Updating and validating the Domestic and Community Skills Assessment

INTRODUCTION: This study outlines the revision and content validity process for the Domestic and Community Skills Assessment, Third Edition (DACSA-3). The DACSA-3 is an occupational therapy instrumental activities of daily living (IADL) assessment, which can be used to assess a person with a mental health condition. METHODS: The DACSA-3 was developed by considering past development and research, technology changes, and current occupational therapy theories. Nine content experts (occupational therapists with mental health experience) were involved in a qualitative and quantitative review of the DACSA-3 to establish content validity using the content validity ratio (CVR) and content validity index (CVI), with recommended minimum thresholds of 0.78. CONSUMER AND COMMUNITY INVOLVEMENT: The DACSA-3 was reviewed by two content reviewers (professionals with lived mental health experience) to ensure that recovery oriented language was included. RESULTS: The Initial Interview was retained and updated. The Supporting Interview was removed, because it lacked construct validity. The Observation Checklist was renamed to Context List and updated to include environmental and personal factors that may influence task performance. The Objective Assessment subtests were updated and reduced from 17 to 14 subtests. The money handling, personal presentation, and postage handling subtests were removed, because they were no longer relevant or did not fit the occupational category of IADL. The scoring criteria for each subtest were improved by aligning with the rating scale definitions to prevent discrepancies between ratings and clinical judgement. The CVR of DACSA-3 items ranged from 0.78 to 1.00, and the CVI of the DACSA-3 was 0.98. CONCLUSION: The DACSA-3 is a revised, contemporary occupational therapy assessment of IADL, which has content validity. The CVR and CVI exceeded the minimum recommended thresholds, and thus, the content validity of the DACSA-3 was established. Modifications were made to the DACSA-3 to reduce the administration time and it no longer contains a screening tool.