Reliability and construct validity of the Participation in Life Activities Scale for children and adolescents with asthma: an instrument evaluation study

BACKGROUND The purpose of this study was to evaluate the reliability and construct validity of the Participation in Life Activities Scale, an instrument designed to measure older school-age child and early adolescent level of involvement in chosen pursuits. METHODS A cross-sectional design was used. The convenience sample consisted of 313 school-age children and early adolescents with asthma, ages 9-15 years. The self-report summative scale of interest is a 3-indicator survey. Higher scores are reflective of higher levels of participation. Internal consistency reliability and construct validity for the entire sample and sub groups of the sample were evaluated. RESULTS The instrument was deemed sound for the entire sample as well as sub groups based on sex, race, age, socioeconomic status, and severity of illness. Cronbach's alpha coefficient for internal consistency reliability for the entire sample was .74. Exploratory factor analysis indicated a single component solution (loadings .79-.85) accounting for 66% of the explained variance. Construct validity was established by testing the posed relationship between participation in life activities scores and severity of illness. Confirmatory factor analysis revealed a good fit between the data and specified model, chi2(10, n = 302) = 8.074, p = .62. CONCLUSION This instrument could be used (a) in clinical settings to diagnose restricted participation in desired activities, guide decision-making about treatment plans to increase participation, and motivate behavioral change in the management of asthma; and (b) in research settings to explore factors influencing and consequences of restricted and unrestricted participation, and as an outcome measure to evaluate the effectiveness of programs designed to foster child and early adolescent management of asthma.