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

Author(s): 
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: 
H133B990005
Tool type: 
Assessments
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: 
Unknown
Equipment required: 
None
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
Limitations: 
While there are no limitations to the tool itself, the researchers were limited in their original sample size
Findings: 
Publication of results is pending in 2004.
Implications: 
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?: 
No
Tool contact: 
Wendy Coster, PhD, OTR/L