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Open Access Research article

Field-testing of the rapid assessment of disability questionnaire

Manjula Marella12*, Lucy Busija3, Fakir M Amirul Islam24, Alexandra Devine1, Kathy Fotis2, Sally M Baker1, Beth Sprunt1, Tanya J Edmonds1, Nafisa Lira Huq5, Anaseini Cama67 and Jill E Keeffe28

Author Affiliations

1 Nossal Institute for Global Health, University of Melbourne, Level 4, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3010, Australia

2 Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia

3 Deakin Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Victoria, Australia

4 Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Victoria, Australia

5 Centre for Reproductive Health, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh

6 CMW Hospital Eye Department, Ministry of Health, Suva, Fiji

7 International Agency for the Prevention of Blindness, Western Pacific Region, Pacific Secretariat, Suva, Fiji

8 L V Prasad Eye Institute, Hyderabad, India

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BMC Public Health 2014, 14:900  doi:10.1186/1471-2458-14-900

Published: 1 September 2014

Abstract

Background

The Rapid Assessment of Disability (RAD) questionnaire measures the magnitude and impact of disability and aims to inform the design of disability inclusive development programs. This paper reports the psychometric evaluation of the RAD.

Methods

The initial version of the RAD comprised five sections: 1) demographics, 2) functioning, 3) rights awareness, 4) well-being, and 5) access to the community. Item functioning and construct validity were assessed in a population-based study in Bangladesh. Data were analysed using descriptive statistics (sections 2 and 5) and Rasch modelling (sections 3 and 4). A subsequent case–control study in Fiji tested the refined questionnaire in a cross-cultural setting and assessed the sensitivity and specificity of the RAD section 2 to identify people with disability.

Results

2,057 adults took part in the study (1,855 in Bangladesh and 202 in Fiji). The prevalence of disability estimated using RAD section 2 in Bangladesh was 10.5% (95% CI 8.8-12.2), with satisfactory sensitivity and specificity (62.4% and 81.2%, respectively). Section 3 exhibited multidimensionality and poor differentiation between levels of rights awareness in both Bangladesh (person separation index [PSI] = 0.71) and Fiji (PSI = 0.0), and was unable to distinguish between people with and without disability (Bangladesh p = 0.786, Fiji p = 0.403). This section was subsequently removed from the questionnaire pending re-development. Section 4 had good ability to differentiate between levels of well-being (PSI = 0.82). In both countries, people with disability had significantly worse well-being scores than people without disability (p < 0.001) and also access to all sectors of community except legal assistance, drinking water and toilets (p < 0.001).

Conclusions

Filed-testing in Bangladesh and Fiji confirmed the psychometric robustness of functioning, well-being, and community access sections of the RAD. Information from the questionnaire can be used to inform and evaluate disability inclusive development programs.

Keywords:
Disability; Rapid assessment; Validation; Questionnaire; Inclusive development