The Doing, Being, Becoming and Belonging (DB3) Scale: Development and Content Validity

The Doing, Being, Becoming and Belonging (DB3) Scale: Development and Content Validity | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Doing, Being, Becoming and Belonging (DB3) Scale: Development and Content Validity Danielle Hitch, Genevieve Pepin This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7105368/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Occupational being emerges from interactions between the dimensions of occupation - doing, being, becoming and belonging. It is a key concept in occupational therapy practice and is also influenced available resources and opportunities. This study aimed to reflect on the development of a new outcome measure of occupational being - the Doing, Being, Becoming and Belonging Scale (or DB3) – and describe preliminary evidence of its validity and application to occupational therapy. Methods: Applying a descriptive quantitative method, this study recruited occupational therapy academics and consumers to complete a single online survey. Content validity was assessed through participants' perceptions of the DB3 Scale's applicability, relevance, comprehensiveness, and comprehensibility. Data were analysed using descriptive statistics and Lawshe’s content validity ratio, complemented by qualitative data about potential applications to practice. Consumer and Community Involvement: Consumers were study participants, and their perspectives and preferences were incorporated into revisions of the DB3 scale during its development. Findings: Findings indicate that the DB3 Scale possesses adequate content validity. All but two of the scale items met the criterion for relevance, and all met the criterion for comprehensibility. The DB3 was perceived by occupational therapy academics as applicable to clinical practice, research, education, and direct service provision with consumers. It was also generally perceived by both groups as comprehensive, although participants recommended some changes which have been incorporated into the final version. Conclusion: The DB3 Scale meets a previously identified need for a tool to translate the core concepts of the Pan Occupational Paradigm into occupational therapy practice and is the first outcome measure exclusively addressing occupational being. This study underscores its potential utility and applicability across a wide range of settings. Future directions should focus on expanded psychometric evaluation, exploring cross-cultural applicability, and wider implementation of the DB3 into clinical practice, research, and education. Physical Medicine & Rehab Occupational therapy occupational being DB3 Scale outcome measure content validity Pan Occupational Paradigm Figures Figure 1 Figure 2 Figure 3 Introduction The complex relationship between occupation, health and well-being is the core business of occupational therapy. Many outcome measures developed or adopted in occupational therapy to support assessment and evaluation, have arisen from conceptual practice models, related knowledge from other disciplines or are limited to specific clinical populations (Hitch, 2014; Kielhofner, 2008). Currently available measures do not directly evaluate the concept of ‘occupational being’. Occupational being refers to an identity that emerges from interactions between doing, being, becoming, and belonging, the dimensions of occupation (Hitch et al., 2018). This identity is an emergent property of the dimensions of occupation, and occupational being evolves with changes in the inter-relationships between the dimensions (Hitch & Pepin, 2021). The complexity of occupational being poses significant challenges for outcome measurement, which Rogers and Holm (1994) defined as “the functional consequence for the patient of the therapeutic actions implemented by an occupational therapist” (p. 872). The purposes of outcome measurement are to demonstrate functional change over time and the effectiveness of occupational therapy in enabling these changes (Unsworth, 2000). Improved occupational being is a critical outcome of occupational therapy for our consumers. For example, international research priority areas for occupational therapy include the effectiveness of interventions, evidence-based practice, participation in everyday life, healthy ageing, the professions work with chronic conditions, sustainable community development and population-based interventions, technology, and professional issues (World Federation of Occupational et al., 2017). Occupational being is applicable to all these areas both as a goal and an outcome. Therefore, the development and validation of an occupational being measure should be a priority for occupational therapy. This study aimed to reflect on the development of a new outcome measure of occupational being - the Doing, Being, Becoming and Belonging Scale (or DB3) – and describe preliminary evidence of its validity and application to occupational therapy. Structure and Format of the DB3 Scale The DB3 Scale is a Patient-Rated Outcome Measure (PROM) and a generic measure of occupational being. It has been validated for consumers over 18 years who can comprehend the items and respond independently. All items are written at Grade 6 / Year 7 readability level on the Flesch-Kincaid Scale (Kincaid et al., 1975) and it takes approximately 5 minutes to complete. The DB3 Scale contains 42 items across the five sub-scales (doing, being, becoming, belonging, resources & opportunities). Respondents rate their satisfaction regarding each item on a 7-point Likert scale (-3 = Extremely Dissatisfied, 0 = Neutral, +3 = Extremely Satisfied). While a retrospective timeframe of two weeks is recommended to complete the scale, this can be adapted to the needs of consumer groups and practice settings. Sub-scale scores are derived from the mean of all item scores, and the Occupational Being score comprises the mean of the doing, being, becoming and belonging sub-scale scores. The resources and opportunities sub-scale score is not combined with any other. Scores summarise the consumer’s satisfaction or dissatisfaction with their occupational being in relation to their doing, being, becoming, belonging, resources & opportunities. Items which lower scores (i.e., greater dissatisfaction) indicate aspects of occupation which could be targeted during goal setting and intervention, while higher scores identify areas of strength. These DB3 should be completed again after intervention to describe change over time and potentially capture the link between occupational therapy and the consumers’ outcomes. The DB3 can be administered solely as a quantitative scale, or as a mixed methods scale. In the mixed methods version, space is provided under each sub-scale for free text comments by the consumer. This information provides greater context to the data and enhances the information available to occupational therapists. If consumers choose to add comments, the entire scale may take 7-10 minutes to complete. Development of the DB3 Scale Theoretical Foundations The DB3 scale is deeply embedded within occupational therapy principles and knowledge. It was developed from the Pan Occupational Paradigm (POP), in response to requests from occupational therapists for a tangible resource to enable application of the POP into their clinical practice (Hitch et al., 2018). The calls for supporting technology from occupational therapists reflect the ongoing development of the paradigm over time, just as its founding framework (Wilcock’s Occupational Perspective of Health) has continued to evolve (Wilcock & Hocking, 2015). As a paradigm, the POP presents broad assumptions and values rather than specific guidelines for practice (Hitch & Pepin, 2021). Paradigms provide the ‘why’ of occupational therapy while conceptual practice models provide the ‘how’ to put these ideas into action (Kielhofner, 2008). However, both paradigms and conceptual practice models may have outcome measures that evaluate their core concepts. In the case of paradigms, outcomes measures support their verification and validity, drive their ongoing evolution, and enable consistent data collection over time (Kuhn, 2012). The close links between the POP and conceptual practice models was demonstrated by Hitch and Pepin (2021) who mapped how the dimensions of occupation are embedded within multiple occupational therapy models. The DB3 is founded on the two underlying assumptions of the POP. Firstly, humans are occupational beings whose health and well-being are influenced by occupational engagement. This assumption is drawn directly from Wilcock’s Occupational Perspective of Health (Wilcock & Hocking, 2015), and articulates the fact the DB3 was designed to collect information specific to occupational being (and therefore occupational therapy). Secondly, occupational therapy ways of knowing are one perspective amongst many - other ways of knowing are equally valuable to our understanding of occupation. This assumption reflects a commitment to epistemological equity (Dei, 2008) acknowledging the co-existence of multiple occupational understandings and the need for conscious action to include marginalised and excluded ways of knowing. In addition, the DB3 reflects the structure of the POP by including 1) occupational dimensions, 2) the occupational being, 3) resources and opportunities, and 4) a health and wellbeing continuum. The aim of the DB3 is to measure occupational being from the individual (i.e. your patients/consumers/service users), group (i.e. therapeutic groups, sporting teams) and/or population (i.e. refugees, cultural communities) perspective (Wilcock & Hocking, (2015). The authors fully acknowledge the need for validation in a wider range of populations. The impact of specific occupations, occupational roles and groups on occupational being can also be explored and four DB3 templates are available to enable flexible application, which are freely available at https://osf.io/g52e6/files/osfstorage (Hitch & Pepin, 2025). Key Concepts The Dimensions of Occupation. Four subscales in the DB3 align with the four dimensions of occupation - doing, being, becoming and belonging (Hitch et al., 2018; Wilcock & Hocking, 2015). The items of these subscales were initially developed from the comprehensive literature review undertaken to develop the POP (Hitch 2014a and 2014b) and were reaffirmed by an updated literature review in 2020. The authors also continue to monitor new research which cites the Occupational Perspective of Health (Wilcock, 1998; Wilcock, 2006; Wilcock & Hocking, 2015) or the POP (Hitch, 2014; Hitch & Pepin, 2021; Hitch et al., 2017) to identify and explore new aspects of these concepts which may emerge over time. The process of both POP and DB3 development has been subjected to repeated and rigorous peer review as part of the first authors PhD studies and subsequent peer review publications and presentations. The items on the DB3 are abstract in nature and may be open to interpretation. However, consumers are provided with a plain language version of the definitions of these items with prompts developed by Hitch et al. (Hitch et al., 2014a, 2014b) to support a consistent understanding of what they mean in the context of the DB3 (see Table 1). For example, physical tasks are followed by ‘moving, reaching, carrying’. Table 1: Professional and Plain Language Definitions of the Dimensions of Occupation Dimension Professional Definition DB3 Scale Plain Language Definition Doing “The medium through which people engage in occupations and the skills and abilities needed for doing accumulate across time. Doing involves engaging in personally meaningful occupations, but not necessarily purposeful, healthy, or organised. Doing involves being actively engaged, either overtly (i.e., observable, physical) or tacitly (i.e., mental, spiritual). Doing follows broadly similar patterns across the population, and humans can adapt their doing to greater and lesser degrees according to circumstance” (Hitch et al., 2014a, p. 241). People do many things as part of daily life, both alone and with others. These may include what you want to do, have to do and need to do. Being “The sense of who someone is as an occupational and human being. It encompasses the meanings they invest in life and their unique physical, mental, and social capacities and abilities. Occupation may provide a focus for being, but it also exists independently of it during reflection and self-discovery. Being is expressed through consciousness, creativity, and the roles people assume in life. Ideally, individuals can exercise agency and choice in their expression of being, but this is only sometimes possible or even desirable” (Hitch et al., 2014a, p. 241). This is who you are, including what you enjoy or find meaningful. Being includes your unique physical, mental, and social skills, your life roles and the choices you make about activities. Becoming “The perpetual process of growth, development, and change that reside within a person throughout their life. It is directed by goals and aspirations, which can arise through choice or necessity, from the individual or from groups. Regular modifications and revisions of goals and aspirations help to maintain momentum in becoming, as does the opportunity to experience new or novel situations and challenges” (Hitch et al., 2014a, pp. 241-242). People change and develop over time. Everyone has hopes or goals to work towards but change beyond your control can happen. The chance to develop new skills is important, as people adjust to change. Belonging “A sense of connectedness to other people, places, cultures, communities, and times. It is the context within which occupations occur, and a person may experience multiple belongings at the same time. Relationships are essential to belonging, whether they be with a person, place, group, or another factor. A sense of reciprocity, mutuality and sharing characterise both positive and negative belonging relationships, be they positive or negative” (Hitch et al., 2014a, p. 242). Belonging is your sense of connection with other people, places, cultures, communities, and times. All people have multiple relationships with these things and belonging happens when you experience sharing and mutual benefit. Occupational Being. Given that occupational dimensions are continually in flux, occupational being is not a fixed or static entity- it reflects the context, preferences, skills and needs of the individual, group, or population at that time. These changes over time can be evaluated against the health and wellbeing continuum in conjunction with the final sub-scale. Resources and Opportunities Sub-scale. The fifth DB3 sub-scale is external to the occupational being and describes the more tangible entities which manifest through aspects of the external environment to determine the occupational beings access to occupation. Resources are the available assets (including finances, objects, social capital, and other materials) which enable or disable occupational engagement. Opportunities emerge when elements like networks, change over time, goal directed actions, necessity and chance occurrences contribute to environmental conditions that enable or disable occupational engagement. Occupational engagement depends on having both the resources and opportunities to engage in occupations. The conceptualisation of these sub-scales as complimentary to each other also reflects the authors’ commitment to occupational justice as a means to support occupational beings disadvantaged by factors beyond their direct control (Wilcock & Townsend, 2014). Locating resources and opportunities implies occupational beings have direct access to and agency over them and this is often not the case. While occupational therapy primarily targets occupational being, the DB3 scale provides an opportunity to also measures advocacy and activism efforts undertaken by the profession to improve resourcing and opportunities. Further information about how the presence of key concepts of occupational justice in the DB3 is provided in Supplementary Materials 1. Items related to resource and opportunities are presented at the end of the doing, being, becoming