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 I trauma center. PARTICIPANTS: Fifty-eight blacks, 57 Hispanics, and 52 whites with traumatic brain injury living in the community 6 months postinjury. MAIN MEASURES: Open-ended interview questions and a questionnaire assessing perceived importance of community integration activities. RESULTS: Resulting themes indicated that feeling part of the community was related to type and quality of community relationships, perceived safety and security, active involvement, feeling included and respected, and familiarity with the community. Themes regarding barriers 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 domestic activities than did whites. CONCLUSIONS AND IMPLICATIONS: Feeling integrated into the community relates to aspects of the environment as much as to involvement in specific activities. Environmental barriers can be just as important as injury-related changes. Different racial/ethnic groups place different value on participation activities. The results emphasize the importance of assessing subjective aspects of community integration, individualizing rehabilitation goals, and intervening in the environment to facilitate participation.