top of page
hedder_アートボード 1.png

Quality of Activities (A-QOA) is an observational tool to evaluate the quality of a person’s activities.

“Quality of activity” refers to the “strength of a person’s engagement in an activity” and is evaluated by observing the actions of the person, expression of emotions and communication with others, including social interaction during an activity.

Through the use of A-QOA, quality of therapy and care can be improved. Moreover, through this unique software, the scores of the quality of each person’s activity can be calculated.

tag_アートボード 1.jpg

What is A-QOA

What is A-QOA

A-QOA (Assessment of Quality of Activities) is an observational assessment tool to evaluate quality of activities (QOA) when a person is involved in ongoing activities in a natural context.

What is Quality of Activities (QOA)

QOA refers to “the strength of a person’s engagement in an activity”, and this is the concept applied to evaluate the impact of an activity on the person, through observation of verbal and emotional expression as well as social interaction.

Features of A-QOA

  • A-QOA is a client-centered assessment tool that evaluates the effectiveness and meaningfulness of activities and tasks from the person's perspective.

  • If the evaluator can observe the activity from beginning to end, he/she can make an assessment regardless of the duration of observation.

  • An observation consists of 21 items. Each item is assessed on a scale of 1 to 4 based on the frequency and intensity of each observed item.

  • A-QOA uses the Rasch model to validate the adequacy of the construct as an assessment of A-QOA. It demonstrates that the 21 items can be assessed as one scale.

Background to the development of the A-QOA tool

People with dementia or cognitive impairment may have difficulty in expressing their intentions and feelings, which makes it difficult to gauge whether or not an activity is meaningful and worthwhile for the person. This tool has been developed to address problems in evaluating the qualitative and quantitative effects of these activities.

Benefits of A-QOA

- A-QOA assists and facilitates the selection of activities that are meaningful to the person.

- By knowing these observational items which demonstrate effectiveness of activities and tasks, the evaluator can observe the person within the framework of A-QOA, which allows for a more analytical assessment.

- The AqoaPro, an analysis tool that uses the Rasch model, can quantify how effective each activity and task is for the person.

Observational Items and Rating Criteria

Observational items

The 21 observational items consist of: performance of the activity; results of the activity; expression of emotions during the activity; interaction with others; and verbal expression.

Rating criteria

4: Observed very strongly/exceptionally strongly

3: Subject item is observed

2: Subject item observed but to a limited degree/questionable level

1: Subject item is not observed

1. Initiation
Initiating the activity
2. Gaze
Directing one’s gaze at the activity
3. Position
Positioning one’s body toward the activity
4. Continuation
Continuing the activity
5. Focus
Concentrating on the activity
6. Mastery
Demonstrating activity-related knowledge and techniques
7. Choice
Making selections /showing preferences during the activity
8. Inventiveness
Working out a way to make the activity progress smoothly
9. Satisfaction
Expressing satisfaction as a result of the activity
10. Competence
Expressing a sense of capability
11. Willingness
Showing willingness toward the next activity
12. Smiling
Showing a smile
13. Animation
Showing excitement
14. Interaction 
Interacting with others through the activity
15. Cooperation
Cooperating with others in the activity
16. Instruction 
Sharing activity-related knowledge and techniques with others
17. Communication
Conveying one’s intention to others
18. Caring
Considering to others
19. Sharing
Sharing activity-induced emotions with others
20. Verbalizing
Increasing utterance
21. Reminiscence
tag_アートボード 1 のコピー.jpg


AqoaPro quantifies the quality of activity, which contributes to evidence-based practice.

AqoaPro is a computer application specifically developed to analyze A-QOA data for the assessment we conduct here. AqoaPro can convert results obtained from the ordinal variables into continuous variables called probit values. Probit values can be used to achieve the following effects:

  • Probit values enable evaluators to quantitatively analyze the degree of difference between two activities; the degree of difference in activities caused by different support methods; and so on. As a result, it can provide an assessment of the effectiveness of activities and intervention methods, thereby supporting evidence-based practice and improving the quality of support.

  • Probit values set their average to 2.5 and standard deviation to 1.0, and are adjusted to normal distribution. Ninety-nine percent or more of the evaluation results give a score that falls between 0.0 and 5.0. In other words, those scores enable evaluators to determine how good or bad the quality of the observed activity is with clear criteria.

Project Team Members

・Masahiro Ogawa, OTR, PhD. Associate Professor, Kobe Gakuin University.
・Haruna Shirai, OTR, PhD. Associate Professor,  Bukkyo University
・Seiji Nishida, OTR, PhD. Professor, Prefectural University of Hiroshima.
・Chiaki Sakamoto, OTR, MS. Assistant Professor, Prefectural University of Hiroshima.


Thank you

© 2020 by Ogawa Masahiro, Shirai Haruna, Nishida Seiji

bottom of page