More than 1.5 million U.S. soldiers, sailors, and marines have been deployed in Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF). Demobilization and the return home can be challenging, especially for injured veterans [1
]. The ultimate goal of rehabilitative efforts is to help those injured adjust to life at home and in the community [3
], which is also called community reintegration. Community reintegration is especially challenging for injured veterans because it may be complicated by the co-occurrence of physical injuries with postwar adjustment difficulties, such as posttraumatic stress disorder (PTSD), depression, substance abuse, and severe mental illness [1
]. Community reintegration may be particularly problematic for OIF/OEF veterans, who have an unusually high prevalence of traumatic brain injury (TBI) [4
], and PTSD [5
Thus, it is important to assess community reintegration and, whenever possible, to intervene early to prevent long-term consequences for returning service members’ families and society. However, no community reintegration measure exists specifically for the veteran population. In fact, no single generic measurement tool has been developed that can be used in all populations [7
]. Some existing measures are population-specific and have been developed, for example, for those with strokes, spinal cord injuries, or head injuries [3
]. Furthermore, existing measures cover vastly different integration domains.
Recent revision of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) [10
] offers an alternative method of defining and measuring the domains of community integration. According to the ICF, the domain of participation focuses on the person’s involvement in society (i.e., community integration). People are considered to have healthy participation if they take part in all life areas or life situations in which they wish to participate, in a manner or to the extent that is expected of an individual without restrictions in that culture of society [11
]. The ICF taxonomy includes nine overall domains: learning and applying knowledge; general tasks and demands; communication; mobility; self-care; domestic life; interpersonal relationships; major life areas; and community, social, and civic life.
Many questionnaires that are used to assess participation in life were developed using narrower models of disability [12
] and thus fail to cover all nine domains of participation as identified by the ICF. Our review found that very few measures contained at least one item pertaining to each of the nine domains and in many instances, single questions addressed more than one domain [13
]. To date, no community integration measure has been developed that incorporates issues specific to injured service members. Even the most comprehensive existing measures do not have adequate coverage of subcategories relevant to the OIF/OEF veteran population based on a recently completed study that identified numerous areas of restriction in participation in OIF/OEF veterans [14
Thus, we aimed to develop a new measure of community reintegration for injured service members: the Community Reintegration for Service Members (CRIS). The purposes of this study were to (1) design and develop a measure of community reintegration of injured service members using the results of our qualitative research on injured service members in conjunction with the ICF framework and (2) conduct preliminary tests of the measure’s validity and reliability.