and belonging sub-scales to highlight their links (and potentially differential relationships) with each occupational dimension. There is no plain language definition for the resources and opportunities sub-scale, as early users indicated its inclusion in the DB3 was either repetitive or confusing. However, prompts are included with these items to guide interpretations of their meaning – resources (e.g. money, items, tools), opportunities (e.g. chances, enough time). Health and Wellbeing Continuum . The final component of the DB3 is a continuum from ill-being to well-being (Hitch et al., 2018). The continuum is not related to time - it indicates the occupational being’s current health and well-being status. At the bottom of the continuum are the adverse outcomes of occupational engagement: illness, deprivation, alienation, injustice, and death. At the top are the positive outcomes of occupational engagement: well-being, health, happiness, inclusivity, and justice. The arrowhead at the top acknowledges the aims of occupational therapy in moving consumers towards positive outcomes by addressing doing, being, becoming, belonging, resources and opportunities. The location of the occupational being on the health and wellbeing continuum can be indicated with the occupational being score and the resources and opportunities score, as show in Figure 1. An animated version of this figure would show the dimensions pulsing larger and smaller to show how the dimensions are foregrounded at different times and for different occupations. The colours used in this figure are meaningful, as they emphasise the need for sustainable occupations to promote population health. Methods This study used a descriptive quantitative method to explore the measurement (or psychometric) properties of the DB3 Scale. A single descriptive survey was distributed to occupational therapy academics and consumers to capture their perceptions of the content validity of the DB3 with specific reference to its applicability, relevance, comprehensiveness and comprehensibility as recommended by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) collaboration (Terwee et al., 2018). Content validity refers to the extent to which an outcome measure reflects or evaluated the construct of interest (Mokkink et al., 2010). Ethics approval for this study was provided by a university (HEAG-H 78_2020) and a health service (HREC/63606/WH-2020-213755). Recruitment The inclusion criteria for academics were 1) qualified Occupational Therapist, 2) Currently teaching or conducting research in Australian or New Zealand universities providing occupational therapy pre-registration courses, and 3) able to provide informed consent. The contact details of 204 academic staff were identified on publicly available websites and formed the contact list for this participant group. Academics were therefore recruited via a purposeful strategy which was supplemented by snowball sampling. An invitation to participate (with the plain language statement attached) was emailed directly to these academics, and interested participants were provided with an online link to the survey. Academic participants had one month to submit their responses and received two reminder emails in that time. Consumers were recruited as part of a broader study of occupational being during the initial stages of the COVID-19 pandemic. The inclusion criteria were 1) people residing in the catchment area of the health service during the timeframe of the study, 2) aged 18 and over, 3) able to understand written English without assistance, 4) able to provide informed consent and 5) with access to email and internet connection to enable regular response to surveys. The study was advertised with an email and attached plain language statement via the volunteer mailing list of a health service, and via the professional networks of the research team. Interested participants registered for the study via an online link and they completed the DB3 content validity survey. The online registration form included multiple-choice questions that check participant understanding before they provided their consent, in recognition of the challenges to ensuring informed consent when conducting online surveys (Barrera et al., 2016). Consumers went on to complete the DB3 once a month for the following six months, and the findings of the broader study are reported elsewhere. All consumers had two weeks to submit their responses and no reminder emails were distributed. Data Collection The occupational therapy academic survey began with demographic information about gender, age group, location, and years of experience as an academic. The 42 items of the DB3 scale were then presented and rated according to relevance to its associated sub-scale (is relevant / is not relevant / unsure of the relevance). Participants were able to identify additional items they believed should be included in each sub-scale. Questions regarding the effectiveness and efficiency of the DB3 in supporting occupational therapy practice, education, research and consumers followed and were rated on a seven-point Likert scale (extremely ineffective / inefficient = -3, neither effective / efficient or ineffective / inefficient = 0, extremely effective / efficient = 3). Finally, participants were asked how likely they were to recommend the DB3 to clinicians, educators, researchers, and consumers, and describe a situation where they might consider applying it in practice. The survey took approximately 10 minutes to complete. Data were collected in anonymous form, thereby protecting participant privacy and confidentiality. The consumer survey began with demographic information about gender, age group, country of birth, primary language and whether they had a disability or chronic illness. Their survey included the same questions regarding item relevance and opportunity to identify additional items for each sub-scale. This survey took approximately 7 minutes to complete. Data were collected in re-identifiable form to enable future contact for the purposes of the broader study, but identifiers were removed prior to analysis of the data presented here. All online surveys were located on the Qualtrics platform, and submission of responses were considered implied consent. Data Analysis Quantitative data was analysed using the SPSS package (IBM Corp, 2021) and descriptive statistics such as means and frequencies. Lawshe’s (1975) method of quantifying content validity asks a panel of experts to rate items in one of three categories, which in this study were relevant, not relevant, or unsure. The resulting ratio represents a linear transformation of agreement proportions and is calculated as n e – (N/2) / N/2 (where n e is the number of respondents agreeing the item is relevant, and N is the total number of respondents). Ayre and Scally (2014) published updated critical Lawshe ratio values for the number of experts required to agree an item is relevant up to a panel size of 40. The critical values for 40 respondents were applied to all occupational therapy academic responses, as the small number of additional responses (up to n=44) would only have resulted in a lower critical value. The critical values for 17 responses were applied to community member responses to reflect the size of that sample. Qualitative data regarding comprehensiveness and useability were subjected to content analysis (Vaismoradi et al., 2013) given the relative brevity of the responses and comments. The frequency of comments was noted, grouped into similar responses, and categorised under themes. All codes were reviewed by the second author for both consistency of application and the formation of consensus. Results A total of 66 academics (response rate 32%) and 19 consumers submitted surveys, however only 44 and 17 respectively completed all questions therefore valid response numbers are reported below (see Table 2). Academics from all but one Australian state and territory responded, along with four colleagues from New Zealand. All consumers were recruited from locations in the western suburbs of Melbourne. Results from the surveys and qualitative data are combined under five themes presented below. Table 2: Sample Characteristics OT Academics Community Members n, % n, % Gender Female 57, 86.7 Gender Female 18, 94.7 Male 9, 13.6 Male 0, 0.0 Non binary 1, 5.3 Age Group 18-34 10, 15.1 Age Group 18-34 6, 31.6 35-44 11, 16.7 35-44 7, 36.8 45-54 33, 50.0 45-54 0, 0.00 55-64 11, 16.7 55-64 3, 15.8 65+ 1, 1.5 65+ 3, 15.8 Location Australia 96, 93.9 Country of Birth Australia 18, 94.7 New Zealand 4, 6.1 Other 1, 5.3 Years exp. 0-9 24, 36.4 Language English 19, 100.0 10-19 18, 27.3 Other 0, 0.0 20-29 14, 21.2 30+ 10, 15.2 Disability Yes 5, 26.3 No 14, 73.7 Note: exp. = experience Occupational Therapy Academics All but two of the items on the DB3 met the criterion for relevance as measured by Lawshe’s ratio (Table 3). These items were related to having the resources and opportunities to ‘do’ and all the resource and opportunity scale items had lower ratios. Table 3: Occupational therapy academic construct validity ratings for relevance Item Relevant, n (%) Not relevant, n (%) Unsure, n (%) Lawshe’s ratio Doing Sub-Scale Doing things that have personal meaning or value for you (n=43) 42, 97.7 0, 0.0 1, 2.3 0.954 Doing things that have a purpose or meet a goal (n=43) 42, 97.7 0, 0.0 1, 2.3 0.954 Doing physical tasks (e.g. moving, reaching, carrying) (n=43) 36, 83.7 1, 2.3 6, 14.0 0.674 Doing mental tasks (e.g. thinking, remembering) (n=43) 37, 86.0 0, 0.0 6, 14.0 0.721 Doing social tasks (e.g. conversation, eating a meal together) (n=43) 39, 90.7 0, 0.0 4, 9.3 0.814 Doing thing that meet your own personal needs (n=43) 42, 97.7 0, 0.0 1, 2.3 0.954 Doing things that meet the needs of other people (e.g. family, friends, co-workers) (n=42) 41, 97.6 0, 0.0 1, 2.4 0.952 Doing things that help you feel healthy and well (n=44) 42, 95.5 1, 2.3 1, 2.3 0.909 Doing organised things (e.g. planned, specific times) (n=43) 39, 90.7 0, 0.0 4, 9.3 0.814 Doing spontaneous things (e.g. unplanned, spur of the moment) (n=43) 41, 95.4 0, 0.0 2, 4.6 0.907 The resources you have to 'do' things (e.g. money, items, tools) (n=43) 24, 55.8 5, 11.63 14, 32.6 0.116 ** The opportunities you have to do things (e.g. chances, enough time) (n=43) 26, 60.5 3, 7.0 14, 32.6 0.209 ** Being Sub-Scale Having time to reflect and contemplate (n=42) 34, 81.0 2, 4.8 6, 14.3 0.619 Your personal sense of self as a human being (n=42) 38, 90.5 0, 0.00 4, 9.5 0.810 Meeting your personal needs (n=42) 34, 81.0 3, 7.1 5, 11.9 0.619 Meeting your spiritual needs (n=42) 35, 83.3 3, 7.1 4, 9.5 0.667 Meeting your cultural needs (n=42) 36, 85.7 3, 7.1 3, 7.1 0.711 Meeting your creative needs (e.g. play, problem solving, art) (n=42) 35, 83.3 3, 7.1 4, 9.5 0.667 Your life roles (e.g. child, partner, student, worker, carer) (n=42) 39, 92.9 1, 2.4 2, 4.8 0.857 Making choices about what you do (n=42) 34, 81.0 1, 2.4 7, 16.7 0.619 Making use of your existing skills (n=42) 31, 73.8 4, 9.5 7, 16.7 0.476 The resources you have for ‘being’ (e.g. money, items, tools (n=42) 29, 69.1 6, 14.9 7, 16.7 0.391 The opportunities you have to ‘be’ (e.g. chances, enough time) (n=42) 33, 78.6 3, 7.1 6, 14.3 0.571 Becoming Sub-Scale Learning new skills and talents (n=40) 38, 95.0 0, 0.00 2, 5.00 0.900 Your potential to grow and develop as a person (n=41) 38, 92.7 1, 2.4 2, 4.9 0.854 Your potential to grow and develop with other people (n=41) 33, 80.5 2, 4.9 6, 14.6 0.610 Your aspirations or hopes for the future (n=41) 39, 95.1 0, 0.00 2, 4.9 0.902 Changes you want to make for yourself (n=41) 40, 97.6 0, 0.00 1, 2.4 0.951 Changes you want to make with others (n=40) 35, 87.5 1, 2.5 4, 10.0 0.750 Your ability to adapt to change (n=41) 34, 82.9 3, 7.3 4, 9.8 0.659 Maintaining your current skills and talents (n=41) 31, 75.6 6, 14.6 4, 9.8 0.512 The resources you have to 'become' (e.g. money, items, tools) (n=40) 32, 80.0 3, 7.5 5, 12.5 0.600 The opportunities you have to ‘become’ (e.g. chances, enough time) (n=41) 35, 83.4 2, 4.9 4, 9.8 0.707 Belonging Sub-Scale Belonging with partners (i.e. husband/wife, boyfriend/girlfriend) (n=41) 37, 90.2 1, 2.5 3, 7.3 0.805 Belonging with family (i.e. parents, children, other relatives, pets) (p=41) 39, 95.1 0, 0.0 2, 4.9 0.902 Belonging with friends (p=41) 39, 95.1 0, 0.00 2, 4.9 0.902 Belonging with other people in my community (p=41) 39, 95.1 0, 0.00 2, 4.9 0.902 Belonging with people of a similar age to you (i.e. your generation) (p=41) 34, 82.9 0, 0.0 7, 17.1 0.659 Belonging with people of a similar cultural or social background to you (p=41) 36, 87.8 1, 2.5 4, 9.8 0.756 Belonging to the location you call home (i.e. local area, town, state, country) (p=41) 39, 95.1 0, 0.00 2, 4.9 0.902 The resources you have to 'belong' (e.g. money, items, tools) (n=41) 29, 70.7 5, 12.2 7, 71.7 0.415 The opportunities you have to ‘belong’ (e.g. chances, enough time) (n=41) 34, 82.9 2, 4.9 5, 12.2 0.659 Note: * = items not reaching the benchmark for agreed relevance. The Measurement of Occupational Being. While the DB3 measures satisfaction, participants also raised other consideration: “ T he importance level of different areas will vary- they are important but how important? Is there opportunity to rank them? ”. Several participants also commented on a lack of temporality in the items: “ having a sense of your present self as part of a coherent narrative over time ” . One participant described this as ‘historical belongingness’ and there was a sense of it encompassing more than the current item about “Belonging with people of a similar age to you (i.e. your generation)”; “I t is not just the people but the doing with and for … knowing you are doing what people have done in this place before you”. Participants noted the items reflected a limited cultural perspective on occupation which may or may not be relevant to people from culturally and linguistically diverse or marginalised communities; “ This is skewed towards western individualistic sense of self”. Participants also offered more general remarks about the DB3 were also submitted. Some indicated a general lack of certainty around the purpose or scope of the DB3; “ it isn’t quite clear what the 'categories' of doing are intended to be”. There were also concerns that consumers would not understand the language used in the scale; “Most people are really going to struggle with this concept ” . Several comments indicated the explicit occupational focus of the DB3 could be a barrier to its use by consumers; “ OTs know, but not necessarily the public”. However, the general comments also demonstrated significant variability in the participants perspectives on the dimensions of occupation; “the distinction between doing and being and becoming is not quite clear, I think ”. Many of the specific suggestions for inclusion were already addressed (either explicitly or implicitly) by items in other sub-scales; “ I rejected a lot of the items in the list because they point to doing, not being”. For example, participants suggested the inclusion of individual skills and capacity (being); relaxing, resting and reflection (being); objects and places for doing (belonging); choices and prioritisation (being) and social support and connection (belonging) in the doing sub-scale. These responses to the scale’s structure highlight the close interconnectedness between the dimensions of occupation; “ Becoming interrelates to being as well as doing, so the kind of person you want to become as well ”. As a result of a perceived lack of conceptual clarity, respondents expressed concerns that the measurement properties of the DB3 would be ‘messy’ and believed “the list would not stand up in Rasch analysis because they are quite disparate concepts” . Subscale Content. Suggestions for additional items were made for doing (n=24, 45.3%), being (13, 26.0%), becoming (12, 25.5%) and belonging (18, 38.3%) subscales. Many recommended additions were related to specific categories of occupation including recreation, productivity, leisure, cultural, creative, spiritual, activism, and sustainability. Obligated activities and purposeful but unhealthy occupations were also suggested, in recognition that