Abstract
BACKGROUND: Meaningful activity participation has shown good predictability for healthy ageing in older adults, and their participation can be assessed using the Meaningful Activity Participation Assessment (MAPA). However, the MAPA has never been validated in any Taiwanese population. Moreover, different cultures may interpret meaningful activity participation differently. This study thus aimed to cross-culturally adapt the MAPA into a Taiwan version (i.e., the T-MAPA) and to investigate the psychometric properties of the T-MAPA in older adults in Taiwan. METHODS: This study consisted of 3 phases. First, the original MAPA was cross-culturally adapted in 6 stages, including forward, synthesis of, and back translations, cognitive debriefing, expert review, and pilot testing on 18 older adults. Second, a Rasch-Andrich rating scale model was applied to evaluate the psychometric properties (including category function, unidimensionality, item functioning and targeting, and reliability) of the adapted version in a sample of 146 older adults. Lastly, the convergent validity and test-retest reliability were examined on 120 and 49 older adults, respectively. RESULTS: After cross-cultural adaptation, the first version of the T-MAPA contained 29 items. Optimal category function was obtained by reducing the response categories of the frequency subscale to 4 and retaining a 5-point rating for the meaningfulness subscale. After the removal of 1 misfit item, a 28-item T-MAPA was generated. This version demonstrated unidimensionality, measurement invariance among different subgroups (regarding sex and education), acceptable item targeting (< 1 logit) and negligible floor and ceiling effects (1.37%; 0.68%), high reliability (person reliability coefficient = 0.86; small standard error < 0.5 with large test information > 4), confirmed convergent validity (absolute r = .49-0.54 with psychological well-being, depressive symptoms, and mental and physical health), and excellent test-retest reliability (intraclass correlation coefficient = 0.94). CONCLUSION: The cross-culturally adapted 28-item T-MAPA is suitable for application to the older population in Taiwan to measure meaningful activity participation. Future examinations of the T-MAPA in other populations with specific clinical features are warranted to extend its utility in practice.