Keele Assessment of Participation

General population of adults over 50 (Wilkie et. al, 2005)

• For the four filter questions, the mean observed agreement was 87.5% (range: 84–92%) and chance-corrected agreement ranged from moderate (k = 0.54; 95% CI: 0.41, 0.67) to substantial (k = 0.70; 95% CI: 0.57, 0.83)

• The mean observed agreement for the five response options to each participation item was 75.1% (range: 68–83%) and chance-corrected agreement ranged from slight (k w = 0.34; 95% CI: 0.09, 0.59) to moderate (kw = 0.64; 95% CI: 0.54, 0.74).

• For the dichotomised response (mean agreement=90.4%; range: 85.3– 94.4%) with chance-corrected agreement ranging from slight (k= 0.20, 95% CI: 0.04, 0.44) to substantial (k = 0.71; 95% CI: 0.57, 0.85).

• The actual agreement for the categories of ‘None’ and ‘Any’ restriction was 71.6% and chance corrected agreement gave a kappa of 0.42 (95% CI: 0.27, 0.57).

• There was a systematic difference in the prevalence of ‘Any’ participation restriction between the first and second administrations with the prevalence for the first mailing higher than for the second (46.7% cf 37.3%; % difference: -9.4; 95% confidence interval: -1.4%, -17.3%)

• The mean observed agreement for the 5 answer options per questions was 75.1%. Kappa value when chance-corrected ranged from .34 to .64.

Predictive Validity

Older Adults (age 50+ years) with knee pain

• Trend of increasing mobility restriction outside the home (one KAP question) with increasing levels of knee pain and stiffness measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Adjusting for age, sex, and socioeconomic status, the strongest association was with the highest category of pain severity (adjusted odds ratio [OR] 19.8, 95% confidence interval [95% CI] 13.6–28.9) (Wilkie, et al., 2007)

• Restricted mobility outside the home is associated with three environmental factors developed by the study:

  • requirement of aids/assistance [OR 3.1, 95% CI 2.2–4.4]

  • poor access to public transportation [OR 2.3, 95% CI 1.4–3.9]

  • poor access to a car [OR 1.6, 95% CI 1.1–2.4])

• Mobility restriction outside the home (one KAP question) is associated with a number of health conditions measured by the Health Survey questionnaire:

  • Having 2–3 health conditions: OR 2.0, 95% CI 1.2–3.2)

  • depression (possible case: OR 2.3, 95% CI 1.5–3.5, and probable case: OR 3.0, 95% CI 1.7–5.3)

  • cognitive impairment (low level: OR 1.6, 95% CI 1.1–2.4, and high level: OR 1.5, 95% CI 1.0–2.2)

  • Being underweight (OR 3.0, 95% CI 1.5–8.4)

  • NOT associated with bilaterality of knee pain, number of other lower limb joint pains, and anxiety

Construct validity not applicable because the assessment does not have an official score (Magasi & Post, 2010)

Convergent validity

• Moderate to strong convergent validity correlations (r>0.50) with the IPA, PM-PAC, POPS-OBJ, POPS-SUBJ, WHODAS-II (Noonan, et al., 2010) in the following domains:

  • Mobility (6 out of 10 correlations strong or moderate)

  • Self-care (2 out of 2 correlations strong or moderate)

  • Domestic life (10 out of 18 correlations strong or moderate)

  • Interpersonal interactions/relationships (3 out of 5 correlations strong or moderate)

  • Work/Education (8 out of 14 correlations strong or moderate)

  • Economic life (0 out of 1 correlations strong or moderate)

  • Community, social, and civic life (3 out of 5 correlations strong or moderate)

Ankylosing spondylitis (AS)

• Excellent convergent validity with the Social Role Participation Questionnaire (SRPQ) constructs of satisfaction with time spent and role performance ( r=0.72 and r=0.68, respectively) (Davis, et al., 2011)

Psoriatic arthritis (PsA)

• Excellent convergent validity with the Social Role Participation Questionnaire (SRPQ) constructs of satisfaction with time spent and role performance ( r=0.68 and r=0.65, respectively) (Davis, et al., 2011)

Variety of Diagnoses/practice settings

• Excellent convergent validity with the Reintegration to Normal Living Index (RNL) (r=0.72--0.84) (Magasi &Post, 2010; Wood-Dauphinee, et al., 1988)

• Poor divergent validity for items that are non-corresponding on the RNL (r=0.57-0.89) (Magasi & Post, 2010)

Various (mostly traumatic hand and neuromuscular diagnoses)

• Excellent convergent validity with Impact on Participant and Autonomy Scale (IPA) (r= 0.74--0.97) (Magasi & Post, 2010; Cardol, et al., 1999)

• Poor divergent validity for items that are non-corresponding on the IPA (r=0.66--0.97) (Magasi & Post, 2010)

General population of adults over 50:

• In terms of convergent validity, the mean percentage agreement for the 10 pairs of corresponding items between KAP and RNL was 79.3% (range: 72–84%) Mean percentage agreement for 23 pairs of corresponding items between KAP and IPA was 87.7% (range: 74–97%). (Wilkie et al., 2005)

• In terms of discriminant validity, the mean agreement for 60 pairs of non-corresponding items between the KAP and the RNL was 76.0% (range: 57–89%). The mean agreement for 160 pairs of non-corresponding items between the KAP and the IPA was 82.8% (range: 66–97%). (Wilkie et al., 2005)

• Also, in terms of discriminant validity the mean percentage agreement, where responders indicated participation or participation restriction in both matched items for 23 matched pairs, was 47.6% (range: 24–87%) (Wilkie et al., 2005)

General population of adults over 50:

The proportion of responders who indicated ‘no’ in a filter question and also indicated that they did not participate in the corresponding task ranged from 64% to 98% (Wilkie et al., 2005)

General population of adults over 50: (Wilkie et al., 2005)

• Poor ceiling effect (53%)

Adults with joint pain and comorbidity: (Hermsen et al., 2013)

• KAPd1: SEM= 1.75
• KAPd2: SEM= 2.02

Adults with joint pain and comorbidity (Hermsen et al., 2013)

• KAPd1: MDC= 4.8
• KAPd2: MDC= 5.6

Adults with joint pain and comorbidity (Hermsen et al., 2013)

• KAPd1: Adequate test-retest reliability (ICC=0.63)

• KAPd2: Adequate test-retest reliability (ICC=0.57)

Adults with joint pain and comorbidity: (Hermsen et al., 2013)

• KAPd1: Adequate internal consistency (Cronbach’s alpha= 0.74)
• KAPd2: Poor internal consistency (Cronbach’s alpha= 0.57)

Adults with joint pain and comorbidity: (Hermsen et al., 2013)

• KAPd1: Poor ceiling effect (28%)
• KAPd2: Poor ceiling effect (33%)