Development and validation of the activity significance personal evaluation (ASPEn) scale.

Engagement in meaningful occupation for health promotion is a longstanding tenet of occupational therapy (Kielhofner, 2007; Wilcock, 2006). Beyond the direct physical, cognitive, and social benefits of daily activity (Leland & Elliott, 2012), occupational therapists assert that participation in meaningful activity can result in an improved sense of mastery, life satisfaction, and development of hopeful future life narratives (Berger, McAteer, Schreier, & Kaldenberg, 2013; Fallahpour, Jonsson, Joghataei, Nasrabadi, & Tham, 2013; Foster, Bedekar, & Tickle-Degnen, 2014). Further, Jonsson (2008) has eloquently argued for an experiential view occupation that makes more clear the relationship between engagement in occupation and individual well-being. Consequently, an assessment tool that captures personal perceptions regarding the significance of daily activity for health and wellness could enhance the study of potential benefits of participation in daily activities (Hemmingsson & Jonsson, 2005). Additionally, understanding the mechanisms by which occupational therapy interventions benefit individuals requires the ability to quantify differences in activity significance among individuals, and to capture changes over time. To date, no tool captures adults' perceptions of the significance of daily activity for their personal health and wellness. In treating community-living older adults, occupational therapy interventions are premised not just on enabling more frequent participation in activities or in more challenging activities, but on greater engagement in personally meaningful activities (Gustafsson & McKenna, 2010; Pereira & Stagnitti, 2008). Unfortunately, available assessments generally focus on quantifying frequency and/or time devoted to activities. For example, activity checklists solicit the frequency of participating in different activities such as cooking or volunteering and may vary greatly in the number of activities assessed (Everard, Lach, Fisher, & Baum, 2000). Time-use diaries ask participants to record the number of minutes engaged in selected activities within a certain time period (Gerber & Furst, 1992). Participants may additionally be asked to classify or rate dimensions such as satisfaction or performance for activities like self-care or leisure (Archenholtz & Dellhag, 2008; Scanlan & Bundy, 2011). Classifying activity by type may be challenging to interpret, as scholars note that activities can have different meanings depending on social context (Hammell, 2009). For example, cooking could be considered work or leisure depending on the individual's occupational role (Mallinson & Hammel, 2010). Thus, checklists and time-use diaries, which may be cumbersome and time-consuming, may not inform providers about the perceived value and personal meaning of activities in promoting health and wellness. A brief, easily administered instrument is clearly needed to capture the extent to which older adults consider their everyday activities, in a global sense, to be meaningful and healthy. The aim of this study was to develop such an assessment that captures differences among older adults' perceptions of meaningful activity and that conforms to contemporary guidelines for scale development and testing.