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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2019

Open Access 01-12-2019 | Research

Validity and reliability of the (adjusted) Impact on Participation and Autonomy questionnaire for social-support populations

Authors: Lucienne Berenschot, Yolanda Grift

Published in: Health and Quality of Life Outcomes | Issue 1/2019

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Abstract

Background

Decentralisation of social support and budget cuts spurred interest in outcome-oriented payment systems in the Netherlands. Hence, measurement of relevant outcomes, such as self-reliance and participation, is needed. The Impact on Participation and Autonomy (IPA) questionnaire for rehabilitation clients was adapted for social support, called IPA-MO, and its validity and reliability were tested among social support clients in eight municipalities in 2014 and 2016.

Methods

The total research sample comprised of 4120 persons. Homogeneous subgroups were distinguished based on 1) disability and 2) age. Exploratory factor analysis (PCF) was used to identify domains for IPA-MO. Model fit was assessed with Confirmatory Factor Analysis (CFA) using structural equation modelling.

Results

PCF revealed that the IPA-MO model consists of all five original IPA domains: Autonomy indoors, Family role, Autonomy outdoors, Social life and relations, and Work and education. As a result of new items added, a new, sixth domain was developed: Financial autonomy. Due to high non-response on Work & education, construct validity was first tested for a five-domain IPA-MO model. The composition of the IPA-MO domains showed slight differences: the item on ‘mobility indoor’ shifted from Autonomy indoors (IPA) to Family Role in IPA-MO. The item on reciprocity shifted from Social Life and relations (IPA) to Autonomy outdoors (IPA-MO). Internal reliability was confirmed for all domains (Cronbach’s alpha >.80). CFA showed acceptable construct validity of the five-domain IPA-MO model for the social support population (CFI .936, TLI .925, SRMR .051), all age groups and most disability-based groups. Construct validity including Work & education was tested for 234 participants. Then, PCF revealed six domains and the model fit was acceptable (CFI .915, TLI .903, SRMR .067).

Conclusions

IPA-MO is a valid and reliable instrument to assess outcomes of social support. Further research on the domain Financial autonomy is needed. Social-support clients are numerous and dispersed and, in spite of the best intentions, hard to involve widely in policy processes. A valid outcome measure offers municipalities possibilities to gain insight in social costs and benefits of new policies. Outcome measurement also allows to contract bundled-services of providers, thereby changing the incentives for providers from increasing production to much needed innovation. Taking the perceptions of autonomy and participation of social-support clients as the acid test for the effectiveness of social support policies, may prove a serious game-changer in politics.
Appendix
Available only for authorised users
Footnotes
1
Following the instruction manual, sections of the questionnaire are invalid when less than 75% of the items have been answered
 
2
Up to the age of 95 years old, the majority of Dutch inhabitants live independently. Under the Social Support Act (Wmo), local governments have the responsibility to assist them with technical aids and ambulant support if needed. Given the ageing Dutch population and the fact that government policies have restricted entrance to intramural care, the number of elderly Wmo clients is likely to increase [37]
 
3
E.g. 6a is “Getting washed and dressed the way I want” and 6b is “getting washed and dressed when I want”
 
4
MO refers to Maatschappelijke Ondersteuning (Social Support)
 
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Metadata
Title
Validity and reliability of the (adjusted) Impact on Participation and Autonomy questionnaire for social-support populations
Authors
Lucienne Berenschot
Yolanda Grift
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2019
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-019-1106-0

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