Recent conceptual and empirical advances in participation measurement

While participation is a central concept in disability research and the World Health Organization's International Classification of Functioning, Disability, and Health, there is no current agreement on a standard measure of participation. Early measures like the Craig Handicap Assessment and Reporting Technique focused on assessment of performance of social roles by gathering objective information about hours spent in productive activity, times engaged in community activities, and counts of social contacts, but this approach was criticized for not recognizing individual choice in which types of participation a person wanted to engage in. This in turn led to more subjective approaches to the measurement of participation. Recently, the Traumatic Brain Injury Model Systems and the Spinal Cord Injury Model Systems have both embarked on a strategy of pooling items from many existing instruments in an attempt to identify the best items for measuring participation and examining the conceptual and empirical structure underlying the concept of participation. This paper will report on these ongoing efforts and discuss early findings from item pools including the Craig Handicap Assessment and Reporting Technique, the Participation Objective Participation Subjective, the Community Integration Questionnaire Version 2, the Mayo Portland Participation Measure, the Community Participation Index, the Community Integration Measure, the Participation Measure for Post-Acute Care, and the Participation Profile. Conceptual distinctions among these measures will also be discussed.