not all occupational engagement is positive; “ There is the usual positive slant - how will people account for things they mindfully and deliberately do that are not good for their own health, don't benefit other people, respond to deficits rather than needs - violence, addiction ” . Items related to resources and opportunity were listed with their associated occupational dimension, and while respondents recognized their links to each, they also perceived them as distinctive from the rest of the items on the sub-scales; “ the resources and opportunities questions might be 'relevant' to each scale, but they do tap a completely different construct” . Scale Effectiveness and Efficiency. Most academics perceived the DB3 as having some degree of effectiveness for clinical practice (n=31, 73.8%), research (n=35, 83.3%), education (n=35, 85.4%) and direct work with patients / consumers (n=32, 76.2%) (Fig. 2). A slightly lower proportion perceived the DB3 as being an efficient tool in clinical practice (n=29, 69.0%), research (n=28, 66.7%), education (n=30, 71.4%) and direct work with patients / consumers (n=27, 64.3%) (Fig. 3). Applications to Occupational Therapy Practice. Most academics were slightly, likely or extremely likely to recommend the DB3 for use in clinical practice (n=29, 67.4%), education (n=28, 65.1%), research (n=30, 69.8%) and with patients/consumers (n=28, 65.1%). When asked about the potential applications of the DB3, several participants commented they could see the DB3 being applicable to mental health settings, especially because “ there are few other tools that really explicitly address 'being' and 'belonging' .” Other populations or settings identified included people with disability, consumers transitioning to new occupational identities after a health event, marginalised group and occupational participation patterns in the general community. Participants felt they could use the DB3 as part of initial or more comprehensive assessments, and that it could form part of a suite of outcome measures alongside tools like the Canadian Occupational Performance Measure (COPM). They generally recognised the DB3 was not designed to be a stand-alone assessment and would be complemented by other data collection; “I f I was using it clinically, I would interview as well - just the survey response wouldn't be enough for me to work with”. The DB3 was perceived as having a potential role in goal setting, strategy development, reflections on recovery, identifying and readjusting priorities. Many of the recommendations for educational use related to orienting students to the general principles and concepts of occupational therapy and occupational science. Participants also believed the DB3 could support awareness and reflective practice by getting students to engage with their own occupational beings. Areas for Improvement and Development. In terms of overall improvements, some participants asked for the DB3 to ‘drill down to specific examples’ to avoid it being too theoretical or broad in its scope; “I t's a conceptual tool rather than a specific assessment of where anyone is on these scales” . They also cautioned against presenting the occupational dimensions as categorical and were concerned consumers would not comprehend the core concepts; “I am not sure they would resonate well with clients and I think the nuances that distinguish between them, would be very hard for clients to understand in a meaningful way” . Someone also expressed concern about potential overuse of the terminology. I think the profession has completely overused these terms and think any further use of them should be very carefully considered - and not necessarily encouraged. I think their overuse is making them more and more meaningless. Participants recommended future development of the constructs from a non-Western perspective, and validation for a paediatric or caregiver version. A ‘not applicable to me’ option was suggested for some items, along allowing for different timeframes for completion in response to the specific needs of consumer groups or practice settings. Several recommendations addressed the wording used in the DB3, which were reviewed and incorporated into the final version of the scale. Consumers Qualitative data from consumers was more limited given the smaller sample size, and the number of comments offered was too small for meaningful content analysis. All the items on the DB3 rated by consumers met the criterion for relevance as measured by Lawshe’s ratio (Table 4). The items which attracted lower ratios related to cultural needs, spiritual need and belonging with people of a similar cultural or social background. All the DB3 items were rated as understandable by all participants. Table 4: Community member construct validity ratings for relevance and understandability Relevance Understanding Item Relevant, n (%) Not relevant, n (%) Unsure, n (%) LR Yes, n (%) No, n (%) Unsure, n (%) LR Doing Sub-Scale Doing things that have personal meaning or value for you (n=19) 19, 100.0 0, 0.0 0, 0.0 1.000 19, 100.0 0, 0.0 0, 0.00 1.000 Doing things that have a purpose or meet a goal (n=19) 19, 100.0 0, 0.0 0, 0.0 1.000 19, 100.0 0, 0.0 0, 0.00 1.000 Doing physical tasks (e.g. moving, reaching, carrying) (n=19) 17, 89.5 1, 5.3 1, 5.3 0.789 19, 100.0 0, 0.0 0, 0.00 1.000 Doing mental tasks (e.g. thinking, remembering) (n=19) 18, 94.7 1, 5.3 0, 0.0 0.895 19, 100.0 0, 0.0 0, 0.00 1.000 Doing social tasks (e.g. conversation, eating a meal together) (n=19) 19, 100.0 0, 0.0 0, 0.0 1.000 19, 100.0 0, 0.0 0, 0.00 1.000 Doing thing that meet your own personal needs (n=19) 18, 94.7 1, 5.3 0, 0.0 0.895 19, 100.0 0, 0.0 0, 0.00 1.000 Doing things that meet the needs of other people (e.g. family, friends, co-workers) (n=19) 18, 94.7 0, 0.0 1, 5.3 0.895 19, 100.0 0, 0.0 0, 0.00 1.000 Doing things that help you feel healthy and well (n=19) 19, 100.0 0, 0.0 0, 0.0 1.000 19, 100.0 0, 0.0 0, 0.00 1.000 Doing organised things (e.g. planned, specific times) (n=19) 17, 89.5 2, 10.5 0, 0.0 0.789 19, 100.0 0, 0.0 0, 0.00 1.000 Doing spontaneous things (e.g. unplanned, spur of the moment) (n=19) 18, 94.7 1, 5.3 0, 0.0 0.895 19, 100.0 0, 0.0 0, 0.00 1.000 The resources you have to 'do' things (e.g. money, items, tools) (n=19) 19, 100.0 0, 0.0 0, 0.0 1.000 19, 100.0 0, 0.0 0, 0.00 1.000 The opportunities you have to do things (e.g. chances, enough time) (n=19) 18, 94.7 1, 5.3 0, 0.0 0.895 19, 100.0 0, 0.0 0, 0.00 1.000 Being Sub-Scale Having time to reflect and contemplate (n=17) 16, 94.1 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Your personal sense of self as a human being (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Meeting your personal needs (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Meeting your spiritual needs (n=17) 12, 70.6 3, 17.7 2, 11.8 0.412 17, 100.0 0, 0.0 0, 0.00 1.000 Meeting your cultural needs (n=17) 12, 70.6 5, 29.4 0, 0.0 0.412 17, 100.0 0, 0.0 0, 0.00 1.000 Meeting your creative needs (e.g. play, problem solving, art) (n=17) 16, 94.1 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Your life roles (e.g. child, partner, student, worker, carer) (n=17) 16, 94.1 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Making choices about what you do (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Making use of your existing skills (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 The resources you have for ‘being’ (e.g. money, items, tools (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 The opportunities you have to ‘be’ (e.g. chances, enough time) (n=17) 16, 94.1 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Becoming Sub-Scale Learning new skills and talents (n=17) 17, 100.0 0, 0.0 0, 0.0 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Your potential to grow and develop as a person (n=17) 15, 88.2 0, 0.0 2, 11.8 0.765 17, 100.0 0, 0.0 0, 0.00 1.000 Your potential to grow and develop with other people (n=17) 17, 100.0 0, 0.0 0, 0.0 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Your aspirations or hopes for the future (n=17) 16, 92.4 0, 0.0 1, 5.9 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Changes you want to make for yourself (n=17) 16, 92.4 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Changes you want to make with others (n=17) 16, 92.4 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Your ability to adapt to change (n=17) 15, 88.2 0, 0.0 2, 11.8 0.765 17, 100.0 0, 0.0 0, 0.00 1.000 Maintaining your current skills and talents (n=17) 16, 92.4 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 The resources you have to 'become' (e.g. money, items, tools) (n=17) 16, 92.4 0, 0.0 1, 5.9 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 The opportunities you have to ‘become’ (e.g. chances, enough time) (n=17) 17, 100.0 0, 0.0 0, 0.0 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Belonging Sub-Scale Belonging with partners (i.e. huband/wife, boyfriend/girlfriend) (n=17) 15, 88.2 2, 11.8 0, 0.0 0.765 17, 100.0 0, 0.0 0, 0.00 1.000 Belonging with family (i.e. parents, children, other relatives, pets) (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Belonging with friends( n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Belonging with other people in my community (n=17) 16, 92.4 1, 5.9 0, 0.0 0.882 17, 100.0 0, 0.0 0, 0.00 1.000 Belonging with people of a similar age to you (i.e. your generation) (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Belonging with people of a similar cultural or social background to you (n=17) 12, 70.6 2, 11.8 3, 17.7 0.412 17, 100.0 0, 0.0 0, 0.00 1.000 Belonging to the location you call home (i.e. local area, town, state, country) (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 The resources you have to 'belong' (e.g. money, items, tools) (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 The opportunities you have to ‘belong’ (e.g. chances, enough time) (n=17) 17, 100.0 0, 0.0 0, 0.00 1.000 17, 100.0 0, 0.0 0, 0.00 1.000 Note: LR = Lawshe’s ratio Consumers made few suggestions for additional for doing (n=2, 10.5%), being (1, 5.9%), becoming (1, 5.9%) and belonging (1, 5.9%) subscales. Their recommendations included a reference to doing things they are obligated to do, references to specific occupations (such as volunteering), additional examples of aspects of being (including sensual and tactile experiences), and the possibility of online belonging. Discussion This study described the development and initial validation of the DB3 scale which was proposed as a novel measure of occupational being. The use of the POP ensures the scale has a rigorous theoretical foundation, while the development of its content from an extensive review of occupational therapy literature provided an evidence-based approach to its development. The iterative process of regular literature review and seeking feedback from early users about utility and accessibility also supported a comprehensive and responsive approach to development. This study presents encouraging initial evidence for the content validity of the scale as a measure of occupational being (Mokkink et al., 2010 ) however, further studies are required (and underway) to fully describe its psychometric properties. Many academic participants commented on the difficulty of operationalising abstract concepts like doing, being, becoming and belonging. Categorical representations of occupational therapy theories risk oversimplification and reflect outdated positivist perspectives on occupation and health (Reid et al., 2020 ). However, the measurement of latent variables using outcome measures can assist in unpacking the dynamic complexity that produces emergent properties (Bandeen-Roche et al., 1997 ). The DB3 provides a tangible and accessible entry point to understanding the influence of doing, being, becoming, belonging, resource and opportunities on occupational engagement, which should be supplemented with the use of additional outcome measures developed from conceptual practice models. As a paradigm, the POP is a sociologically constructed archetype of the stable core values and principles of occupational therapy (Khan, 2009 ). The concept of Multi Attribute Utility Indexes (MAUIs) provides a useful perspective on outcome measures that measure latent variables and emergent properties. MAUIs are based multi attribute utility theory and enable consumers to report how a broad range of influential factors impact upon their health and wellbeing (Torrance et al., 1982 ). A common example is quality of life measures which, like the DB3, do not provide specific guidance on how to complete assessment and interventions but are commonly employed by occupational therapists (Baron et al., 2019 ). Some participants reported struggling with the purpose and scope of the DB3, and quality of life measures may provide a useful analogy for occupational therapists and consumers to understand what it can (and cannot) contribute to their work together. Another key question to arise from this study is what occupational knowledge consumers need to benefit from the DB3. Many academics were concerned consumers would not understand its terminology, but consumers found the scale relevant and comprehensible. A similar finding was reported in another DB3 study (Hanrahan, 2021 ) with occupational therapists worried about the understanding of community-based rehabilitation clients, despite all scales being completed independently and without requests for clarification or assistance. These concerns reflect a deficit approach to science communication, where communication flows only from experts (occupational therapists) and knowledge is adjusted to the perceived limitations of consumers (Dawson, 2019 ; Gross, 1994 ). The purposeful design of the DB3 to be understandable at the Grade 6 / Year 7 readability level may have supported accessible terminology, but occupational therapists should explore what doing, being, becoming, belonging, resources and opportunities means in the context of each occupational being rather than impose definitions developed by the discipline. The findings of this study also raise interesting questions about the nature of ‘expertise’ when it comes to occupation and occupational therapy. The DB3 is a patient rated outcome measure and therefore captures their lived experience expertise. The skew towards positive and westernised perspectives of occupation noted by academic participants stems from the evidence-base of the scale, within which these are well recognised biases both in the literature and the broader profession (Hammell, 2011 ; Ivlev, 2023 ). Occupational therapists (along with consumers) are the intended users of the scale, and the academic responses are influenced by their distinctive realm of expertise. However, a key limitation of this study is the relatively small number of consumers who participated. Further testing with a wide range of consumers is needed to fully understand what occupational therapists and consumers get from the DB3 when applied in practice. Other limitations were the small geographical distribution of consumer participants, and the risk of bias inherent in purposive sampling. While many other measurement properties need to be established for the DB3, content validity is considered the most important psychometric property to establish initially (Terwee et al., 2018 ). This study had some strengths, including the diversity of academics participating, close attention to theoretical rigour during scale development and revision, and the use of the COSMIN standards to guide the evaluation of content validity. Conclusion The Doing Being Becoming and Belonging (DB3) Scale offers a novel approach to measuring the concept of occupational being. This study provides an overview of its theoretical underpinnings and their influence on its development, emphasising how deeply the occupational therapy paradigm in embedded within the scale. This preliminary study indicates the scale has adequate content validity, based on the perceptions of occupational therapy academics and consumers. The findings suggest the DB3 scale could meet a significant need in outcome measurement by providing a tool that evaluates the complex and dynamic nature of occupational being. This study underscores