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A 6-Year Longitudinal Study of Community Integration, Subjective Well-Being, and Health after Spinal Cord Injury: Relationship with Gender, Race/Ethnicity, and Environmental Factors. Field Initiated Research Grant, National Institute on Disability and Rehabilitation Research, Department of Education; $449,515, September 1, 2002 to August 31, 2006.

The purpose of this longitudinal study is to identify changes quality of life and health outcomes over a 6 year period as a function of gender, race/ethnicity, and environmental factors.  Follow-up data are being collected from 466 participants from 3 collaborating sites that include the Shepherd Center, Rancho Los Amigos National Rehabilitation Center, and Craig Hospital.  The same core outcome measures are being re-administered by phone that was used during the preliminary data collection in 1997-8.  Measures include the Craig Handicap Assessment Reporting Technique, Older Adult Health and Mood Questionnaire, Reciprocal Support Scale, Behavioral Risk Factor Surveillance Survey and the Life Situation Questionnaire.  In addition, newly developed measures are being used to identify the relationship of environmental factors with adverse outcomes.  These measures include the Craig Hospital Inventory of Environmental Factors, the Acculturation, Integration, Marginalization, and Segregation, and the assimilation factor of the Community Integration Measure.  A 2x4x2 longitudinal factorial design is being used to analyze the data, with two between factors (gender and race/ethnicity) and a within subjects factor (time of measurement—time 1, time 2).  A mediational model is being used to identify the extent to which differences in environmental factors explain any associations of gender and race-ethnicity with participation, subjective well-being, health behaviors, and health outcomes.  This study addresses two priorities of the NIDRR long-range plan (independent living and community integration; health and function) and it fully embraces the new paradigm of disability by investigating “focusing on the whole person functioning in an environmental context.”

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