Confirmatory Factor Analysis of the 12-Item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) Within the Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness

Jessica A. Wojtalik, Anju Kotwani, Rochanne L. Honarvar, Shaun M. Eack, Lori D’Angelo, Chrissy Whiting-Madison, Wilson J. Brown

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Objective: The Clubhouse model (CM) for serious mental illness is a recovery-oriented and member-driven programthat aims to facilitate functional recovery. Efficacy evaluation of the CMis limited by lack of uniform functional disability assessment. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) is a widely accepted measure of functional disability, but its psychometric properties have yet to be examined within the CM. Method: This research sought to confirm the generic six-factor structure of the 12-item WHODAS-2.0 using retrospective administrative data from 339 adults with serious mental illness from an accredited Clubhouse. A second-order confirmatory factor analysis was conducted, followed by secondary known-groups analyses to examine whether the WHODAS-2.0 differentiates between subgroups with varying degrees of disability. Results: The WHODAS-2.0 demonstrated good overall reliability. The generic six-factor structure produced nonsignificant loadings due to lack of independence between the “participation” and “getting along” factors. The items of these two factors were combined into a five-factor model, which displayed excellent fit, with all significant paths and adequate-to-strong loadings, and no correlation among errors. The WHODAS-2.0 significantly differentiated members by receipt of public assistance, employment status, and number of medical comorbidities, supporting construct validity. Conclusions and Implications for Practice: These results provide initial support for the use of the 12-item WHODAS-2.0 as a CM-related outcome measure and encourage future research of the full 36-item version. The intentional community approach of the CM is unique and may require adjustments to the factor structure of the WHODAS-2.0 by merging the “participation” and “getting along” domains.

Original languageEnglish (US)
JournalPsychiatric Rehabilitation Journal
StateAccepted/In press - 2023

All Science Journal Classification (ASJC) codes

  • Health Professions (miscellaneous)
  • Rehabilitation
  • Psychiatry and Mental health

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