its potential utility and applicability across a wide range of settings. As acknowledged in the paper, several lines of further research are needed to fully understand the measurement properties of the DB3. These should explore its use in clinical practice, perceived value to occupational therapists and consumers and potential applications as a service wide outcome measure. Further studies are also recommended to describe the reliability, sensitivity, construct validity, and applicability across diverse populations and cultural contexts of this scale, with larger and more diverse samples. In occupational therapy education settings, the use of the DB3 Scale to enhance understanding of the core concepts of occupational therapy and enable reflective practice should be evaluated. References Ayre, C., & Scally, A. (2014). Critical Values for Lawshe’s Content Validity Ratio: Revisiting the Original Methods of Calculation. Measurement and Evaluation in Counseling and Development , 47 (1), 79-86. Bandeen-Roche, K., Miglioretti, D. L., Zeger, S. L., & Rathouz, P. J. (1997). Latent Variable Regression for Multiple Discrete Outcomes. Journal of the American Statistical Association , 92 (440), 1375-1386. https://doi.org/10.1080/01621459.1997.10473658 Baron, H., Hawrylyshyn, N., Hunt, S. S., & McDougall, J. (2019). Understanding quality of life within occupational therapy intervention research: A scoping review. Australian Occupational Therapy Journal . Barrera, A., Dunn, L., Nichols, A., Reardon, S., & Munoz, R. (2016). Ensuring informed consent for an online clinical trial. Journal of Empirical Research on Health Research Ethics , 11 (4), 291-298. Dawson, E. (2019). Equity, exclusion and everyday science learning: The experiences of minoritised groups. Routledge. Dei, G. J. S. (2008). Indigenous Knowledge Studies and the Next Generation: Pedagogical Possibilites for Anti-Colonial Education. The Australian Journal of Indigenous Education , 37 (S1), 5-13. Gross, A. (1994). The roles of rhetoric in the public understanding of science. Public Understanding of Science , 3 (1), 3-23. Hammell, K. W. (2011). Resisting theoretical imperialism in the Disciplines of Occupational Science and Occupational Therapy. British Journal of Occupational Therapy , 74 (1), 27-33. Hanrahan, L. (2021). Implementing the Doing, Being, Becoming and Belonging Scale in Community-Based Rehabilitation Deakin University]. Geelong. Hitch, D. (2014). Dynamic and Diverse Ways of Knowing in Mental Health Occupational Therapy Deakin University]. Geelong. http://dro.deakin.edu.au/eserv/DU:30067342/hitch-dynamic-2014A.pdf Hitch, D., & Pepin, G. (2021). Doing, being, becoming and belonging at the heart of occupational therapy: An analysis of theoretical ways of knowing. Scand J Occup Ther , 28 (1), 13-25. https://doi.org/10.1080/11038128.2020.1726454 Hitch, D., & Pepin, G. (2025). The Doing Being Becoming Belonging (DB3) Scale Version 1.0). https://doi.org/https://doi.org/10.17605/OSF.IO/G52E6 Hitch, D., Pepin, G., & Stagnitti, K. (2014a). In the footsteps of Wilcock, Part One: The evolution of doing, being, becoming and belonging. Occupational Therapy in Health Care , 28 (3), 231-246. Hitch, D., Pepin, G., & Stagnitti, K. (2014b). In the footsteps of Wilcock, Part Two: The interdependent nature of doing, being, becoming and belonging. Occupational Therapy in Health Care , 28 (3), 247-263. Hitch, D., Pepin, G., & Stagnitti, K. (2017). The Pan Occupational Paradigm: Development and Key Concepts. 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An Occupational Perspective of Health (3rd ed.). SLACK Incorporated. Wilcock, A. A., & Townsend, E. A. (2014). Occupational justice. In B. A. Boyt Schnell, G. Gillen, & M. Scaffa (Eds.), Willard and Spackman’s occupational therapy (12th ed., pp. 541-552). Lippincott Williams & Wilkins. World Federation of Occupational, T., Mackenzie, L., Coppola, S., Alvarez, L., Cibule, L., Maltsev, S., Loh, S. Y., Mlambo, T., Ikiugu, M. N., Pihlar, Z., Sriphetcharawut, S., Baptiste, S., & Ledgerd, R. (2017). International Occupational Therapy Research Priorities. OTJR (Thorofare N J) , 37 (2), 72-81. https://doi.org/10.1177/1539449216687528 Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7105368","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":484294009,"identity":"c6adbdbe-a81c-495f-974e-8c582708c8be","order_by":0,"name":"Danielle Hitch","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBUlEQVRIiWNgGAWjYDCCA0DE2CDBwCDBfABIJvCABCWI0SLBIMGWQLwWBsYGoCIJHgOQFgaCWviOnz14gHGHRR3/7J6PNz7UpMmYMzAfvM3DYJfYgEOL5Jm8hAOMZyQkJO6c3Ww541gOj2UDW7I1D0MyTi0GB3IMDjC2SUgYSORuk+Zhq+AxOMBjJs3DwIxby/k3MC05z6T//ANp4f8G1FKPW8sNuC05bNKMbTkgW9iAWg7j9ssNoC2JbRKSM26kGVv29qXxGBxmM7acY3DcGJcWvvM5xh8+ttXx889Ifnjjx7dke4PjzQ9vvKmolsWlBQwSUHjMYAfjUz8KRsEoGAWjgBAAAP4KVfZikm5tAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0003-2798-2246","institution":"Deakin University","correspondingAuthor":true,"prefix":"","firstName":"Danielle","middleName":"","lastName":"Hitch","suffix":""},{"id":484294010,"identity":"1b6254ed-42ea-4e41-ae92-7bfa95a25920","order_by":1,"name":"Genevieve Pepin","email":"","orcid":"https://orcid.org/0000-0002-8382-160X","institution":"Deakin University","correspondingAuthor":false,"prefix":"","firstName":"Genevieve","middleName":"","lastName":"Pepin","suffix":""}],"badges":[],"createdAt":"2025-07-12 03:12:52","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7105368/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7105368/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87033719,"identity":"7b3a35c2-a572-4eb7-bf07-8461c122bc43","added_by":"auto","created_at":"2025-07-18 13:07:55","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":68577,"visible":true,"origin":"","legend":"\u003cp\u003eComponents of the DB3\u003c/p\u003e","description":"","filename":"DB3Fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7105368/v1/b34ec5433f96684b07df101b.jpg"},{"id":87032425,"identity":"1183f6e8-48c0-4383-bd54-b14ac33d2046","added_by":"auto","created_at":"2025-07-18 12:59:55","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":183691,"visible":true,"origin":"","legend":"\u003cp\u003eOccupational Therapy Academic perceptions of DB3 effectiveness\u003c/p\u003e","description":"","filename":"DB3Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-7105368/v1/a883ca175ce1115cb02cfb20.png"},{"id":87033721,"identity":"81d51f37-157f-4e97-95cf-8fcebe5bc8a5","added_by":"auto","created_at":"2025-07-18 13:07:55","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":185702,"visible":true,"origin":"","legend":"\u003cp\u003eOccupational Therapy Academic perceptions of DB3 efficiency\u003c/p\u003e","description":"","filename":"DB3Fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-7105368/v1/0ffc55bed5fba9cb3cea3975.png"},{"id":87037547,"identity":"13e3398f-443c-4939-a6d5-6da2fe979427","added_by":"auto","created_at":"2025-07-18 13:24:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1353073,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7105368/v1/54863b02-7137-4609-a18e-c313f79d5580.pdf"},{"id":87032421,"identity":"2bef526f-c39b-4cf9-9cf4-e8de42ca60bb","added_by":"auto","created_at":"2025-07-18 12:59:55","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":57327,"visible":true,"origin":"","legend":"","description":"","filename":"AOTJSupplementaryMaterials12.07.2025.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7105368/v1/6f6f9e3aa2d07f2e29795c72.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eThe Doing, Being, Becoming and Belonging (DB3) Scale: Development and Content Validity\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe complex relationship between occupation, health and well-being is the core business of occupational therapy. Many outcome measures developed or adopted in occupational therapy to support assessment and evaluation, have arisen from conceptual practice models, related knowledge from other disciplines or are limited to specific clinical populations (Hitch, 2014; Kielhofner, 2008). Currently available measures do not directly evaluate the concept of \u0026lsquo;occupational being\u0026rsquo;. Occupational being refers to an identity that emerges from interactions between doing, being, becoming, and belonging, the dimensions of occupation (Hitch et al., 2018). This identity is an emergent property of the dimensions of occupation, and occupational being evolves with changes in the inter-relationships between the dimensions (Hitch \u0026amp; Pepin, 2021).\u003c/p\u003e\n\u003cp\u003eThe complexity of occupational being poses significant challenges for outcome measurement, which Rogers and Holm (1994) defined as \u0026ldquo;the functional consequence for the patient of the therapeutic actions implemented by an occupational therapist\u0026rdquo; (p. 872). The purposes of outcome measurement are to demonstrate functional change over time and the effectiveness of occupational therapy in enabling these changes (Unsworth, 2000).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eImproved occupational being is a critical outcome of occupational therapy for our consumers. For example, international research priority areas for occupational therapy include the effectiveness of interventions, evidence-based practice, participation in everyday life, healthy ageing, the professions work with chronic conditions, sustainable community development and population-based interventions, technology, and professional issues (World Federation of Occupational et al., 2017). Occupational being is applicable to all these areas both as a goal and an outcome. Therefore, the development and validation of an occupational being measure should be a priority for occupational therapy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study aimed to reflect on the development of a new outcome measure of occupational being - the Doing, Being, Becoming and Belonging Scale (or DB3) \u0026ndash; and describe preliminary evidence of its validity and application to occupational therapy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStructure and Format of the DB3 Scale\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe DB3 Scale is a Patient-Rated Outcome Measure (PROM) and a generic measure of occupational being. It has been validated for consumers over 18 years who can comprehend the items and respond independently. All items are written at Grade 6 / Year 7 readability level on the Flesch-Kincaid Scale (Kincaid et al., 1975) and it takes approximately 5 minutes to complete.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe DB3 Scale contains 42 items across the five sub-scales (doing, being, becoming, belonging, resources \u0026amp; opportunities). Respondents rate their satisfaction regarding each item on a 7-point Likert scale (-3 = Extremely Dissatisfied, 0 = Neutral, +3 = Extremely Satisfied). While a retrospective timeframe of two weeks is recommended to complete the scale, this can be adapted to the needs of consumer groups and practice settings. \u0026nbsp;Sub-scale scores are derived from the mean of all item scores, and the Occupational Being score comprises the mean of the doing, being, becoming and belonging sub-scale scores. The resources and opportunities sub-scale score is not combined with any other.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eScores summarise the consumer\u0026rsquo;s satisfaction or dissatisfaction with their occupational being in relation to their doing, being, becoming, belonging, resources \u0026amp; opportunities. Items which lower scores (i.e., greater dissatisfaction) indicate aspects of occupation which could be targeted during goal setting and intervention, while higher scores identify areas of strength. These DB3 should be completed again after intervention to describe change over time and potentially capture the link between occupational therapy and the consumers\u0026rsquo; outcomes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe DB3 can be administered solely as a quantitative scale, or as a mixed methods scale. In the mixed methods version, space is provided under each sub-scale for free text comments by the consumer. This information provides greater context to the data and enhances the information available to occupational therapists. If consumers choose to add comments, the entire scale may take 7-10 minutes to complete. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDevelopment of the DB3 Scale\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTheoretical Foundations\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe DB3 scale is deeply embedded within occupational therapy principles and knowledge. It was developed from the Pan Occupational Paradigm (POP), in response to requests from occupational therapists for a tangible resource to enable application of the POP into their clinical practice (Hitch et al., 2018). The calls for supporting technology from occupational therapists reflect the ongoing development of the paradigm over time, just as its founding framework (Wilcock\u0026rsquo;s Occupational Perspective of Health) has continued to evolve (Wilcock \u0026amp; Hocking, 2015). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs a paradigm, the POP presents broad assumptions and values rather than specific guidelines for practice (Hitch \u0026amp; Pepin, 2021). Paradigms provide the \u0026lsquo;why\u0026rsquo; of occupational therapy while conceptual practice models provide the \u0026lsquo;how\u0026rsquo; to put these ideas into action (Kielhofner, 2008). However, both paradigms and conceptual practice models may have outcome measures that evaluate their core concepts. In the case of paradigms, outcomes measures support their verification and validity, drive their ongoing evolution, and enable consistent data collection over time (Kuhn, 2012). The close links between the POP and conceptual practice models was demonstrated by Hitch and Pepin (2021) who mapped how the dimensions of occupation are embedded within multiple occupational therapy models. \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe DB3 is founded on the two underlying assumptions of the POP. Firstly, humans are occupational beings whose health and well-being are influenced by occupational engagement. This assumption is drawn directly from Wilcock\u0026rsquo;s Occupational Perspective of Health (Wilcock \u0026amp; Hocking, 2015), and articulates the fact the DB3 was designed to collect information specific to occupational being (and therefore occupational therapy). Secondly, occupational therapy ways of knowing are one perspective amongst many - other ways of knowing are equally valuable to our understanding of occupation. This assumption reflects a commitment to epistemological equity (Dei, 2008) acknowledging the co-existence of multiple occupational understandings and the need for conscious action to include marginalised and excluded ways of knowing. In addition, the DB3 reflects the structure of the POP by including 1) occupational dimensions, 2) the occupational being, 3) resources and opportunities, and 4) a health and wellbeing continuum. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe aim of the DB3 is to measure occupational being from the individual (i.e. your patients/consumers/service users), group (i.e. therapeutic groups, sporting teams) and/or population (i.e. refugees, cultural communities) perspective (Wilcock \u0026amp; Hocking, (2015). The authors fully acknowledge the need for validation in a wider range of populations. The impact of specific occupations, occupational roles and groups on occupational being can also be explored and four DB3 templates are available to enable flexible application, which are freely available at https://osf.io/g52e6/files/osfstorage (Hitch \u0026amp; Pepin, 2025).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eKey Concepts\u0026nbsp;\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe Dimensions of Occupation.