The Community Integration Questionnaire (CIQ)

Background:

A key component following the rehabilitation of individuals with traumatic traumatic brain injuries (TBI) is the level of community integration they can subsequently achieve post-treatment. Integration is broadly defined in terms of the home, social networks, other productive outlets such as employment, school, or volunteer work. In a study by Willer, Rosenthal, Kreutzer, Gordon & Rempel (1993) the Community Integration Questionnaire (CIQ) was shown to reliably discriminate between individuals with TBI and those with no obvious impairments. The rehabilitation received by those with TBI came in the form of model systems programs. Furthermore, patients with TBI who received model systems programs rehabilitation scored significantly better on the CIQ for levels of home and social integration compared to those with TBI who did not receive the same rehabilitation.

Psychometrics:

Psychometric properties of the Community Integration Questionnaire (CIQ) are discussed in Willer, Rosenthal, Kreutzer, Gordon, and Rempel (1993).

Author of Tool:

Willer, B., Rosenthal, M., Kreutzer, S., Gordon, A., Rempel, R.

Key references:

Willer, B., Rosenthal, M., Kreutzer, S., Gordon, A., & Rempel, R. (1993). Assessment of community integration following rehabilitation for traumatic brain injury. Journal of Head Trauma Rehabilitation, 8(2).

Primary use / Purpose:

The Community Integration Questionnaire (CIQ) is a 15-item inventory designed to measure levels of community integration. It has typically been used to measure levels of community integration among individuals who have suffered traumatic brain injuries (TBI).

The Community Integration Questionnaire (CIQ)

Background and Rationale

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.

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

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.

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.

CIQ Rating Form

Subject:                                                                                                        Date:                       

1. Who usually does the shopping for groceries or other necessities in your household?❍ 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 the 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

7.   Approximately how many times a month do you usually participate in shopping outside your home?❍ Never

❍ 1 - 4 times

❍ 5 or more

8. Approximately how many times a month do you usually participate in leisure activities such as movies, sports, restaurants, etc.❍ Never

❍ 1 - 4 times

❍ 5 or more

 

9. Approximately how many times a month do you usually visit your 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 member   s

❍ Mostly with friends who do not have head injuries

❍ With a combination of family and friends

Please complete page two

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 that best corresponds

to your current (during the past month) work situation:

❍ Full-time

(more than 20 hours/week)

❍ Part-time

(less than or equal to 20 hrs/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 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

❍ Not applicable, retired due to age

 

15. In the past month, how often did you engage in volunteer activities?

❍ Never

❍ 1 - 4 times

❍ 5 or more

Scoring Guidelines

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.

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
 

1

 

=

friends

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 Work

Score
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

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:

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.

 

Item Number

CIQ Scoring Sheet

Description

 

Score

1Shopping 

 

 

2Prepare Meals 

 

3Housework 

 

4Caring for Children 

 

5Social Arrangements 

 

HOME INTEGRATION SUBSCALE 

 

 

6

 

Personal Finances

 

 

 

 

7Shopping (times/month) 

 

8Leisure activities (times/month) 

 

9Visiting friends or relatives 

 

10Leisure activities (with whom) 

 

11Having a best friend 

 

SOCIAL INTEGRATION SUBSCALE 

 

 

12

 

Travel outside of home

 

 

 

 

13,14,15Productivity 

 

PRODUCTIVITY SUBSCALE 

 

 

CIQ TOTAL SCORE