Development of the Occupational Therapy Cognitive Outcome Measure-Computer-Based Assessment (OTCOM-CA) for older adults with cognitive impairment: A prototype mobile application

Abstract

Background: Cognitive impairment is common in older adults and increases with age. It affects independence in daily activities, such as financial management, meal preparation, medication management, and driving. In healthcare, outcome measurement tools are essential for evaluating a patient’s status, establishing baseline performance, guiding intervention planning, and monitoring intervention effectiveness. Computer-based assessments are feasible and well-accepted by patients, providing immediate and accurate scoring, real-time feedback, and automated reporting of results. However, in the Thai context, the availability of standardized assessment tools specifically designed for older adults with cognitive impairment remains limited. Consequently, occupational therapists require comprehensive and contextually appropriate instruments to effectively guide cognitive interventions throughout the continuum of care. To address this gap, a new assessment tool was developed and implemented as an Android tablet-based application to facilitate evidence-based practice.

Objectives: To develop the Occupational Therapy Cognitive Outcome Measure-Computer-Based Assessment (OTCOM-CA) for older adults with cognitive impairment and evaluate its content validity and feasibility.

Materials and methods: This study employed a research and development (R&D) design to establish the content and workflow structure of OTCOM-CA. Following the content validity evaluation, the application’s workflow and interface were designed in accordance with established user experience (UX) and user interface (UI) principles and subsequently validated. A pilot study involving 10 healthy older adults was conducted to evaluate the clarity of the workflow and the appropriateness of the language used within the application.

Results: Content validity evaluation of the OTCOM-CA’s structure, workflow, and screen design showed acceptable ratings for all items (IOC=0.66-1.00). Most participants understood the workflow and test instructions.

Conclusion: OTCOM-CA demonstrated acceptable content validity. The prototype Android version shows a good workflow and language validation. Once revisions are made, its psychometric properties should be evaluated.