\u003c/em\u003e Four subscales in the DB3 align with the four dimensions of occupation - doing, being, becoming and belonging (Hitch et al., 2018; Wilcock \u0026amp; Hocking, 2015). The items of these subscales were initially developed from the comprehensive literature review undertaken to develop the POP (Hitch 2014a and 2014b) and were reaffirmed by an updated literature review in 2020. The authors also continue to monitor new research which cites the Occupational Perspective of Health (Wilcock, 1998; Wilcock, 2006; Wilcock \u0026amp; Hocking, 2015) or the POP (Hitch, 2014; Hitch \u0026amp; Pepin, 2021; Hitch et al., 2017) to identify and explore new aspects of these concepts which may emerge over time. The process of both POP and DB3 development has been subjected to repeated and rigorous peer review as part of the first authors PhD studies and subsequent peer review publications and presentations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe items on the DB3 are abstract in nature and may be open to interpretation. However, consumers are provided with a plain language version of the definitions of these items with prompts developed by Hitch et al. (Hitch et al., 2014a, 2014b) to support a consistent understanding of what they mean in the context of the DB3 (see Table 1). For example, physical tasks are followed by \u0026lsquo;moving, reaching, carrying\u0026rsquo;. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 1: Professional and Plain Language Definitions of the Dimensions of Occupation \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003eDimension\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eProfessional Definition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eDB3 Scale Plain Language Definition\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003eDoing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026ldquo;The medium through which people engage in occupations and the skills and abilities needed for doing accumulate across time. Doing involves engaging in personally meaningful occupations, but not necessarily purposeful, healthy, or organised. Doing involves being actively engaged, either overtly (i.e., observable, physical) or tacitly (i.e., mental, spiritual). Doing follows broadly similar patterns across the population, and humans can adapt their doing to greater and lesser degrees according to circumstance\u0026rdquo; (Hitch et al., 2014a, p. 241).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003ePeople do many things as part of daily life, both alone and with others. These may include what you want to do, have to do and need to do.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003eBeing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026ldquo;The sense of who someone is as an occupational and human being. It encompasses the meanings they invest in life and their unique physical, mental, and social capacities and abilities. Occupation may provide a focus for being, but it also exists independently of it during reflection and self-discovery. Being is expressed through consciousness, creativity, and the roles people assume in life. Ideally, individuals can exercise agency and choice in their expression of being, but this is only sometimes possible or even desirable\u0026rdquo; (Hitch et al., 2014a, p. 241).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eThis is who you are, including what you enjoy or find meaningful. Being includes your unique physical, mental, and social skills, your life roles and the choices you make about activities.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003eBecoming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026ldquo;The perpetual process of growth, development, and change that reside within a person throughout their life. It is directed by goals and aspirations, which can arise through choice or necessity, from the individual or from groups. Regular modifications and revisions of goals and aspirations help to maintain momentum in becoming, as does the opportunity to experience new or novel situations and challenges\u0026rdquo; (Hitch et al., 2014a, pp. 241-242).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003ePeople change and develop over time. Everyone has hopes or goals to work towards but change beyond your control can happen. The chance to develop new skills is important, as people adjust to change.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003eBelonging\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026ldquo;A sense of connectedness to other people, places, cultures, communities, and times. It is the context within which occupations occur, and a person may experience multiple belongings at the same time. Relationships are essential to belonging, whether they be with a person, place, group, or another factor. A sense of reciprocity, mutuality and sharing characterise both positive and negative belonging relationships, be they positive or negative\u0026rdquo; (Hitch et al., 2014a, p. 242).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eBelonging is your sense of connection with other people, places, cultures, communities, and times. All people have multiple relationships with these things and belonging happens when you experience sharing and mutual benefit.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eOccupational Being.\u003c/em\u003e Given that occupational dimensions are continually in flux, occupational being is not a fixed or static entity- it reflects the context, preferences, skills and needs of the individual, group, or population at that time. These changes over time can be evaluated against the health and wellbeing continuum in conjunction with the final sub-scale.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eResources and Opportunities Sub-scale.\u003c/em\u003e The fifth DB3 sub-scale is external to the occupational being and describes the more tangible entities which manifest through aspects of the external environment to determine the occupational beings access to occupation. Resources are the available assets (including finances, objects, social capital, and other materials) which enable or disable occupational engagement. Opportunities emerge when elements like networks, change over time, goal directed actions, necessity and chance occurrences contribute to environmental conditions that enable or disable occupational engagement.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOccupational engagement depends on having both the resources and opportunities to engage in occupations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe conceptualisation of these sub-scales as complimentary to each other also reflects the authors\u0026rsquo; commitment to occupational justice as a means to support occupational beings disadvantaged by factors beyond their direct control (Wilcock \u0026amp; Townsend, 2014). Locating resources and opportunities implies occupational beings have direct access to and agency over them and this is often not the case. While occupational therapy primarily targets occupational being, the DB3 scale provides an opportunity to also measures advocacy and activism efforts undertaken by the profession to improve resourcing and opportunities. Further information about how the presence of key concepts of occupational justice in the DB3 is provided in Supplementary Materials 1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eItems related to resource and opportunities are presented at the end of the doing, being, becoming and belonging sub-scales to highlight their links (and potentially differential relationships) with each occupational dimension. There is no plain language definition for the resources and opportunities sub-scale, as early users indicated its inclusion in the DB3 was either repetitive or confusing. However, prompts are included with these items to guide interpretations of their meaning \u0026ndash; resources (e.g. money, items, tools), opportunities (e.g. chances, enough time).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHealth and Wellbeing Continuum\u003c/em\u003e. The final component of the DB3 is a continuum from ill-being to well-being (Hitch et al., 2018). The continuum is not related to time - it indicates the occupational being\u0026rsquo;s current health and well-being status. At the bottom of the continuum are the adverse outcomes of occupational engagement: illness, deprivation, alienation, injustice, and death. At the top are the positive outcomes of occupational engagement: well-being, health, happiness, inclusivity, and justice. The arrowhead at the top acknowledges the aims of occupational therapy in moving consumers towards positive outcomes by addressing doing, being, becoming, belonging, resources and opportunities.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe location of the occupational being on the health and wellbeing continuum can be indicated with the occupational being score and the resources and opportunities score, as show in Figure 1. An animated version of this figure would show the dimensions pulsing larger and smaller to show how the dimensions are foregrounded at different times and for different occupations. The colours used in this figure are meaningful, as they emphasise the need for sustainable occupations to promote population health.\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study used a descriptive quantitative method to explore the measurement (or psychometric) properties of the DB3 Scale. A single descriptive survey was distributed to occupational therapy academics and consumers to capture their perceptions of the content validity of the DB3 with specific reference to its applicability, relevance, comprehensiveness and comprehensibility as recommended by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) collaboration (Terwee et al., 2018). Content validity refers to the extent to which an outcome measure reflects or evaluated the construct of interest (Mokkink et al., 2010). Ethics approval for this study was provided by a university (HEAG-H 78_2020) and a health service (HREC/63606/WH-2020-213755). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRecruitment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria for academics were 1) qualified Occupational Therapist, 2) Currently teaching or conducting research in Australian or New Zealand universities providing occupational therapy pre-registration courses, and 3) able to provide informed consent. The contact details of 204 academic staff were identified on publicly available websites and formed the contact list for this participant group. Academics were therefore recruited via a purposeful strategy which was supplemented by snowball sampling. An invitation to participate (with the plain language statement attached) was emailed directly to these academics, and interested participants were provided with an online link to the survey. Academic participants had one month to submit their responses and received two reminder emails in that time. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsumers were recruited as part of a broader study of occupational being during the initial stages of the COVID-19 pandemic. The inclusion criteria were 1) people residing in the catchment area of the health service during the timeframe of the study, 2) aged 18 and over, 3) able to understand written English without assistance, 4) able to provide informed consent and 5) with access to email and internet connection to enable regular response to surveys. The study was advertised with an email and attached plain language statement via the volunteer mailing list of a health service, and via the professional networks of the research team. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInterested participants registered for the study via an online link and they completed the DB3 content validity survey. The online registration form included multiple-choice questions that check participant understanding before they provided their consent, in recognition of the challenges to ensuring informed consent when conducting online surveys (Barrera et al., 2016). Consumers went on to complete the DB3 once a month for the following six months, and the findings of the broader study are reported elsewhere. All consumers had two weeks to submit their responses and no reminder emails were distributed. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Collection\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe occupational therapy academic survey began with demographic information about gender, age group, location, and years of experience as an academic. The 42 items of the DB3 scale were then presented and rated according to relevance to its associated sub-scale (is relevant / is not relevant / unsure of the relevance). Participants were able to identify additional items they believed should be included in each sub-scale. Questions regarding the effectiveness and efficiency of the DB3 in supporting occupational therapy practice, education, research and consumers followed and were rated on a seven-point Likert scale (extremely ineffective / inefficient = -3, neither effective / efficient or ineffective / inefficient = 0, extremely effective / efficient = 3). Finally, participants were asked how likely they were to recommend the DB3 to clinicians, educators, researchers, and consumers, and describe a situation where they might consider applying it in practice. \u0026nbsp;The survey took approximately 10 minutes to complete. Data were collected in anonymous form, thereby protecting participant privacy and confidentiality.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe consumer survey began with demographic information about gender, age group, country of birth, primary language and whether they had a disability or chronic illness. Their survey included the same questions regarding item relevance and opportunity to identify additional items for each sub-scale. This survey took approximately 7 minutes to complete. Data were collected in re-identifiable form to enable future contact for the purposes of the broader study, but identifiers were removed prior to analysis of the data presented here.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll online surveys were located on the Qualtrics platform, and submission of responses were considered implied consent.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eQuantitative data was analysed using the SPSS package (IBM Corp, 2021) and descriptive statistics such as means and frequencies. Lawshe\u0026rsquo;s (1975) method of quantifying content validity asks a panel of experts to rate items in one of three categories, which in this study were relevant, not relevant, or unsure. The resulting ratio represents a linear transformation of agreement proportions and is calculated as n\u003csub\u003ee\u0026nbsp;\u003c/sub\u003e\u0026ndash; (N/2) / N/2 (where n\u003csub\u003ee\u0026nbsp;\u003c/sub\u003eis the number of respondents agreeing the item is relevant, and N is the total number of respondents). Ayre and Scally (2014) published updated critical Lawshe ratio values for the number of experts required to agree an item is relevant up to a panel size of 40. The critical values for 40 respondents were applied to all occupational therapy academic responses, as the small number of additional responses (up to n=44) would only have resulted in a lower critical value. The critical values for 17 responses were applied to community member responses to reflect the size of that sample.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eQualitative data regarding comprehensiveness and useability were subjected to content analysis (Vaismoradi et al., 2013) given the relative brevity of the responses and comments. The frequency of comments was noted, grouped into similar responses, and categorised under themes. All codes were reviewed by the second author for both consistency of application and the formation of consensus. \u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 66 academics (response rate 32%) and 19 consumers submitted surveys, however only 44 and 17 respectively completed all questions therefore valid response numbers are reported below (see Table 2). Academics from all but one Australian state and territory responded, along with four colleagues from New Zealand. All consumers were recruited from locations in the western suburbs of Melbourne. Results from the surveys and qualitative data are combined under five themes presented below.