Computer-adaptive test to measure community reintegration of Veterans.

The Community Reintegration of Injured Service Members (CRIS) measure consists of three scales measuring extent of, perceived limitations in, and satisfaction with community reintegration. Length of the CRIS may be a barrier to its widespread use. Using item response theory (IRT) and computer-adaptive test (CAT) methodologies, this study developed and evaluated a briefer community reintegration measure called the CRIS-CAT. Large item banks for each CRIS scale were constructed. A convenience sample of 517 Veterans responded to all items. Exploratory and confirmatory factor analyses (CFAs) were used to identify the dimensionality within each domain, and IRT methods were used to calibrate items. Accuracy and precision of CATs of different lengths were compared with the full-item bank, and data were examined for differential item functioning (DIF). CFAs supported unidimensionality of scales. Acceptable item fit statistics were found for final models. Accuracy of 10-, 15-, 20-, and variable-item CATs for all three scales was 0.88 or above. CAT precision increased with number of items administered and decreased at the upper ranges of each scale. Three items exhibited moderate DIF by sex. The CRIS-CAT demonstrated promising measurement properties and is recommended for use in community reintegration assessment.