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BACKGROUND/RATIONALE:
If the research studies that contribute to evidence-based care in VHA rely on measures that are not valid for their proposed purpose, the conclusions that inform care will be flawed and incomplete. In this context, further development and validation of the Deployment Risk and Resilience Inventory (DRRI) is critical. The DRRI is a widely used suite of scales designed to assess key psychosocial risk and resilience factors experienced before, during, and after deployment. Prior research indicates that the factors addressed in the DRRI have significant implications for veterans' post-deployment health. However, it was developed and validated on veterans of the 1990-1991 Gulf War and therefore it is unclear whether the scales adequately capture the breadth of experiences for other veteran cohorts.
OBJECTIVE(S):
The overarching goal of this project was to update the DRRI to make it more broadly applicable across veteran cohorts. The primary objective of this study was to examine the content coverage of the DRRI, identify additional risk and resilience domains, and use this information to elaborate existing DRRI scales and develop new scales as needed. A secondary objective was to update existing DRRI items for enhanced clarity and broader applicability across veteran cohorts.
METHODS:
This project involved a multistage iterative item development process. First, existing literature was examined to identify areas for expansion of the DRRI. Next, focus groups were conducted with OEF/OIF veterans to explore the comprehensiveness of the DRRI. Six two-hour focus groups were conducted in two locations (Boston VA Healthcare System and Central Texas VA Health Care System) with a total of 29 participants; 24 were men, 5 were women, 12 were racial/ethnic minorities, and a diverse array of military services and experiences were represented. Participants were led through a semi-structured discussion of deployment-related experiences and results were coded for themes of risk and resilience. This information was used to modify existing DRRI items and identify additional content for inclusion in the DRRI. Items were developed to supplement existing scales and to address newly identified construct domains. Next, newly identify DRRI constructs and their associated items were reviewed by content and instrument development experts. Following relevant changes to the scales based on expert review, items were reviewed by members of the target population. Items were again revised based on feedback.
FINDINGS/RESULTS:
Revisions to the DRRI centered primarily on expanding the assessment of combat-related experiences and family functioning. Six new scales were created to address previously unmeasured factors. In addition, items from a number of existing scales benefited from rewording, and several scales required the addition or removal of specific items to enhance relevance across cohorts. Results highlight the usefulness of focus groups for obtaining detailed qualitative information about veterans' experiences, as well as the benefit of an iterative multistage item development process.
IMPACT:
The results of this project have implications for both research and clinical care. Researchers and clinicians require measures that can be used to assess the experiences of veterans with confidence. The focus of this project on evaluating the content coverage of the DRRI, and updating this suite of scales as necessary, addresses this need. Future research will involve validating updated scales and developed short forms of DRRI scales in a nationally representative sample of OEF/OIF veterans.
PUBLICATIONS:
None at this time.
DRA:
Military and Environmental Exposures
DRE:
Communication and Decision Making, Technology Development and Assessment
Keywords:
Research measure, Research method
MeSH Terms:
none
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