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2: Sample Characteristics\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 307px;\"\u003e\n \u003cp\u003eOT Academics\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 316px;\"\u003e\n \u003cp\u003eCommunity Members\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003en, %\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003en, %\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003eFemale\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e57, 86.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eFemale\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e18, 94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003eMale\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9, 13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eMale\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eNon binary\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e18-34\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10, 15.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e18-34\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e6, 31.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e35-44\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e11, 16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e35-44\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e7, 36.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e45-54\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e33, 50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e45-54\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e55-64\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e11, 16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e55-64\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e3, 15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e65+\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e1, 1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e65+\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e3, 15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003eLocation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003eAustralia\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e96, 93.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eCountry of Birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eAustralia\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e18, 94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003eNew Zealand \u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4, 6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eOther\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003eYears exp.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e0-9\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e24, 36.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eLanguage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eEnglish\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e10-19\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e18, 27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eOther\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e20-29\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e14, 21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e30+\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10, 15.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eDisability\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eYes\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e5, 26.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cem\u003eNo\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e14, 73.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: exp. = experience\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOccupational Therapy Academics\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll but two of the items on the DB3 met the criterion for relevance as measured by Lawshe\u0026rsquo;s ratio (Table 3). These items were related to having the resources and opportunities to \u0026lsquo;do\u0026rsquo; and all the resource and opportunity scale items had lower ratios. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3: Occupational therapy academic construct validity ratings for relevance\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eItem\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eRelevant,\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003eNot relevant, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUnsure, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eLawshe\u0026rsquo;s ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eDoing Sub-Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that have\u0026nbsp;personal\u0026nbsp;meaning\u0026nbsp;or value\u0026nbsp;for you\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e42, 97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1, 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.954\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that have\u0026nbsp;a\u0026nbsp;purpose\u0026nbsp;or meet a\u0026nbsp;goal\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e42, 97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1, 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.954\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;physical\u0026nbsp;tasks\u0026nbsp;(e.g.\u0026nbsp;moving,\u0026nbsp;reaching,\u0026nbsp;carrying) (n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e36, 83.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e6, 14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.674\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;mental\u0026nbsp;tasks\u0026nbsp;(e.g.\u0026nbsp;thinking,\u0026nbsp;remembering)\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e37, 86.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e6, 14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.721\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;social\u0026nbsp;tasks\u0026nbsp;(e.g.\u0026nbsp;conversation,\u0026nbsp;eating a\u0026nbsp;meal\u0026nbsp;together)\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 90.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.814\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;thing that\u0026nbsp;meet\u0026nbsp;your own\u0026nbsp;personal\u0026nbsp;needs\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e42, 97.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1, 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.954\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that\u0026nbsp;meet the\u0026nbsp;needs of\u0026nbsp;other\u0026nbsp;people\u0026nbsp;(e.g.\u0026nbsp;family,\u0026nbsp;friends,\u0026nbsp;co-workers)\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e41, 97.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1, 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.952\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that help\u0026nbsp;you feel\u0026nbsp;healthy\u0026nbsp;and well\u0026nbsp;(n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e42, 95.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1, 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.909\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;organised\u0026nbsp;things\u0026nbsp;(e.g.\u0026nbsp;planned,\u0026nbsp;specific\u0026nbsp;times)\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 90.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.814\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;spontaneous\u0026nbsp;things\u0026nbsp;(e.g.\u0026nbsp;unplanned, spur of\u0026nbsp;the\u0026nbsp;moment)\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e41, 95.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.907\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;resources\u0026nbsp;you\u0026nbsp;have\u0026nbsp;to\u0026nbsp;\u0026apos;do\u0026apos;\u0026nbsp;things\u0026nbsp;(e.g.\u0026nbsp;money,\u0026nbsp;items,\u0026nbsp;tools)\u0026nbsp;(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e24, 55.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e5, 11.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e14, 32.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.116 **\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to do things (e.g. chances, enough time) (n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e26, 60.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e14, 32.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.209 **\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eBeing Sub-Scale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eHaving\u0026nbsp;time to\u0026nbsp;reflect\u0026nbsp;and\u0026nbsp;contemplate\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e34, 81.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e2, 4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e6, 14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.619\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;personal\u0026nbsp;sense of\u0026nbsp;self as a\u0026nbsp;human\u0026nbsp;being\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e38, 90.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.810\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;personal\u0026nbsp;needs\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e34, 81.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e5, 11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.619\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;spiritual\u0026nbsp;needs\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e35, 83.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.667\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;cultural\u0026nbsp;needs\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e36, 85.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e3, 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;creative\u0026nbsp;needs\u0026nbsp;(e.g.\u0026nbsp;play,\u0026nbsp;problem\u0026nbsp;solving,\u0026nbsp;art)\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e35, 83.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.667\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eYour life\u0026nbsp;roles\u0026nbsp;(e.g.\u0026nbsp;child,\u0026nbsp;partner,\u0026nbsp;student,\u0026nbsp;worker,\u0026nbsp;carer) (n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 92.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMaking\u0026nbsp;choices\u0026nbsp;about\u0026nbsp;what you\u0026nbsp;do\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e34, 81.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e7, 16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.619\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMaking\u0026nbsp;use of\u0026nbsp;your\u0026nbsp;existing\u0026nbsp;skills\u0026nbsp;(n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e31, 73.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e4, 9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e7, 16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.476\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;resources\u0026nbsp;you have for \u0026lsquo;being\u0026rsquo; (e.g. money, items, tools (n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e29, 69.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e6, 14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e7, 16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.391\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to \u0026lsquo;be\u0026rsquo; (e.g. chances, enough time) (n=42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e33, 78.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e6, 14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.571\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eBecoming Sub-Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eLearning\u0026nbsp;new skills\u0026nbsp;and\u0026nbsp;talents\u0026nbsp;(n=40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e38, 95.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eYour potential to grow and develop as a person \u0026nbsp;(n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e38, 92.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.854\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;potential\u0026nbsp;to grow\u0026nbsp;and\u0026nbsp;develop\u0026nbsp;with\u0026nbsp;other\u0026nbsp;people\u0026nbsp;(n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e33, 80.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e6, 14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.610\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;aspirations or\u0026nbsp;hopes for\u0026nbsp;the\u0026nbsp;future\u0026nbsp;(n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eChanges\u0026nbsp;you want\u0026nbsp;to make\u0026nbsp;for\u0026nbsp;yourself\u0026nbsp;(n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e40, 97.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1, 2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.951\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eChanges\u0026nbsp;you want\u0026nbsp;to make\u0026nbsp;with\u0026nbsp;others (n=40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e35, 87.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.750\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;ability to\u0026nbsp;adapt to\u0026nbsp;change (n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e34, 82.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.659\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMaintaining your\u0026nbsp;current\u0026nbsp;skills and\u0026nbsp;talents (n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e31, 75.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e6, 14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.512\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe resources you have\u0026nbsp;to \u0026apos;become\u0026apos; (e.g. money, items, tools) (n=40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e32, 80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e3, 7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e5, 12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.600\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to \u0026lsquo;become\u0026rsquo; (e.g. chances, enough time) (n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e35, 83.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.707\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eBelonging Sub-Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eBelonging with partners (i.e. husband/wife, boyfriend/girlfriend) (n=41)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e37, 90.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e3, 7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.805\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eBelonging with family (i.e. parents, children, other relatives, pets) (p=41)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eBelonging with\u0026nbsp;friends\u0026nbsp;(p=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eBelonging with\u0026nbsp;other\u0026nbsp;people in\u0026nbsp;my\u0026nbsp;community\u0026nbsp;(p=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eBelonging with\u0026nbsp;people of\u0026nbsp;a similar\u0026nbsp;age to you (i.e. your generation) (p=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e34, 82.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e7, 17.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.659\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eBelonging with people of a similar cultural or social background to you\u0026nbsp;(p=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e36, 87.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e1, 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e4, 9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.756\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eBelonging to the\u0026nbsp;location\u0026nbsp;you call home (i.e. local area, town, state, country) (p=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e39, 95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe resources you have\u0026nbsp;to \u0026apos;belong\u0026apos; (e.g. money, items, tools) (n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e29, 70.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e5, 12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e7, 71.