Validation of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) and reference norms in a French-Canadian population with traumatic brain injury receiving rehabilitation

Abstract

Objective: To validate the factor structure and establish internal consistency reliability of the French-Canadian version of the Mayo-Portland Adaptability Inventory (MPAI-4), using a Canadian sample of adults with traumatic brain injury (TBI) receiving post-acute rehabilitation services. Design: Psychometric analysis of prospectively collected French-Canadian MPAI-4 data. Setting: Inpatient and outpatient TBI rehabilitation programs. Participants: Adults (N = 1012) with a mild, moderate or severe TBI who received inpatient or outpatient rehabilitation interventions and for whom a first French-Canadian MPAI-4 measure was completed between 2016 and 2020. Interventions: Not applicable. Main Outcome Measure: French-Canadian MPAI-4 questionnaire. Results: To evaluate the factor structure of the French-Canadian MPAI-4, an exploratory factor analysis using a varimax rotation method was conducted on z-scores for all items. The final and best solution was a three-factor solution, which accounted for 48.68% of the variance. The internal consistency of the French-Canadian MPAI-4 was determined using Cronbach's alpha and all three subscales showed good internal consistency (all alpha values between .70 and .89). Reference norms for the TBI sample are provided in the form of T scores for subscales and total score, as well as descriptive raw data according to sex, age, TBI severity and rehabilitation setting. Conclusions: The three factors extracted using data from the French-Canadian MPAI-4 are similar, but not entirely identical to the three subscales of the original MPAI-4. Overall, the French-Canadian MPAI-4 factor structure is validated. The questionnaire shows good psychometric properties and represents a suitable tool to measure functional evolution and social participation of TBI adults receiving rehabilitation services in a French-Canadian context. The provided reference norms will also help guide the clinical use of the MPAI-4 in French-Canadian TBI populations.