PART-O Syllabus

Introduction

The original validation study of the PART-O (Whiteneck et al., 2011) employed a sample of 400 participants in the TBI Model Systems National Database. Participants were 1, 2, 5, 10, or 15 years post-injury. If the participant was not able to participate in the interview, the person's proxy was asked to complete the questions. Rasch and conceptual analyses of the resulting data were used to reduce the original pool of 69 items to 24 items. The validation study demonstrated the expected relationships of PART-O scores with injury severity, activity limitations, subjective well-being, as well as with legacy measures of participation, supporting the construct validity of the PART-O.

A subsequent study reduced the length of the instrument to 17 items, identified domains, and provided standard scores based on a population-based sample (Bogner et al., 2011). A formal consensus development process using input from primary, secondary, and tertiary consumers (persons with TBI, family members, advocates, and researchers) was used to classify items into three domains: Out and About, Productivity, and Social Relations. The domains were evaluated empirically using item-subscale correlations.

All items are scored on a 0 to 5 scale, and domain scores are the average of the items in the domain. Two algorithms were developed to combine domain scores into total scores: the Averaged Total score and the Balanced Total score. The Averaged Total score was based on the assumption that more participation, of any kind, is better; it is calculated by averaging the three domain scores. The Balanced Total score was suggested by the work-life balance literature, and reflects the assumption that ideal participation involves a balance between participation in the three domains, as well as greater participation. The Balanced Total score is calculated by subtracting the standard deviation of the person's three domain scores from the Averaged Total score.

Standardized scores on the PART-O-17 can be calculated using data from samples of persons with and without disability living in Colorado and a sample of persons living in three states who received rehabilitation for a range of conditions. However, the Colorado samples had an overall higher level of education than the general population, necessitating caution when using the normative data with persons of lower educational level.

Administration

Specific instructions for administration of each item are provided in the PART-O manual (https://www.tbindsc.org/Documents/41a_PART-O%20Manual.pdf). The PART-O can be administered via interview or as a written questionnaire to either the person with the disability or a proxy. While not directly studied with the current version, proxy-participant agreement was investigated with an earlier version (Hart, Sherer, Temkin et al., 2010). Strong correlations were observed between proxy and participant responses to earlier versions of the Total, Out and About, and Productivity scores, with a moderate correlation observed with the Social Relations score.

Scoring

1. Items are based on a rating scale that ranges from 0 to 5. With the exception of two items, items are rated based on frequency or hours of engagement in specified activities during the past week or month.

2. Items are combined into three domain subscales: Productivity, Social Relations, and Out and About. Subscale scores are based on the average item score for the domain in question.

3. As long as the majority of items (>50%) within a domain are completed, subscale scores can be calculated by taking the average of the completed items.

4. The Averaged Total Score is calculated by taking the average of the three domain subscale scores. The Averaged Total Score can range from 0 to 5.

5. The Balanced Total Score is calculated by subtracting the person's domain standard deviation from the person's Averaged Total Score.The Balanced Total score can range from less than 0 (for those with low levels of participation and great variability between domains) to 5 (for those with a high and equal levels of participation across domains).

6. Standardized scores can also be calculated using data from samples of persons with and without disability living in Colorado and a sample of persons living in three states who received rehabilitation for a range of conditions.

7. Please see Bogner et al. (2011) for more information on calculation of all scores.