The Keele Assessment of Participation

  • R. Wilkie
Reference work entry


The World Health Organization has proposed  participation restriction to reflect the societal consequences of health conditions. Participation restriction can be multiply determined and represents the outcome of an individual’s ongoing interaction with their environment and with society; it emphasizes the independent causal role of environmental factors in determining functioning and refers to what is actually performed by the individual in real life situations. It is appealing concept for those interested in older populations and the impact of chronic diseases because even when health conditions and activity limitations persist, there may still be potential to maintain participation. Despite its importance, participation restriction is inconsistently represented or absent from the content of many health status instruments and has not been clearly measured in population studies.

This chapter describes the development of the Keele Assessment of Participation (KAP), a self-complete instrument designed to provide estimates of  person-perceived participation restriction in population-based surveys. It specifies a  conceptual model of participation restriction (based on the individual’s perception of  performance of tasks), outlines how the instrument was developed (with the aim of being short and simple for application in epidemiological studies) and how its scale scores were decided (to allow differentiation between large groups in the population). It also describes, and reports the results of the  pre-pilot studies and pilot studies designed to investigate its measurement properties. The KAP performed adequately in  validity and  reliability tests and can be considered as an instrument that is likely to detect and provide sensible estimates of participation restriction in postal surveys.


Discriminant Validity Activity Limitation Cognitive Interview Participation Restriction Item Discrimination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

95% CI

95% confidence intervals


international classification of functioning, disability and health


impact on participation and autonomy




weighted kappa


keele assessment of participation




North Staffordshire osteoarthritis project


reintegration to normal living


World Health Organization



The study in which this work was undertaken was supported financially by a Program Grant awarded by the Medical Research Council, UK (grant code: G9900220) and by funding secured from the North Staffordshire Primary Care R&D Consortium for NHS service support costs. The author would like to thank Dr George Peat, Dr Elaine Thomas, Dr Helen Hooper and Professor Peter Croft for their input in developing the KAP. Also the administrative and health informatics staff at Keele University’s Primary Care Sciences Research Centre and the doctors, staff and patients of the participating general practice and the rheumatology wards of the Haywood Hospital, North Staffordshire.


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  • R. Wilkie

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