SIGNIFICANCE: To be able to study the effectiveness of specific occupational therapy interventions (e.g., home modifications) on community participation, an objective, valid measurement tool is necessary. By using global positioning system (GPS)-enabled cell phones to objectively measure community participation, researchers can determine which occupational therapy intervention actually improves it and thus implement changes in standard clinical practice. This would result in improvement in functional outcomes for older adults.

INNOVATION: The research is innovative because it is the first trial known to us to use GPS technology to objectively measure community participation in community-dwelling older adults. Instead of relying on current measures of self-report, more objective measures, such as GPS, could be used to more accurately and effectively measure community participation, leading to better outcome measurement after interventions, thus giving clinicians better knowledge of the efficacy of the intervention.

RESEARCH QUESTION: Are GPS-enabled cellular telephones a feasible way to objectively measure community participation in a population of older adults?

BACKGROUND: Social engagement and community participation have been associated with health benefits—such as healthier physical and mental status, decreased mortality, and higher quality of life—in older adults. However, current measurements of these constructs are often limited to self-reported measures. To better understand outcomes of health interventions, it is important to have objective measures of community participation.

METHOD: We used a pilot analysis of cross-sectional data collected as a baseline assessment in a larger randomized controlled trial of home modifications. Homes and communities of participants served as the setting.

Participants were 65 yr of age or older, lived in their own home or condominium, had difficulty with activities of daily living, and had a mobility impairment.

All participants completed a standardized in-home occupational therapy assessment. Participants carried GPS-enabled cell phones for 48 hr, which logged data points of latitude, longitude, speed, and time.

RESULTS: All participants tolerated carrying the phone. Participants traveled an average of 10.6 miles per day and spent a majority of their time at home. The destination location derived from the cell phone data corresponded to the destination recorded in the participants’ travel diaries, thus supporting the accuracy of the GPS data.

CONCLUSION: This pilot study demonstrates that it is feasible to use commercially available cellular telephones to accurately and automatically measure the temporal and spatial patterns of an older adult’s community participation. It should continue to be studied as a more effective measurement of community participation in older adults.