Aim. Self-report diaries are a low-cost method of measuring community participation but may be inaccurate, while the “gold standard,” observation is time consuming and costly. This study aimed to investigate the feasibility and validity of a global positioning system (GPS) for measuring outings after stroke. Design. Cross-sectional cohort study. Methods. Twenty ambulant people with stroke wore a GPS device and kept a diary for 7 days, and 18 were observed for half a day. We recorded recruitment rate, user perceptions, and data extraction time. GPS data were analysed against Google maps. Percent exact agreement (PEA) with observation was calculated for GPS and diary. Results. Of 23 eligible participants, 20 consented (mean 3.6 years after stroke). GPS data recovery was high (87%). Some participants had difficulty operating the on/off switch and reading the small screen. Data extraction took an average of 5 hours per participant. PEA with observation was high for number of outings (GPS 94%; diary 89%) but lower for purpose of outings (GPS 71%; diary 82%). Conclusions. The GPS device and diary were both feasible and valid for measuring outings after stroke. Simultaneous use of GPS and diaries is recommended for comprehensive analysis of outings. 1. Introduction Community participation is an objective indicator of the success and outcome of stroke rehabilitation [1]. The “amount” and “type” of community participation, such as outings, can be quantified, providing valuable information about changes over time due to intervention. While the measurement of participation is increasingly common in health research, the measurement process remains challenging. The criterion standard method is direct observation, which is objective but time-consuming and costly. In addition, the process of observation may influence a person’s behaviour. Self-report diaries are a simple and cheap method of measuring physical activity. Yet diaries produce unreliable data and are burdensome for participants, especially those with impaired cognitive abilities [2]. When retrospective interviews about events were compared with daily diary recordings of events, fewer recall errors were seen in the diary [3]. Diaries capture minor events and produce higher “incidence” rates, especially for healthy unimpaired populations; however, diaries can also underreport events and lead to lower compliance by people with disabling conditions when compared to retrospective interviews [3]. Collecting information about outings can provide a picture of someone’s ability to get out of their house and into
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