Preliminary psychometric analyses of two assessment measures quantifying communicative and social activities: the COMACT and SOCACT

Abstract

Background: There is a need for clinical tools that capture the real-life impact of aphasia. This study reports on a psychometric investigation of two self-report tools: the Communicative Activities Checklist and the Social Activities Checklist (COMACT; SOCACT), which assess the dimensions of communication activity and social participation in aphasia.

Aims: (1) To investigate internal consistency (IC), convergent, and known validity of the COMACT and SOCACT and (2) to investigate the impact of personal contextual factors: gender, age, years in education, linguistic ability, and emotional health on communicative and social activities.

Methods & Procedures: Thirty participants with mild-moderate chronic aphasia (people with aphasia (PWA); mean age 71 years, mean time post onset 41 months, mean years in education 10.77) and 75 control neurologically healthy participants (NHP; mean age 74 years, mean years in education 13.18) completed the COMACT and SOCACT reporting how frequently they engaged in particular activities. The COMACT has 45 communication activities with subscales of Talking, Listening, Reading, and Writing. The SOCACT contains 20 social activities with subscales of Leisure, Informal, and Formal. IC was examined using Cronbach’s alpha (α). Correlations with published assessments, Western Aphasia Battery (WAB) and Communication Activities of Daily Living were computed for COMACT only. Multiple regression models were examined for differences in participant (PWA vs. NHP) performance on COMACT and SOCACT.

Outcomes & Results: Total COMACT IC was 0.83 (PWA) and 0.84 (NHP). Following deletion of four items, to further improve subscale ICs, total COMACT IC was 0.83 (PWA) and 0.86 (NHP). COMACT total score and WAB AQ were moderately correlated (r = 0.55). Total SOCACT IC was 0.58 (PWA) and 0.63 (NHP). Following single item deletion, total IC was 0.65 (PWA) and 0.64 (NHP). Statistical analysis revealed PWA, in comparison to NHP, participated in significantly fewer communication and social activities. Personal contextual factors impacted both groups differently; particular aspects were associated with communication activity (age and language severity) and social activity (age only). For NHP, ageing, emotional health and years in education were significant predictors of social and communication activity.

Conclusions: This study finds the COMACT to be a reliable, valid measure of communication activity. The SOCACT had “questionable” IC and requires further psychometric investigation. Both tools demonstrate known group validity. Relationships between impairment-level and personal contextual factors for communication activity and social participation are highlighted.

KEYWORDS:

• aphasia
• communication activity
• social participation
• psychometric

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Convergent validity could not be tested for the SOCACT as no formal standardised assessment of social participation was administered in this research.

2. One participant was just below the 12-month cut-off post stroke.

3. Members of the parent project were asked to introduce new people to the research; some of these in turn nominated further individuals.

4. “Not at all” refers to communication or social activities which the participant chooses not engage in. “Not applicable” is for those communication or social activities that the participant cannot engage in, for example, COMACT Item 1 Talk to Spouse is not applicable if the participant is unmarried/without partner.

5. The revised version of the WAB (published in 2006) was not published when study data were originally collected.