Development of the Key Behaviors Change Inventory: a traumatic brain injury behavioral outcome assessment instrument

OBJECTIVE: To describe the development and initial validation of a neurobehavioral outcome measure, the Key Behaviors Change Inventory (KBCI), for individuals with traumatic brain injury (TBI). DESIGN: Scale construction and development, and validity study. SETTING: Large state university and postal survey. PARTICIPANTS: Seventy-five volunteer undergraduate students and 25 volunteer collateral informants of individuals with TBI participated in the item-analysis phase. Thirty members of the Brain Injury Association and 20 members of the National Multiple Sclerosis Society rated both an identified patient and an age- and gender-equated control in the validation phase. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Content validity was examined through expert panel item sorts. Scale internal consistencies were examined with the Cronbach alpha. Construct validity was examined by comparing scale elevations between controls and 2 neurologic groups. RESULTS: Item-analysis procedures resulted in 8 scales of 8 items each: inattention, impulsivity, unawareness of problems, apathy, interpersonal difficulties, communication problems, somatic difficulties, and emotional adjustment. Internal consistency reliability coefficients ranged from.82 to.91. Multivariate analysis of variance revealed significant (P