment groups. People with disabilities consistently reported higher overall level of barriers on all subscales and total CHIEF score than those without disabilities. People with severe disabilities generally scored higher on subscales and the total score than all people reporting any disability
    • Factory Analysis (N=2269):Principle components factor analysis created 5 factors/subscales, with 3-7 items each.
    • Content Validity:4 separate groups of subject matter experts produced 4 instruments representing common environmental factors. High consistency between groups allowed for authors to combine into one instrument.

(Costa et al. 2001)


Not established in SCI

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects for the SCI population.


Dr. Ben Mortenson, Jeff Tan, John Zhu, Jeremy Mak

Date Last Updated

16 March 2017

Soni S, Walia S, Noohu MM. Hindi translation and evaluation of psychometric properties of Craig Hospital Inventory of Environmental Factors instrument in spinal cord injury subjects. J Neurosci Rural Pract. 2016;7(1):13-22.

Whiteneck G, Meade MA, Dijkers M, Tate DG, Bushnik T, Forchheimer MB. Environmental factors and their role in participation and life satisfaction after spinal cord injury. Arch Phys Med Rehabil. 2004;85(11):1793-803.

Whiteneck GG, Harrison-felix CL, Mellick DC, Brooks CA, Charlifue SB, Gerhart KA. Quantifying environmental factors: a measure of physical, attitudinal, service, productivity, and policy barriers. Arch Phys Med Rehabil. 2004;85(8):1324-35.