Perceptions of community integration in an ethnically diverse sample

Objective: To investigate the meaning of community integration in an ethnically diverse sample. Design: Prospective study using mixed qualitative and quantitative methods. Setting: County level Itrauma center. Participants: Fifty-eight blacks, 57 Hispanics, and 52 whites with traumatic brain injuryliving in the community 6 months postinjury. MAIN Measures: Open-ended interview questions and aquestionnaire assessing perceived importance of community integration activities. Results: Resulting themesindicated that feeling part of the community was related to type and quality of community relationships, perceived safetyand security, active involvement, feeling included and respected, and familiarity with the community. Themes regardingbarriers included the following: environmental and social barriers; injury-related cognitive and physical changes;dissimilarities to others; relocation; and financial issues. Blacks and Hispanics placed more emphasis on domesticactivities than did whites. Conclusions and Implications: Feeling integrated into the community relates toaspects of the environment as much as to involvement in specific activities. Environmental barriers can be just asimportant as injury-related changes. Different racial/ethnic groups place different value on participation activities. Theresults emphasize the importance of assessing subjective aspects of community integration, individualizing rehabilitationgoals, and intervening in the environment to facilitate participation.