The Keele Assessment of Participation: A New Instrument to Measure Participation Restriction in Population Studies. Combined Qualitative and Quantitative Examination of its Psychometric Properties

Abstract

The World Health Organization has proposed participation restriction to reflect the societal consequences of health conditions. Despite its importance, participation restriction appears to be inconsistently represented or absent from the content of many health status instruments. This paper describes the development and testing of a new self-complete measure of participation restriction from the conceptual basis of participation as an individual's perception of their actual involvement in life situations. The psychometric properties (face, content and construct validity, responder burden, performance and repeatability) of the instrument were examined using qualitative and quantitative methods. Person-perceived participation restriction did not reflect the frequency of participation but was associated with participants' expectations, aspirations, and needs, as well as contextual factors. We conclude that the instrument can provide estimates of person-perceived participation restriction in population surveys.

Treatment of Forefoot Problems in Older People: A Randomized Clinical Trial Comparing Podiatric Treatment With Standardized Shoe Advice

“…Secondary outcomes were general health, measured with the 12-Item Short Form Health Survey (SF-12), 28 and social participation, measured with the Keel Assessment of Participation. 29 Adherence was also assessed in every questionnaire. If the podiatric treatment (orthotics or other) were worn more than 3 days a week at 2 or more time points, participants were considered to be adherent.…”

Reasons Why Multimorbidity Increases the Risk of Participation Restriction in Older Adults With Lower Extremity Osteoarthritis: A Prospective Cohort Study in Primary Care

“…Data on pathway variables were collected by self-report. Although this is susceptible to measurement error, validated instruments (e.g., KAP [28], WOMAC [30], FDI [31], HADS [34], and the SF-36 [35]) were used to measure participation, pain severity, depression, and locomotor disability. There may be some differential reporting for height and weight that may lead to misclassification of BMI, and this is particularly notable in older adults (54).…”

“…At the 6-year followup, incident participation restriction was defined as moving from no restriction at baseline to participation restriction at 6 years. The reliability and validity of the KAP have been established as adequate for providing estimates of perceived participation restriction in population studies (28).…”

A review of instruments assessing participation in persons with spinal cord injury

“…Since the ICF was published in 2001 a number of new participation instruments have been developed using the ICF. [48][49][50][51][52][53][54][55] Some of these instruments have been assessed in persons with SCI, 48,[50][51][52]54 but no data on the measurement properties were specified for this group and so they were not included in this review. Future studies reporting the measurement properties of these instruments in persons with SCI will provide the evidence necessary to use these instruments in research and clinical practice.…”