Model of Human Occupation Screening Tool

Abstract

The Model of Human Occupation Screening Tool (MOHOST) is an assessment instrument fundamentally based on the principles of the Model of Human Occupation (MOHO). This tool is designed to systematically measure a client’s level of occupational participation within their environment, specifically focusing on three core areas: self-care, productivity, and leisure/relaxation. MOHOST allows practitioners to compare and track a client’s occupational performance across various situations and environments, making it suitable for repeated administration throughout the course of treatment. Data collection is comprehensive, utilizing observations, clinical records, interviews with clients and caregivers, and input from the multidisciplinary team. The scoring system employs a 4-point rating scale, generating a visual profile that clearly highlights the client’s strengths and weaknesses regarding their occupational performance and participation.

Keywords

MOHOST, MOHO, Occupational Screening, Occupational Therapy, Participation Assessment, Self-care, Productivity, Leisure, Rehabilitation.

Authors

The original tool was developed by occupational therapists affiliated with the Model of Human Occupation framework. The specific authorized Dutch version was developed by: Bitter NA, Gijsbertsen E, Kloos AJ, Vierwind GH, Pol MC, Tigchelaar E (2008).

Purpose

The primary purpose of the MOHOST is to provide a broad, holistic screening of a client’s occupational functioning. It serves as an efficient method for gathering essential information about the client’s strengths and challenges regarding their engagement in daily life. This information is crucial for informing the initial treatment plan and setting relevant therapeutic goals within the scope of Occupational Therapy practice.

Furthermore, MOHOST is designed to be utilized as an outcome measure, allowing clinicians to monitor changes in a client’s occupational participation over time. The instrument’s ability to be repeated ensures that the effectiveness of interventions can be objectively tracked and documented, providing a visual representation of progress in areas such as productivity and self-care.

Construct

The MOHOST is a direct practical application of the theoretical concepts embedded within the Model of Human Occupation (MOHO). This model posits that human occupation is influenced by three internal components—volition (motivation), habituation (roles and habits), and performance capacity (skills)—as well as the external environment. The MOHOST operationalizes these constructs by observing behaviors related to occupational engagement.

The scale measures the client’s ability to engage, adapt, and perform meaningful activities related to their life roles. By assessing areas like self-care, the tool evaluates fundamental skills and habits necessary for daily living. In measuring productivity, it examines the client’s engagement in work, education, or contributions to society. The overall results provide insight into the underlying factors (volitional, habitual, and environmental) that support or inhibit the client’s successful occupational performance.

Validity

As an instrument derived directly from the robust MOHO theoretical framework, the MOHOST possesses strong content validity, ensuring that the items accurately reflect the construct of occupational participation as defined by the model. Extensive research, particularly within the field of Occupational Therapy, has supported its construct validity, demonstrating that the scale measures the intended theoretical dimensions across diverse clinical populations.

While specific psychometric data varies depending on the population and language version tested, the MOHOST is generally recognized for its ability to differentiate between clients with varying levels of functional impairment. Its acceptance and widespread use in clinical settings further support its face validity and clinical utility as a comprehensive screening tool.

Reliability

Studies examining the psychometric properties of the MOHOST frequently report acceptable to high levels of inter-rater reliability, particularly when the assessors have received standardized training in the MOHO framework and the specific MOHOST scoring guidelines. This suggests that the observational data, while qualitative in nature, can be consistently interpreted by different clinicians.

Furthermore, the MOHOST has demonstrated good test-retest reliability, indicating stability of the scores over short periods when the client’s occupational status is not expected to change significantly. The reliability of the instrument is critical given its intended use as an outcome measure, where accurate comparison of scores across multiple time points during intervention is essential.

Factor Analysis

Factor analysis of the MOHOST often reveals a multi-faceted but coherent structure, aligning with the core components of the MOHO theory. While the tool is frequently used to provide a single, summary score of overall participation, statistical analysis typically confirms that the items cluster into meaningful factors corresponding to volition, habituation, performance skills, and environmental support. This structural evidence reinforces the scale’s theoretical underpinnings and suggests that it is capturing distinct, yet interacting, dimensions of occupational engagement.

The factor structure supports the clinical interpretation that a client’s occupational difficulties are rarely isolated to one domain but rather result from the complex interplay between their internal characteristics and external environmental demands. This complexity is successfully mapped by the MOHOST item clusters.

Instrument

Test Type: Screening and Outcome Measure

Format: Observational rating scale supplemented by interview, chart review, and secondary sources.

Language Available: Multiple languages, including the Dutch version (2008) referenced.

Population Group: Adults

Age Group: Typically 18 years and older.

Population Details: Applicable across a wide range of clinical populations, including those with physical, cognitive, mental health, or developmental challenges, where occupational participation is impaired.

Test Methodology: Data is gathered through a flexible, multi-source approach, including direct observation of performance, review of existing records (dossiers), interviews with the client and significant others (caregivers, family), and consultation with the multidisciplinary team. The resulting data is rated using a 4-point scale, providing a visual profile of performance.

Keywords

Screening, Assessment, Rehabilitation, Performance Capacity, Volition, Habituation, Self-care, Productivity, Occupational Performance.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Correspondence is typically handled through the MOHO Clearinghouse or the specific publishing entity for the translated version.

Permissions & Fee and Test Year

The documented Dutch version was published in 2008 (Bitter et al.). Permissions for use are generally managed by the official holders of the MOHO instruments, often requiring purchase of the manual and authorized copies for clinical use. Users should consult the MOHO Clearinghouse for current licensing and fee structures.

Reference’s

• Bitter NA, Gijsbertsen E, Kloos AJ, Vierwind GH, Pol MC, Tigchelaar E (2008). Nederlandse versie: Model of Human Occupation Screening Tool (MOHOST).
• The theoretical foundation is derived from the Model of Human Occupation (MOHO) literature.
• The original PDF explaining the Dutch version (Toelichtingsformulier) can be downloaded here: Toelichtingsformulier PDF.

Items of the Model of Human Occupation Screening Tool

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way. The source material did not provide the individual specific items but identified the domains of measurement.

The MOHOST assesses the client’s participation across the following broad domains:

• Zelfverzorging (Self-care)
• Productiviteit (Productivity)
• Ontspanning (Leisure/Relaxation)