Development,Content,and Construct Validity of the Complexities of Co-Occupation (CoCO) Scale

We present the development of a measure of co-occupation. The research is composed of two phases: (1) development and content validity as well as (2) construct validity through an exploratory factor analysis.

SIGNIFICANCE: The purpose of occupational therapy is to promote participation with others, which often presents as co-occupation. This research addresses an American Occupational Therapy Foundation (AOTF) priority to determine means of evaluating occupational therapy client-centered outcomes.

INNOVATION: The research addresses underlying constructs of co-occupation to challenge what is currently understood. The process of development and factor analysis may shift our thinking on the construct to consider whether this idea is different and, if so, how different an idea it actually is.

For Phase 1, the research question is as follows: Can the complexities of co-occupation be measured using a Likert scale? The rationale for this question is that a measurement tool that is designed to specifically measure co-occupation presents challenges: the existence of multiple definitions of co-occupation and the complexities of the multidimensional domains.

METHOD: A methodological research design was used. Each scale item in the initial Complexities of Co-Occupation (CoCO) Scale was identified and defined from the literature with relevant anchors. Ten scholars who had either published or presented on co-occupation were invited to participate. Five women and 2 men—who had 3 to 25 yr of academic experience, who had published 1 to 5 works on co-occupation, and who had given 0 to 10 presentations—participated.

ANALYSIS AND RESULTS: Responses were compiled using a content analysis matrix. Initial feedback revealed four aspects of the tool that required further development or clarification: (1) the purpose and use of the tool needed to be explicitly described; (2) additional information was required to clarify and feel confident in administration and scoring; (3) tighter, more descriptive definitions with examples for each of the anchors on the subscales were needed; and (4) descriptors on each of the levels within the subscales were needed. A revised tool was sent to two experts (from the original 7 participants) for a final Phase 1 review. Feedback was used to modify and further revise the tool before proceeding to Phase 2. For Phase 2, the research question is as follows: What factors underlie the construct of co-occupation as presented in the CoCO Scale? Using an exploratory factor analysis on the developing tool, we will further examine the underlying construct of the CoCO Scale. Data will be gathered using an online survey (PsychData) with 110 participants from three Master of Occupational Therapy (MOT) program locations.

The participants will engage in a face-to-face training module on co-occupation, with practice scoring using the CoCO Scale and video clips. Following the training, each student will be sent an e-mail with links to access PsychData and three unique YouTube™ videos for a total of 330 units scored.

Data will be entered into SPSS for an exploratory factor analysis. Demographic data will be separated from the rating data. The scale will be further refined on the basis of the factor loadings. The factor loadings will be interpreted on the basis of the interrelationships among the scale items, the number of factors created, and the extent to which the factors describe the three domains of co-occupation.

CONCLUSION: At the time of submission, Phase 2 data collection was still occurring.