Peering into the black box of rehabilitation: Content validity of a new taxonomy for interventions

The research for this dissertation included three inter-related studies that systematically examined the validity of a new taxonomy, the Occupational Therapy Taxonomy of Rehabilitation Interventions (OT-TRI). The overarching question for this research was whether the OT-TRI is a valid observational measure that captures the key components of occupational therapy intervention processes in stroke rehabilitation. Study One used an expert panel review process to examine the relevance, clarity, and inter-observer agreement of the OT-TRI categories and items. Findings suggest that the OT-TRI can be used to identify the categories of the therapeutic process, but that further delimitation of items will be necessary to improve the consistency of observers' coding. Study Two examined the content validity of the OT-TRI through a comparison of it and the most widely published taxonomy in the stroke rehabilitation literature. The results demonstrated that the OT-TRI not only represented the domains presented in the published taxonomy but also provided additional information about interventions (e.g., observable components of client-therapist interactions). Study Three examined the OT-TRI capacity to capture change in intervention methods over time. The findings demonstrated the sensitivity to change of a few items within each of the OT-TRI categories. Overall, the results of this dissertation research support the perspective that the OT-TRI provides a more domain-complete taxonomy in comparison to taxonomies published in the past 20 years. The results also provided valuable information toward needed revisions of the OT-TRI and subsequent assessment of the inter-observer agreement and sensitivity to change of specific items.