CHIEF Environmental Barriers

The Craig Hospital Inventory of Environmental Factors, known as CHIEF, is a self-report instrument that quantifies the environmental barriers people with disabilities encounter in daily life. Developed by Whiteneck and colleagues in 2004, it operationalizes the environmental-factors component of the WHO ICF, which holds that disability arises from the interaction between a person and their surroundings rather than from impairment alone. CHIEF asks respondents about barriers across five domains — physical and structural, attitudinal and support, services and assistance, productivity, and policy — and for each potential barrier it captures two things: how often the barrier is encountered (frequency) and how big a problem it is when encountered (magnitude). The defining feature of the instrument is that these two ratings are multiplied into a frequency-by-magnitude product, so that a barrier counts for more if it is both common and serious. These products are averaged into domain scores and an overall score, giving a quantitative profile of the environmental obstacles a person faces.