CIQ (COMMUNITY INTEGRATION QUESTIONNAIRE) - ARCHIVE

Definition

Questions for the 15 items of the Community Integration Questionnaire (CIQ), as asked of the best source of information. The person with brain injury is the best source of information unless she or he is considered unreliable or is unavailable. Administer on “less dynamic” schedule (years 1, 2, 5, and every 5 yrs. thereafter).

CIQResp: Person(s) who provided the information used to answer CIQ. This should be the person with TBI unless he/she is unreliable or unavailable.

Form

[ ] Form 1
[X] Form 2

Source

Interview, Mail-Out (participant or proxy

Details

The actual code for each question is entered into the computer database. The four CIQ subscale scores and the total CIQ scores will be calculated by the National Data Center. For details on calculating the subscale and total CIQ scores.

If the person with brain injury is living in a skilled nursing facility at the time of annual follow-up; the CIQ should still be completed. This will be taken into consideration during analysis of data.

Characteristics

7/1/2001 - best source can provide information. Prior to this, questions were asked of both participant and proxy.

Variables

Form Type	Variable	ID	Question	History
Form 2	CIQChildCare	3626	CIQ - Who usually cares for the children in your home?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQFinance	3627	CIQ - Who usually looks after your personal finances, such as banking or paying bills?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQFriend	3628	CIQ - Do you have a best friend with whom you confide?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQHouseWk	3629	CIQ - In your home who does normal everyday housework?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQLeisFreq	3630	CIQ - How many times per month do you participate in the following activities outside your home: Leisure activities such as movies, sports, restaurants?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQLeisure	3631	CIQ - When you participate in leisure activities do you usually do this alone or with others?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQMeal	3632	CIQ - Who usually prepares meals in your household?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQResp	3633	Respondent to CIQ	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQSchool	3634	CIQ - Please choose the answer that best corresponds to your current (during the past month) school/training program situation	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQShop	3635	CIQ - Who usually does shopping for groceries or other necessities in your household?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQShpFreq	3636	CIQ - How many times per month do you participate in the following activities outside your home: Shopping?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQSocial	3637	CIQ - Who usually plans social arrangements such as get-togethers with family and friends?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQTravel	3638	CIQ - How often do you travel outside the home?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQVisitFreq	3639	CIQ - How many times per month do you participate in the following activities outside your home: Visiting friends or relatives?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQVol	3640	CIQ - In the past month, how often did you engage in volunteer activities?	1989-10-01 - Variable Added 2003-01-01 - Variable Removed
Form 2	CIQWork	3641	CIQ - Please choose the answer that best corresponds to your current (during past month) work situation.	1989-10-01 - Variable Added 2003-01-01 - Variable Removed

Codes and Values

ID 3626

For Form: [Form 2]
For Variables: [CIQChildCare]

Code	Description
0	Someone Else
1	Yourself and Someone Else
2	Yourself Alone
6	Not Testable
7	Not Applicable
8	Not Applicable: No Children under 17 years of age in the home
9	Unknown

ID 3627

For Form: [Form 2]
For Variables: [CIQFinance]

Code	Description
0	Someone Else
1	Yourself and Someone Else
2	Yourself Alone
6	Not Testabe
7	Not Applicable
9	Unknown

ID 3628

For Form: [Form 2]
For Variables: [CIQFriend]

Code	Description
0	No
2	Yes
6	Not Testabe
7	Not Applicable
9	Unknown

ID 3629

For Form: [Form 2]
For Variables: [CIQHouseWk]

Code	Description
0	Someone Else
1	Yourself and Someone Else
2	Yourself Alone
6	Not Testable
7	Not Applicable
9	Unknown

ID 3630

For Form: [Form 2]
For Variables: [CIQLeisFreq]

Code	Description
0	Never
1	1 - 4 Times
2	5 or More Times
6	Not Testable
7	Not Applicable
9	Unknown

ID 3631

For Form: [Form 2]
For Variables: [CIQLeisure]

Code	Description
0	Mostly Alone
1	Combo Family or Friends with Head Injuries
2	Combo Family or Friends with Head Injuries
6	Not Testable
7	Not Due
9	Unknown

ID 3632

For Form: [Form 2]
For Variables: [CIQMeal]

Code	Description
0	Someone Else
1	Yourself and Someone Else
2	Yourself Alone
6	Not Testable
7	Not Applicable
9	Unknown

ID 3633

For Form: [Form 2]
For Variables: [CIQResp]

Code	Description
1	Person with TBI
2	Significant Other
3	Person with TBI and Significant Other
6	Variable Did Not Exist
7	Not Due
9	Unknown

ID 3634

For Form: [Form 2]
For Variables: [CIQSchool]

Code	Description
a	Full Time
b	Part Time
c	Not Attending School
6	Not Testable
7	Not Applicable
9	Unknown

ID 3635

For Form: [Form 2]
For Variables: [CIQShop]

Code	Description
0	Someone Else
1	Yourself and Someone Else
2	Yourself Alone
6	Not Testable
7	Not Applicable
9	Unknown

ID 3636

For Form: [Form 2]
For Variables: [CIQShpFreq]

Code	Description
0	Never
1	1 - 4 Times
2	5 or More Times
6	Not Testable
7	Not Applicable
9	Unknown

ID 3637

For Form: [Form 2]
For Variables: [CIQSocial]

Code	Description
0	Someone Else
1	Yourself and Someone Else
2	Yourself Alone
6	Not Testable
7	Not Applicable
9	Unknown

ID 3638

For Form: [Form 2]
For Variables: [CIQTravel]

Code	Description
0	Seldom/Never
1	Almost Every Week
2	Almost Every Day
6	Not Testable
7	Not Applicable
9	Unknown

ID 3639

For Form: [Form 2]
For Variables: [CIQVisitFreq]

Code	Description
0	Never
1	1 - 4 Times
2	5 or More Times
6	Not Testable
7	Not Applicable
9	Unknown

ID 3640

For Form: [Form 2]
For Variables: [CIQVol]

Code	Description
a	5 or More Times
b	1 - 4 Times
c	Never
6	Not Testable
7	Not Applicable
9	Unknown

ID 3641

For Form: [Form 2]
For Variables: [CIQWork]

Code	Description
a	Full Time: More Than 20 hrs/wk
b	Part Time: 20 or More hrs/wk
c	Not Working: Actively looking
d	Not Working: Not looking
6	Not Testable
7	Not Applicable
8	Retired: Age-related
9	Unknown

History

No history found for the Domain.