• Christine M McDonough, Alan M Jette, Pengsheng Ni, Kara Bogusz, Elizabeth E Marfeo, Diane E Brandt, Leighton Chan, Mark Meterko, Stephen M Haley, and Elizabeth K Rasch.
• Health and Disability Research Institute, Department of Health Policy and Management, School of Public Health, Boston University Medical Campus, Boston, MA, USA. cmm@bu.edu
• Arch Phys Med Rehabil. 2013 Sep 1; 94 (9): 1653-60.

ObjectivesTo build a comprehensive item pool representing work-relevant physical functioning and to test the factor structure of the item pool. These developmental steps represent initial outcomes of a broader project to develop instruments for the assessment of function within the context of Social Security Administration (SSA) disability programs.DesignComprehensive literature review; gap analysis; item generation with expert panel input; stakeholder interviews; cognitive interviews; cross-sectional survey administration; and exploratory and confirmatory factor analyses to assess item pool structure.SettingIn-person and semistructured interviews and Internet and telephone surveys.ParticipantsSample of SSA claimants (n=1017) and a normative sample of adults from the U.S. general population (n=999).InterventionsNot applicable.Main Outcome MeasureModel fit statistics.ResultsThe final item pool consisted of 139 items. Within the claimant sample, 58.7% were white; 31.8% were black; 46.6% were women; and the mean age was 49.7 years. Initial factor analyses revealed a 4-factor solution, which included more items and allowed separate characterization of: (1) changing and maintaining body position, (2) whole body mobility, (3) upper body function, and (4) upper extremity fine motor. The final 4-factor model included 91 items. Confirmatory factor analyses for the 4-factor models for the claimant and the normative samples demonstrated very good fit. Fit statistics for claimant and normative samples, respectively, were: Comparative Fit Index=.93 and .98; Tucker-Lewis Index=.92 and .98; and root mean square error approximation=.05 and .04.ConclusionsThe factor structure of the physical function item pool closely resembled the hypothesized content model. The 4 scales relevant to work activities offer promise for providing reliable information about claimant physical functioning relevant to work disability.Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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