Development and validation of the Activities and Participation Children and Adolescents –neck (APCAN) Measure

Research Objectives: The purpose of this study was to develop and establish content validity of a new measure i.e., Activities and Participation Children and Adolescents –neck (APCAN), measure specific to evaluating activity limitation and participation restrictions due to neck pain in children.

Design: Cross-sectional

Setting: Not Applicable

Participants: Ten clinical experts in different fields of practice (physical therapy, occupational therapy, and nursing) were recruited via email to participate in the modified Delphi process. The experts were selected based on their content, clinical, or research expertise in pediatric neck pain.

Interventions: A comprehensive pool of items related to activities and participation was developed by conducting an exhaustive review of the ICF-CY model. Two experts from the study team linked each item from the APCAN to the ICF-CY categories. A modified Delphi process was used for content validation. Cognitive testing of the APCAN was performed to ensure comprehension and comprehensiveness of APCAN.

Main Outcome Measures: To determine content validity, the content validity ratio (CVR) was calculated using Lawshe’s formula CVR = (ne – N/2)/N/2 where “ne” is the number of experts identifying an item as “essential” whereas N is the total number of experts. The content validity index (CVI) was calculated to obtain a numeric value of the content validity.

Results: the APCAN comprised 20 items that target various aspects of activity limitation and participation. Each item was rated on a 0-10 numeric rating scale (0 = not difficult at all, 10 = extremely difficult). All 20 items retained the CVRcritical values. The CVI value of 0.88 indicated good content validity.

Conclusions: The APCAN provides an easy to use and comprehensive assessment of limitations in function associated with neck pain in children. Clinicians can gather meaningful information from APCAN to identify functional limitations, create therapeutic goals and monitor effectiveness of targeted rehabilitation interventions.

Author(s) Disclosures: Authors report no conflict of interest.