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.415\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to \u0026lsquo;belong\u0026rsquo; (e.g. chances, enough time) (n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e34, 82.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e2, 4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e5, 12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.659\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: * = items not reaching the benchmark for agreed relevance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Measurement of Occupational Being.\u003c/strong\u003e While the DB3 measures satisfaction, participants also raised other consideration: \u0026ldquo;\u003cem\u003eT\u003c/em\u003e\u003cem\u003ehe importance level of different areas will vary- they are important but\u0026nbsp;how important? Is there opportunity to rank them?\u003c/em\u003e\u003cem\u003e\u0026rdquo;.\u0026nbsp;\u003c/em\u003eSeveral participants also commented on a lack of temporality in the items: \u003cem\u003e\u0026ldquo;\u003c/em\u003e\u003cem\u003ehaving a sense of your present self as part of a coherent narrative over time\u003c/em\u003e\u003cem\u003e\u0026rdquo;\u003c/em\u003e. One participant described this as \u003cem\u003e\u0026lsquo;historical belongingness\u0026rsquo;\u003c/em\u003e and there was a sense of it encompassing more than the current item about \u0026ldquo;Belonging with people of a similar age to you (i.e. your generation)\u0026rdquo;; \u003cem\u003e\u0026ldquo;I\u003c/em\u003e\u003cem\u003et is not just the people but the\u0026nbsp;doing with and for \u0026hellip; knowing you are doing what\u0026nbsp;people have done in this place before you\u0026rdquo;.\u003c/em\u003e Participants noted the items reflected a limited cultural perspective on occupation which may or may not be relevant to people from culturally and linguistically diverse or marginalised communities; \u0026ldquo;\u003cem\u003eThis is skewed towards western individualistic sense of self\u0026rdquo;. \u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants also offered more general remarks about the DB3 were also submitted. Some indicated a general lack of certainty around the purpose or scope of the DB3; \u003cem\u003e\u0026ldquo;\u003c/em\u003e\u003cem\u003eit isn\u0026rsquo;t quite clear what the \u0026apos;categories\u0026apos; of doing are intended to be\u0026rdquo;.\u003c/em\u003e There were also concerns that consumers would not understand the language used in the scale; \u003cem\u003e\u0026ldquo;Most people are really going to struggle with this concept\u003c/em\u003e\u003cem\u003e\u0026rdquo;\u003c/em\u003e. Several comments indicated the explicit occupational focus of the DB3 could be a barrier to its use by consumers; \u003cem\u003e\u0026ldquo;\u003c/em\u003e\u003cem\u003eOTs know, but not necessarily the public\u0026rdquo;.\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever, the general comments also demonstrated significant variability in the participants perspectives on the dimensions of occupation; \u003cem\u003e\u0026ldquo;the\u003c/em\u003e \u003cem\u003edistinction between doing and being and\u0026nbsp;becoming is not quite clear, I think\u003c/em\u003e\u003cem\u003e\u0026rdquo;.\u0026nbsp;\u003c/em\u003eMany of the specific suggestions for inclusion were already addressed (either explicitly or implicitly) by items in other sub-scales; \u0026ldquo;\u003cem\u003eI rejected a lot of the items in the list because they point to doing, not being\u0026rdquo;.\u0026nbsp;\u003c/em\u003eFor example, participants suggested the inclusion of individual skills and capacity (being); relaxing, resting and reflection (being); objects and places for doing (belonging); choices and prioritisation (being) and social support and connection (belonging) in the doing sub-scale. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThese responses to the scale\u0026rsquo;s structure highlight the close interconnectedness between the dimensions of occupation; \u0026ldquo;\u003cem\u003eBecoming interrelates to being as well as doing, so the kind of person you want to\u0026nbsp;become as well\u003c/em\u003e\u003cem\u003e\u0026rdquo;.\u0026nbsp;\u003c/em\u003eAs a result of a perceived lack of conceptual clarity, respondents expressed concerns that the measurement properties of the DB3 would be \u003cem\u003e\u0026lsquo;messy\u0026rsquo;\u003c/em\u003e and believed \u003cem\u003e\u0026ldquo;the list would not stand up in Rasch analysis because they are quite disparate concepts\u0026rdquo;\u003c/em\u003e. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSubscale Content.\u0026nbsp;\u003c/strong\u003eSuggestions for additional items were made for doing (n=24, 45.3%), being (13, 26.0%), becoming (12, 25.5%) and belonging (18, 38.3%) subscales. Many recommended additions were related to specific categories of occupation including recreation, productivity, leisure, cultural, creative, spiritual, activism, and sustainability. Obligated activities and purposeful but unhealthy occupations were also suggested, in recognition that not all occupational engagement is positive; \u0026ldquo;\u003cem\u003eThere is the usual positive slant - how will people account\u0026nbsp;for things they mindfully and deliberately do that are not good for their own health, don\u0026apos;t benefit\u0026nbsp;other people, respond to deficits rather than needs - violence, addiction\u003c/em\u003e\u003cem\u003e\u0026rdquo;\u003c/em\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eItems related to resources and opportunity were listed with their associated occupational dimension, and while respondents recognized their links to each, they also perceived them as distinctive from the rest of the items on the sub-scales; \u0026ldquo;\u003cem\u003ethe resources and\u0026nbsp;opportunities questions might be \u0026apos;relevant\u0026apos; to each scale, but they do tap a completely different\u0026nbsp;construct\u0026rdquo;\u003c/em\u003e.\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eScale Effectiveness and Efficiency.\u003c/strong\u003e Most academics perceived the DB3 as having some degree of effectiveness for clinical practice (n=31, 73.8%), research (n=35, 83.3%), education (n=35, 85.4%) and direct work with patients / consumers (n=32, 76.2%) (Fig. 2). A slightly lower proportion perceived the DB3 as being an efficient tool in clinical practice (n=29, 69.0%), research (n=28, 66.7%), education (n=30, 71.4%) and direct work with patients / consumers (n=27, 64.3%) (Fig. 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eApplications to Occupational Therapy Practice.\u0026nbsp;\u003c/strong\u003eMost academics were slightly, likely or extremely likely to recommend the DB3 for use in clinical practice (n=29, 67.4%), education (n=28, 65.1%), research (n=30, 69.8%) and with patients/consumers (n=28, 65.1%). When asked about the potential applications of the DB3, several participants commented they could see the DB3 being applicable to mental health settings, especially because \u003cem\u003e\u0026ldquo;\u003c/em\u003e\u003cem\u003ethere are few other tools that\u0026nbsp;really explicitly\u0026nbsp;address \u0026apos;being\u0026apos; and \u0026apos;belonging\u0026apos;\u003c/em\u003e.\u0026rdquo; Other populations or settings identified included people with disability, consumers transitioning to new occupational identities after a health event, marginalised group and occupational participation patterns in the general community. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParticipants felt they could use the DB3 as part of initial or more comprehensive assessments, and that it could form part of a suite of outcome measures alongside tools like the Canadian Occupational Performance Measure (COPM). They generally recognised the DB3 was not designed to be a stand-alone assessment and would be complemented by other data collection; \u003cem\u003e\u0026ldquo;I\u003c/em\u003e\u003cem\u003ef I was using it clinically,\u0026nbsp;I would\u0026nbsp;interview as well - just the survey response\u0026nbsp;wouldn\u0026apos;t\u0026nbsp;be\u0026nbsp;enough for me to work with\u0026rdquo;.\u003c/em\u003e The DB3 was perceived as having a potential role in goal setting, strategy development, reflections on recovery, identifying and readjusting priorities. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMany of the recommendations for educational use related to orienting students to the general principles and concepts of occupational therapy and occupational science. Participants also believed the DB3 could support awareness and reflective practice by getting students to engage with their own occupational beings. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAreas for Improvement and Development.\u003c/strong\u003e In terms of overall improvements, some participants asked for the DB3 to \u003cem\u003e\u0026lsquo;drill down to specific examples\u0026rsquo;\u003c/em\u003e to avoid it being too theoretical or broad in its scope; \u003cem\u003e\u0026ldquo;I\u003c/em\u003e\u003cem\u003et\u0026apos;s\u0026nbsp;a conceptual tool rather than a specific\u0026nbsp;assessment of where anyone is on these scales\u0026rdquo;\u003c/em\u003e. They also cautioned against presenting the occupational dimensions as categorical and were concerned consumers would not comprehend the core concepts; \u003cem\u003e\u0026ldquo;I am not sure they would resonate well with\u0026nbsp;clients\u0026nbsp;and I think the nuances that distinguish\u0026nbsp;between them, would be very hard for clients to understand in a meaningful way\u0026rdquo;\u003c/em\u003e. Someone also expressed concern about potential overuse of the terminology. \u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eI think the profession has completely overused these terms and think any further use of them should be very carefully considered - and not necessarily encouraged. I think their overuse is making them more and more meaningless.\u0026nbsp;\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParticipants recommended future development of the constructs from a non-Western perspective, and validation for a paediatric or caregiver version. A \u003cem\u003e\u0026lsquo;not applicable to me\u0026rsquo;\u003c/em\u003e option was suggested for some items, along allowing for different timeframes for completion in response to the specific needs of consumer groups or practice settings. \u0026nbsp;Several recommendations addressed the wording used in the DB3, which were reviewed and incorporated into the final version of the scale.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConsumers\u0026nbsp;\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eQualitative data from consumers was more limited given the smaller sample size, and the number of comments offered was too small for meaningful content analysis. All the items on the DB3 rated by consumers met the criterion for relevance as measured by Lawshe\u0026rsquo;s ratio (Table 4). The items which attracted lower ratios related to cultural needs, spiritual need and belonging with people of a similar cultural or social background. All the DB3 items were rated as understandable by all participants. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4: Community member construct validity ratings for relevance and understandability\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003eRelevance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003eUnderstanding\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eItem\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eRelevant,\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003eNot relevant, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003eUnsure, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eLR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eYes,\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eNo, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eUnsure, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eLR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eDoing Sub-Scale \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that have\u0026nbsp;personal\u0026nbsp;meaning\u0026nbsp;or value\u0026nbsp;for you\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that have\u0026nbsp;a\u0026nbsp;purpose\u0026nbsp;or meet a\u0026nbsp;goal\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;physical\u0026nbsp;tasks\u0026nbsp;(e.g.\u0026nbsp;moving,\u0026nbsp;reaching,\u0026nbsp;carrying) (n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 89.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;mental\u0026nbsp;tasks\u0026nbsp;(e.g.\u0026nbsp;thinking,\u0026nbsp;remembering)\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18, 94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;social\u0026nbsp;tasks\u0026nbsp;(e.g.\u0026nbsp;conversation,\u0026nbsp;eating a\u0026nbsp;meal\u0026nbsp;together)\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;thing that\u0026nbsp;meet\u0026nbsp;your own\u0026nbsp;personal\u0026nbsp;needs\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18, 94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that\u0026nbsp;meet the\u0026nbsp;needs of\u0026nbsp;other\u0026nbsp;people\u0026nbsp;(e.g.\u0026nbsp;family,\u0026nbsp;friends,\u0026nbsp;co-workers)\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18, 94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;things\u0026nbsp;that help\u0026nbsp;you feel\u0026nbsp;healthy\u0026nbsp;and well\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;organised\u0026nbsp;things\u0026nbsp;(e.g.\u0026nbsp;planned,\u0026nbsp;specific\u0026nbsp;times)\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 89.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2, 10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eDoing\u0026nbsp;spontaneous\u0026nbsp;things\u0026nbsp;(e.g.\u0026nbsp;unplanned, spur of\u0026nbsp;the\u0026nbsp;moment)\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18, 94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;resources\u0026nbsp;you\u0026nbsp;have\u0026nbsp;to\u0026nbsp;\u0026apos;do\u0026apos;\u0026nbsp;things\u0026nbsp;(e.g.\u0026nbsp;money,\u0026nbsp;items,\u0026nbsp;tools)\u0026nbsp;(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to do things (e.g. chances, enough time) (n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18, 94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eBeing Sub-Scale \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eHaving\u0026nbsp;time to\u0026nbsp;reflect\u0026nbsp;and\u0026nbsp;contemplate\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 94.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;personal\u0026nbsp;sense of\u0026nbsp;self as a\u0026nbsp;human\u0026nbsp;being\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;personal\u0026nbsp;needs\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;spiritual\u0026nbsp;needs\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e12, 70.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3, 17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e2, 11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;cultural\u0026nbsp;needs\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e12, 70.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5, 29.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;your\u0026nbsp;creative\u0026nbsp;needs\u0026nbsp;(e.g.\u0026nbsp;play,\u0026nbsp;problem\u0026nbsp;solving,\u0026nbsp;art)\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 94.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eYour life\u0026nbsp;roles\u0026nbsp;(e.g.\u0026nbsp;child,\u0026nbsp;partner,\u0026nbsp;student,\u0026nbsp;worker,\u0026nbsp;carer) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 94.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMaking\u0026nbsp;choices\u0026nbsp;about\u0026nbsp;what you\u0026nbsp;do\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMaking\u0026nbsp;use of\u0026nbsp;your\u0026nbsp;existing\u0026nbsp;skills\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;resources\u0026nbsp;you have for \u0026lsquo;being\u0026rsquo; (e.g. money, items, tools (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to \u0026lsquo;be\u0026rsquo; (e.g. chances, enough time) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 94.