Initial Validation of Personal Self-Advocacy Measures for Individuals With Acquired Brain Injury

Purpose/Objective: The purpose of this study was to evaluate the psychometric properties of 2 novel measures assessing personal advocacy, self-efficacy and personal advocacy activities in individuals with acquired brain injury (ABI). Design: This was an instrument development study using (a) expert panel review with a content validity index, (b) consumer survey, and (c) Rasch analysis. Participants were adults (N = 162) with ABI recruited through a community survey. Main Outcome Measure: Participants completed the Self-Advocacy Scale (SAS) and the Personal Advocacy Activity Scale (PAAS). Results: Using Rasch analysis to inform instrument development, after modification on the basis of item response theory analysis, the SAS, a measure of advocacy self-efficacy, was found to be unidimensional with an eigenvalue of 1.6, exhibited monotonicity, and had an item reliability of 0.97. Similarly, the PAAS, a measure of advocacy activity, was found to exhibit monotonicity, is unidimensional (eigenvalue of 1.7) and had an item reliability of 0.97. Both measures demonstrated concurrent validity, because they were significantly correlated with other established measures of related constructs and with each other. A separation reliability of 0.97 (real not model) for both the SAS and PAAS suggests that items will likely hold their relative positions in a similar sample. Conclusions: This study supported the PAAS and the SAS as reliable and valid measures of personal advocacy activity and associated self-efficacy in individuals post-ABI. Impact and Implications Although individuals with acquired brain injury (ABI) have an increased need for personal self-advocacy to obtain necessary services and resources, there are no specific measures of personal advocacy self-efficacy and behaviors post-ABI. This study provides initial validation of two novel measures assessing personal advocacy self-efficacy and personal advocacy behaviors for individuals with ABI. Rehabilitation clinicians should consider using these measures when planning interventions designed to empower individuals with ABI as self-advocates.