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Activity Measure for Post Acute Care (AMPAC)/ Participation Measure for Post Acute Care.

Haley, S.
Project title: 
Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes: Develop and Evaluate Activity Measures of Therapeutic Interventions across Rehabilitation Outcomes.
Project Number: 
Tool type: 
Tool class: 
Nonengineering tool
Disability targeted: 
All disabilities
Study target: 
People receiving medical rehabilitation services
Study purpose or goal: 
To learn how many activities can a person do and how many they recover once they return to community. Same with participation: how many people go back to important life roles after rehabilitation.
Who administers this tool?: 
Providers of medical rehabilitation services. It can also be self-reported.
Ease of use: 
Very easy
Time to complete: 
Equipment required: 
Sensitive issues: 
While there are no sensitive issues, per se, it does ask how many friends the subject has and collects income data to gauge socioeconomic status.
Are any approvals required?: 
The assessments received IRB approval.
How is it administered?: 
These measures are applied by medical rehabilitation professionals utilizing multiple venues: interview, computer-based forms, and self-reporting. Confidentiality is maintained by eliminating names during data processing. Researchers are developing a manual which will include scoring instructions.
What is the scope or what areas does it cover?: 
The Activity Measure covers three major components: physical function (navigating the environment), applied cognitive (communicating, write/read, scheduling day), and personal and instrumental care (dishes, laundry, etc). The Participation Measure, while still in development, covers two major areas: daily living activities at home (organizing home and finances, managing repairs) and community-based activities outside of home (visits with friends and social contacts, travel, voting, community events, volunteers, work). There will be multiple iterations of these measures: the short form will include no more than ten items. The computerized version will include six or seven items with questions chosen based on previous responses.
Development background: 
Development of these two assessment tools included extensive literature review in outcomes and measures design, as well as rehabilitation outcomes.
Development methodology: 
Questions and methodology were selected based on consumer input and tools existing in the field. The scales were field tested and questions were omitted or edited as necessary.
Outside consultation: 
Consultations were made with researchers within and outside the institution.
Consumer input: 
Consumer input was gathered through focus groups, including an focus group within the RRTC and disability-specific support groups in the community at large.
Can this tool be used for other purposes/populations?: 
The assessment is specific to the purpose: for rehabilitation providers to monitor quality of care by understanding which people recover and which do not. The development process evaluates facets of life during the rehabilitation process.
Sample type: 
The original sample included a broad spectrum of participants.
Data analysis: 
Is in process
While there are no limitations to the tool itself, the researchers were limited in their original sample size
Publication of results is pending in 2004.
These instruments will allow rehabilitation providers to collect data more easily across the rehabilitation setting and make quality improvements in care.
Research methods: 
Multiple data analysis techniques were utilized with item response theory predominating.
Peer review status: 
1. Latham NK, Mehta V, Nguyen AM, Jette AM, Olarsch S, Papanicolaou D, Chandler J. Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients? Arch Phys Med Rehabil. 2008 Nov;89(11):2146-55. 2. Tao W, Haley SM, Coster WJ, Ni P, Jette AM. An exploratory analysis of functional staging using an item response theory approach.Arch Phys Med Rehabil. 2008 Jun;89(6):1046-53. 3. Jette et al. On “Prospective Evaluation of the AM-PAC-CAT…” Phys Ther. 2007;87:385-398. Hart DL. Phys Ther. 2007 May;87(5):609-11; athor reply 611. No abstract available. 4. Jette AM, Haley SM, Tao W, Ni P, Moed R, Meyers D, Zurek M. Prospective evaluation of the AM-PAC-CAT in outpatient rehabilitation settings. Phys Ther. 2007 Apr;87(4):385-98. Epub 2007 Feb 20. Erratum in: Phys Ther. 2007 May;87(5):617. 5. Haley SM, Ni P, Coster WJ, Black-Schaffer R, Siebens H, Tao W. Agreement in functional assessment: graphic approaches to displaying respondent effects. Am J Phys Med Rehabil. 2006 Sep;85(9):747-55. 6. Haley SM, Siebens H, Coster WJ, Tao W, Black-Schaffer RM, Gandek B, Sinclair SJ, Ni P.Computerized adaptive testing for follow-up after discharge from inpatient rehabilitation: I. Activity outcomes. Arch Phys Med Rehabil. 2006 Aug;87(8):1033-42. 7. Coster WJ, Haley SM, Jette AM.Measuring patient-reported outcomes after discharge from inpatient rehabilitation settings. J Rehabil Med. 2006 Jul;38(4):237-42. 8. Siebens H, Andres PL, Pengsheng N, Coster WJ, Haley SM. Measuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach. Am J Phys Med Rehabil. 2005 Oct;84(10):741-8. 9. Haley SM, Coster WJ, Andres PL, Kosinski M, Ni P.Score comparability of short forms and computerized adaptive testing: Simulation study with the activity measure for post-acute care. Arch Phys Med Rehabil. 2004 Apr;85(4):661-6. 10. Coster WJ, Haley SM, Andres PL, Ludlow LH, Bond TL, Ni PS. Refining the conceptual basis for rehabilitation outcome measurement: personal care and instrumental activities domain. Med Care. 2004 Jan;42(1 Suppl):I62-72. 11. Haley SM, Coster WJ, Andres PL, Ludlow LH, Ni P, Bond TL, Sinclair SJ, Jette AM. Activity outcome measurement for postacute care. Med Care. 2004 Jan;42(1 Suppl):I49-61. 12. Dechamps A, Alban R, Jen J, Decamps A, Traissac T, Dehail P. Individualized Cognition-Action intervention to prevent behavioral disturbances and functional decline in institutionalized older adults: a randomized pilot trial. Int J Geriatr Psychiatry. 2010 Aug;25(8):850-60.
Who uses the collected data?: 
Rehabilitation providers and rehabilitation research funding groups will be the most likely users of the data gathered.
Is this tool available free of charge?: 
Tool contact: 
Wendy Coster, PhD, OTR/L