Introduction: Veterans face several challenges when returning to civilian life, including social integration (SI); however, optimal strategies to measure this construct are uncertain. The authors conducted a systematic review to identify and appraise instruments measuring SI. Methods: The MEDLINE, EMBASE, PsycINFO, CINAHL, and ERIC databases were searched through Oct. 2, 2023, for studies reporting instruments measuring SI, with no restrictions based on geographical setting. The COSMIN instrument was used to assess risk of bias of eligible studies and measurement properties of identified instruments. Three Veteran partners who were members of the Canadian Armed Forces (CAF) independently reviewed and assessed all instruments’ clarity and applicability to Veterans. Results: The authors identified 37 instruments evaluating SI. Of these, 18 (49%) showed sufficient structural validity, 25 (68%) sufficient internal consistency, 1 (3%) sufficient cross-cultural validity, 7 (19%) sufficient test-retest reliability, 2 (5%) sufficient criterion validity, and 25 (68%) sufficient hypothesis testing for construct validity. Four had sufficient psychometrics: Strathclyde Citizenship Measure (SCM), Enfranchisement Participation (EP), Well-Being Inventory (WBI), and Social Integration in Later Life Scale (SILLS). CAF Veteran partners rated all four instruments as clear but found only the SCM to be highly applicable; the other tools did not fully reflect Canadian Veteran transition experiences, including Canadian military culture and post-service identity. Discussion: Among the instruments with sufficient psychometrics and endorsed by Veteran partners, the SCM is the most promising and applicable to Veterans but requires further validation before use. The EP, SILLS, and WBI may need further augmentation and validation before use.
Lay Summary Social integration is an important component of Veteran well-being; however, uncertainty exists regarding the optimal approach to measuring this construct. The authors conducted a systematic review to identify tools that measure social integration and to evaluate their quality, and they asked three Veteran partners to review their clarity and applicability to Veterans. Thirty-seven tools that measure social integration were found, among which the Strathclyde Citizenship Measure was the most promising. The Enfranchisement Participation, Social Integration in Later Life Scale, and Well-Being Inventory were clear but may require further revision before use. These findings should prove useful to clinicians, researchers, and policy makers who want to assess social integration well-being among Veterans.
