Quality of Life Concepts

Secondary Health Conditions

Community Integration Questionnaire (CIQ)

Description: A measure of ability to perform normal role functions in and outside the home in 3 domains: home (participating in shopping, meal preparation, housework, child care), social (participating in activities outside of home, travel, leisure activities with others, and existence/availability of a ‘best friend’), and productive activity (employment status) [1].

Format: 15 items

Scoring: Items are rated on a scale from 0 (performed by someone else) to 2 (performed alone). Scores on each item are summed to produce the overall score, which can range from 0 to 29, with higher scores indicating greater integration. The CIQ can be further divided into 3 sub-scores for integration in the home, social integration, and productivity.

Administration and Burden: Self-administered; Proxy-administered. Approximately 15 minutes.

Psychometrics for SCI: Multiple sub-scales of the CIQ have been found to correlate significantly with sub-scales of the Craig Handicap Assessment and Reporting Technique Short-Form (CHART-SF); this was particularly the case with the social integration sub-scales of each measure [2].

Languages: English.

QoL Concept: The CIQ measures Community Reintegration, which corresponds to Boxes B (societal standards and priorities) and C (achievements) of Dijker’s Model.

Permissions/Where to Obtain: Copyrighted; The CIQ can be acquired by obtaining permission from Dr. Barry Willer - Details about the CIQ and contact information for Dr. Willer are available at the Centre for Outcome Measurement in Brain Injury at: http://www.tbims.org/combi/ciq/index.html.


  1. Willer B, Rosenthal M, Kreutzer JS, Gordon WA, Rempel R. Assessment of community integration following rehabilitation for traumatic brain injury. J Head Trauma Rehabil 1993;8:75-87.

  2. Gontkovsky ST, Russum P, Stokic DS. Comparison of the CIQ and chart short form in assessing community integration in individuals with chronic spinal cord injury: A pilot study NeuroRehabil 2009;24:185-92.


Pain SCI Studies: One cross-sectional and longitudinal survey.

  1. Jensen MP, Hoffman AJ, Cardenas DD. Chronic pain in individuals with spinal cord injury: a survey and longitudinal study. Spinal Cord 2005;43:704-12.

Sensitivity to Impact: Jensen and colleagues (2005) compared the severity of pain after spinal cord injury (SCI) to national norms, and examined the association between pain measures and the prevalence and intensity of pain over time in patients with SCI (N = 147). Their battery included the SF-36, the Community Integration Questionnaire (CIQ), and a modified version of the Brief Pain Inventory (BPI). Results showed an association between presence of pain and trends toward poorer psychological functioning and social integration, as measured by the CIQ.

Suggestions for Use: The CIQ may be useful for assessing the impact of pain after SCI but there are some noted problems with the CIQ stemming from the traumatic brain injury literature that are also relevant for SCI.  For example, the assumptions reflected in the metric and scoring criteria of the CIQ favours time spent with friends without disabilities over time spent with friends with disabilities [1, 2], as well their is a lack of group norms [1, 3]. In addition, the scope of the CIQ includes limited dimensions of community integration and premature reduction of items in its development [1].

The CIQ is an acceptable tool for use in SCI [4], but further work is recommended to establish its psychometric properties for this population.

Additional References:

  1. Dijkers M. Measuring the long-term outcomes of traumatic brain injury: A review of the community integration questionnaire. J Head Trauma Rehabil 1997;12:74-91.

  2. McColl MA, Davies D, Carlson P, Johnston J, Minnes P. The community integration measure: Development and preliminary validation. Arch Phys Med Rehabil 2001;82:429-34.

  3. Kaplan CP. The community integration questionnaire with new scoring guidelines: Concurrent validity and need for appropriate norms. Brain Inj 2001;15:725-31.

  4. Gontkovsky ST, Russum P, Stokic DS. Comparison of the CIQ and CHART short form in assessing community integration in individuals with chronic spinal cord injury: A pilot study. NeuroRehabil 2009; 24:185-92.
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