Linking COURAGE in Europe Built Environment instrument to the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)

Objectives: The aim of the paper is to prove that the COURAGE in Europe Built Environment (CBE) instrument selected items are relevant to health and disability assessment and evaluation. Study design: The two lists of the CBE preliminary items - outdoor checklist and self-reported questionnaire - were linked to the World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) through established linking rules. Results: The pool of the CBE 162 preliminary items were linked to a total of 184 categories of ICF-CY, and belonged mainly to two out of the four of the ICF-CY components. Fifteen of the items were not linked to any category of the ICF-CY classification at all. The linking process showed that more than 90% of CBE preliminary items were linked to ICF-CY categories and more than 4/5 of them were linked to the ICF-CY component of environmental factors. Conclusion: The fact that most of the linked CBE preliminary items referred to few ICF categories, on one hand showed that the ICF framework encompasses a lot of different aspects related to functioning and disability; on the other hand ICF categories are not very detailed for a comprehensive description of the built environment features.