The Doing, Being, Becoming and Belonging (DB3) Scale: Development and Content Validity

Introduction: Occupational being emerges from interactions between the dimensions of occupation - doing, being, becoming and belonging. It is a key concept in occupational therapy practice and is also influenced available resources and opportunities. This study aimed to reflect on the development of a new outcome measure of occupational being - the Doing, Being, Becoming and Belonging Scale (or DB3) – and describe preliminary evidence of its validity and application to occupational therapy. Methods: Applying a descriptive quantitative method, this study recruited occupational therapy academics and consumers to complete a single online survey. Content validity was assessed through participants' perceptions of the DB3 Scale's applicability, relevance, comprehensiveness, and comprehensibility. Data were analysed using descriptive statistics and Lawshe’s content validity ratio, complemented by qualitative data about potential applications to practice. Consumer and Community Involvement: Consumers were study participants, and their perspectives and preferences were incorporated into revisions of the DB3 scale during its development. Findings: Findings indicate that the DB3 Scale possesses adequate content validity. All but two of the scale items met the criterion for relevance, and all met the criterion for comprehensibility. The DB3 was perceived by occupational therapy academics as applicable to clinical practice, research, education, and direct service provision with consumers. It was also generally perceived by both groups as comprehensive, although participants recommended some changes which have been incorporated into the final version. Conclusion: The DB3 Scale meets a previously identified need for a tool to translate the core concepts of the Pan Occupational Paradigm into occupational therapy practice and is the first outcome measure exclusively addressing occupational being. This study underscores its potential utility and applicability across a wide range of settings. Future directions should focus on expanded psychometric evaluation, exploring cross-cultural applicability, and wider implementation of the DB3 into clinical practice, research, and education.