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eBecoming Sub-Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eLearning\u0026nbsp;new skills\u0026nbsp;and\u0026nbsp;talents\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eYour potential to grow and develop as a person \u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e15, 88.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e2, 11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;potential\u0026nbsp;to grow\u0026nbsp;and\u0026nbsp;develop\u0026nbsp;with\u0026nbsp;other\u0026nbsp;people\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;aspirations or\u0026nbsp;hopes for\u0026nbsp;the\u0026nbsp;future\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 92.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eChanges\u0026nbsp;you want\u0026nbsp;to make\u0026nbsp;for\u0026nbsp;yourself\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 92.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eChanges\u0026nbsp;you want\u0026nbsp;to make\u0026nbsp;with\u0026nbsp;others (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 92.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eYour\u0026nbsp;ability to\u0026nbsp;adapt to\u0026nbsp;change (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e15, 88.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e2, 11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMaintaining your\u0026nbsp;current\u0026nbsp;skills and\u0026nbsp;talents (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 92.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe resources you have\u0026nbsp;to \u0026apos;become\u0026apos; (e.g. money, items, tools) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 92.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to \u0026lsquo;become\u0026rsquo; (e.g. chances, enough time) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eBelonging Sub-Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eBelonging with partners (i.e. huband/wife, boyfriend/girlfriend) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e15, 88.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2, 11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eBelonging with family (i.e. parents, children, other relatives, pets) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eBelonging with\u0026nbsp;friends( n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eBelonging with\u0026nbsp;other\u0026nbsp;people in\u0026nbsp;my\u0026nbsp;community\u0026nbsp;(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16, 92.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1, 5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eBelonging with\u0026nbsp;people of\u0026nbsp;a similar\u0026nbsp;age to you (i.e. your generation) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eBelonging with\u0026nbsp;people of\u0026nbsp;a similar\u0026nbsp;cultural\u0026nbsp;or social background to you (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e12, 70.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2, 11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e3, 17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eBelonging to the\u0026nbsp;location\u0026nbsp;you call home (i.e. local area, town, state, country) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe resources you have\u0026nbsp;to \u0026apos;belong\u0026apos; (e.g. money, items, tools) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eThe\u0026nbsp;opportunities you\u0026nbsp;have to \u0026lsquo;belong\u0026rsquo; (e.g. chances, enough time) (n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17, 100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0, 0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eNote: LR = Lawshe\u0026rsquo;s ratio\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eConsumers made few suggestions for additional for doing (n=2, 10.5%), being (1, 5.9%), becoming (1, 5.9%) and belonging (1, 5.9%) subscales. Their recommendations included a reference to doing things they are obligated to do, references to specific occupations (such as volunteering), additional examples of aspects of being (including sensual and tactile experiences), and the possibility of online belonging.\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study described the development and initial validation of the DB3 scale which was proposed as a novel measure of occupational being. The use of the POP ensures the scale has a rigorous theoretical foundation, while the development of its content from an extensive review of occupational therapy literature provided an evidence-based approach to its development. The iterative process of regular literature review and seeking feedback from early users about utility and accessibility also supported a comprehensive and responsive approach to development. This study presents encouraging initial evidence for the content validity of the scale as a measure of occupational being (Mokkink et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) however, further studies are required (and underway) to fully describe its psychometric properties.\u003c/p\u003e\u003cp\u003e Many academic participants commented on the difficulty of operationalising abstract concepts like doing, being, becoming and belonging. Categorical representations of occupational therapy theories risk oversimplification and reflect outdated positivist perspectives on occupation and health (Reid et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). However, the measurement of latent variables using outcome measures can assist in unpacking the dynamic complexity that produces emergent properties (Bandeen-Roche et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e1997\u003c/span\u003e). The DB3 provides a tangible and accessible entry point to understanding the influence of doing, being, becoming, belonging, resource and opportunities on occupational engagement, which should be supplemented with the use of additional outcome measures developed from conceptual practice models.\u003c/p\u003e\u003cp\u003eAs a paradigm, the POP is a sociologically constructed archetype of the stable core values and principles of occupational therapy (Khan, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). The concept of Multi Attribute Utility Indexes (MAUIs) provides a useful perspective on outcome measures that measure latent variables and emergent properties. MAUIs are based multi attribute utility theory and enable consumers to report how a broad range of influential factors impact upon their health and wellbeing (Torrance et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e1982\u003c/span\u003e). A common example is quality of life measures which, like the DB3, do not provide specific guidance on how to complete assessment and interventions but are commonly employed by occupational therapists (Baron et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Some participants reported struggling with the purpose and scope of the DB3, and quality of life measures may provide a useful analogy for occupational therapists and consumers to understand what it can (and cannot) contribute to their work together.\u003c/p\u003e\u003cp\u003eAnother key question to arise from this study is what occupational knowledge consumers need to benefit from the DB3. Many academics were concerned consumers would not understand its terminology, but consumers found the scale relevant and comprehensible. A similar finding was reported in another DB3 study (Hanrahan, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) with occupational therapists worried about the understanding of community-based rehabilitation clients, despite all scales being completed independently and without requests for clarification or assistance. These concerns reflect a deficit approach to science communication, where communication flows only from experts (occupational therapists) and knowledge is adjusted to the perceived limitations of consumers (Dawson, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Gross, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e1994\u003c/span\u003e). The purposeful design of the DB3 to be understandable at the Grade 6 / Year 7 readability level may have supported accessible terminology, but occupational therapists should explore what doing, being, becoming, belonging, resources and opportunities means in the context of each occupational being rather than impose definitions developed by the discipline.\u003c/p\u003e\u003cp\u003eThe findings of this study also raise interesting questions about the nature of \u0026lsquo;expertise\u0026rsquo; when it comes to occupation and occupational therapy. The DB3 is a patient rated outcome measure and therefore captures their lived experience expertise. The skew towards positive and westernised perspectives of occupation noted by academic participants stems from the evidence-base of the scale, within which these are well recognised biases both in the literature and the broader profession (Hammell, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Ivlev, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Occupational therapists (along with consumers) are the intended users of the scale, and the academic responses are influenced by their distinctive realm of expertise. However, a key limitation of this study is the relatively small number of consumers who participated. Further testing with a wide range of consumers is needed to fully understand what occupational therapists and consumers get from the DB3 when applied in practice.\u003c/p\u003e\u003cp\u003eOther limitations were the small geographical distribution of consumer participants, and the risk of bias inherent in purposive sampling. While many other measurement properties need to be established for the DB3, content validity is considered the most important psychometric property to establish initially (Terwee et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). This study had some strengths, including the diversity of academics participating, close attention to theoretical rigour during scale development and revision, and the use of the COSMIN standards to guide the evaluation of content validity.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe Doing Being Becoming and Belonging (DB3) Scale offers a novel approach to measuring the concept of occupational being. This study provides an overview of its theoretical underpinnings and their influence on its development, emphasising how deeply the occupational therapy paradigm in embedded within the scale. This preliminary study indicates the scale has adequate content validity, based on the perceptions of occupational therapy academics and consumers. The findings suggest the DB3 scale could meet a significant need in outcome measurement by providing a tool that evaluates the complex and dynamic nature of occupational being. This study underscores its potential utility and applicability across a wide range of settings.\u003c/p\u003e\u003cp\u003eAs acknowledged in the paper, several lines of further research are needed to fully understand the measurement properties of the DB3. These should explore its use in clinical practice, perceived value to occupational therapists and consumers and potential applications as a service wide outcome measure. Further studies are also recommended to describe the reliability, sensitivity, construct validity, and applicability across diverse populations and cultural contexts of this scale, with larger and more diverse samples. In occupational therapy education settings, the use of the DB3 Scale to enhance understanding of the core concepts of occupational therapy and enable reflective practice should be evaluated.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e\u003c/strong\u003eAyre, C., \u0026amp; Scally, A. (2014). 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A., \u0026amp; Townsend, E. A. (2014). Occupational justice. In B. A. Boyt Schnell, G. Gillen, \u0026amp; M. Scaffa (Eds.), \u003cem\u003eWillard and Spackman\u0026rsquo;s occupational therapy\u003c/em\u003e (12th ed., pp. 541-552). Lippincott Williams \u0026amp; Wilkins. \u003c/li\u003e\n\u003cli\u003eWorld Federation of Occupational, T., Mackenzie, L., Coppola, S., Alvarez, L., Cibule, L., Maltsev, S., Loh, S. Y., Mlambo, T., Ikiugu, M. N., Pihlar, Z., Sriphetcharawut, S., Baptiste, S., \u0026amp; Ledgerd, R. (2017). International Occupational Therapy Research Priorities. \u003cem\u003eOTJR (Thorofare N J)\u003c/em\u003e,\u003cem\u003e 37\u003c/em\u003e(2), 72-81. https://doi.org/10.1177/1539449216687528 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Deakin University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Occupational therapy, occupational being, DB3 Scale, outcome measure, content validity, Pan Occupational Paradigm","lastPublishedDoi":"10.21203/rs.3.rs-7105368/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7105368/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003e Occupational being emerges from interactions between the dimensions of occupation - doing, being, becoming and belonging. It is a key concept in occupational therapy practice and is also influenced available resources and opportunities. This study aimed to reflect on the development of a new outcome measure of occupational being - the Doing, Being, Becoming and Belonging Scale (or DB3) – and describe preliminary evidence of its validity and application to occupational therapy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Applying a descriptive quantitative method, this study recruited occupational therapy academics and consumers to complete a single online survey. Content validity was assessed through participants' perceptions of the DB3 Scale's applicability, relevance, comprehensiveness, and comprehensibility. Data were analysed using descriptive statistics and Lawshe’s content validity ratio, complemented by qualitative data about potential applications to practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsumer and Community Involvement:\u003c/strong\u003e Consumers were study participants, and their perspectives and preferences were incorporated into revisions of the DB3 scale during its development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFindings:\u003c/strong\u003e Findings indicate that the DB3 Scale possesses adequate content validity. All but two of the scale items met the criterion for relevance, and all met the criterion for comprehensibility. The DB3 was perceived by occupational therapy academics as applicable to clinical practice, research, education, and direct service provision with consumers. It was also generally perceived by both groups as comprehensive, although participants recommended some changes which have been incorporated into the final version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The DB3 Scale meets a previously identified need for a tool to translate the core concepts of the Pan Occupational Paradigm into occupational therapy practice and is the first outcome measure exclusively addressing occupational being. This study underscores its potential utility and applicability across a wide range of settings. Future directions should focus on expanded psychometric evaluation, exploring cross-cultural applicability, and wider implementation of the DB3 into clinical practice, research, and education.\u003c/p\u003e","manuscriptTitle":"The Doing, Being, Becoming and Belonging (DB3) Scale: Development and Content Validity","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-18 12:59:50","doi":"10.21203/rs.3.rs-7105368/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"57d64ea8-ac1c-456d-8ed6-63ea54ea1e75","owner":[],"postedDate":"July 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":51424527,"name":"Physical Medicine \u0026 Rehab"}],"tags":[],"updatedAt":"2025-07-18T12:59:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-18 12:59:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7105368","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7105368","identity":"rs-7105368","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}