{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T05:45:04Z","timestamp":1788673504469,"version":"build-2803163510"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009092","name":"Universidad de Alicante","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009092","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Qual Life Res"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH).\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (<jats:italic>N<\/jats:italic>\u2009=\u200913,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53\u201331.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42\u201317.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11136-021-03057-z","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T12:06:30Z","timestamp":1639051590000},"page":"1335-1344","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4452-635X","authenticated-orcid":false,"given":"Julio","family":"Cabrero-Garc\u00eda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9199-5802","authenticated-orcid":false,"given":"Juan Ram\u00f3n","family":"Rico-Juan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9171-820X","authenticated-orcid":false,"given":"Antonio","family":"Oliver-Roig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"issue":"7","key":"3057_CR1","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1177\/0898264316656510","volume":"28","author":"JH Madans","year":"2016","unstructured":"Madans, J. H., & Weeks, J. D. (2016). A Framework for monitoring progress using summary measures of health. Journal of Aging and Health, 28(7), 1299\u20131314. https:\/\/doi.org\/10.1177\/0898264316656510","journal-title":"Journal of Aging and Health"},{"issue":"1","key":"3057_CR2","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1111\/j.1468-0009.2010.00588.x","volume":"88","author":"MC Stiefel","year":"2010","unstructured":"Stiefel, M. C., Perla, R. J., & Zell, B. L. (2010). A healthy bottom line: Healthy life expectancy as an outcome measure for health improvement efforts. The Milbank Quarterly, 88(1), 30\u201353. https:\/\/doi.org\/10.1111\/j.1468-0009.2010.00588.x","journal-title":"The Milbank Quarterly"},{"issue":"10","key":"3057_CR3","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1136\/jech-2015-206870","volume":"70","author":"N Berger","year":"2016","unstructured":"Berger, N., Robine, J., Ojima, T., Madans, J., & van Oyen, H. (2016). Harmonising summary measures of population health using global survey instruments. Journal of Epidemiology and Community Health, 70(10), 1039\u20131044. https:\/\/doi.org\/10.1136\/jech-2015-206870","journal-title":"Journal of Epidemiology and Community Health"},{"issue":"8","key":"3057_CR4","doi-asserted-by":"publisher","first-page":"2233","DOI":"10.1007\/s11136-019-02179-9","volume":"28","author":"A de Wind","year":"2019","unstructured":"de Wind, A., van der Beek, A. J., Boezeman, E. J., Swenneker, R., Anema, J. R., de Boer, A. G. E. M., et al. (2019). A qualitative study investigating the meaning of participation to improve the measurement of this construct. Quality of Life Research, 28(8), 2233\u20132246. https:\/\/doi.org\/10.1007\/s11136-019-02179-9","journal-title":"Quality of Life Research"},{"issue":"4","key":"3057_CR5","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/S0890-4065(97)90026-8","volume":"11","author":"LM Verbrugge","year":"1997","unstructured":"Verbrugge, L. M. (1997). A global disability indicator. Journal of Aging Studies, 11(4), 337\u2013362. https:\/\/doi.org\/10.1016\/S0890-4065(97)90026-8","journal-title":"Journal of Aging Studies"},{"issue":"3 Suppl","key":"3057_CR6","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1093\/eurpub\/13.suppl_1.6","volume":"13","author":"J Robine","year":"2003","unstructured":"Robine, J., & Jagger, C. (2003). Creating a coherent set of indicators to monitor health across Europe: The Euro-REVES 2 project. European Journal of Public Health, 13(3 Suppl), 6\u201314. https:\/\/doi.org\/10.1093\/eurpub\/13.suppl_1.6","journal-title":"European Journal of Public Health"},{"issue":"1","key":"3057_CR7","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s13690-018-0279-z","volume":"76","author":"P Bogaert","year":"2018","unstructured":"Bogaert, P., van Oyen, H., Beluche, I., Cambois, E., & Robine, J. (2018). The use of the Global Activity Limitation Indicator and healthy life years by member states and the European Commission. Archives of Public Health, 76(1), 30. https:\/\/doi.org\/10.1186\/s13690-018-0279-z","journal-title":"Archives of Public Health"},{"issue":"1","key":"3057_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2288-15-1","volume":"15","author":"N Berger","year":"2015","unstructured":"Berger, N., van Oyen, H., Cambois, E., Fouweather, T., Jagger, C., Nusselder, W., et al. (2015). Assessing the validity of the Global Activity Limitation Indicator in fourteen European countries. BMC Medical Research Methodology, 15(1), 1. https:\/\/doi.org\/10.1186\/1471-2288-15-1","journal-title":"BMC Medical Research Methodology"},{"issue":"4","key":"3057_CR9","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1016\/j.jclinepi.2013.10.005","volume":"67","author":"J Cabrero-Garc\u00eda","year":"2014","unstructured":"Cabrero-Garc\u00eda, J., & Juli\u00e1-Sanchis, R. (2014). The Global Activity Limitation Index mainly measured functional disability, whereas self-rated health measured physical morbidity. Journal of Clinical Epidemiology, 67(4), 468\u2013476. https:\/\/doi.org\/10.1016\/j.jclinepi.2013.10.005","journal-title":"Journal of Clinical Epidemiology"},{"issue":"8","key":"3057_CR10","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1016\/j.jclinepi.2009.11.002","volume":"63","author":"C Jagger","year":"2010","unstructured":"Jagger, C., Gillies, C., Cambois, E., van Oyen, H., Nusselder, W., & Robine, J. (2010). The Global Activity Limitation Index measured function and disability similarly across European countries. Journal of Clinical Epidemiology, 63(8), 892\u2013899. https:\/\/doi.org\/10.1016\/j.jclinepi.2009.11.002","journal-title":"Journal of Clinical Epidemiology"},{"issue":"3","key":"3057_CR11","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1007\/s00038-006-0035-y","volume":"51","author":"H van Oyen","year":"2006","unstructured":"van Oyen, H., Heyden, J., Perenboom, R., & Jagger, C. (2006). Monitoring population disability: Evaluation of a new Global Activity Limitation Indicator (GALI). Sozial-und Pr\u00e4ventivmedizin, 51(3), 153\u2013161. https:\/\/doi.org\/10.1007\/s00038-006-0035-y","journal-title":"Sozial-und Pr\u00e4ventivmedizin"},{"issue":"6","key":"3057_CR12","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1093\/eurpub\/ckaa066","volume":"30","author":"J Cabrero-Garc\u00eda","year":"2020","unstructured":"Cabrero-Garc\u00eda, J., Juli\u00e1-Sanchis, R., & Richart-Mart\u00ednez, M. (2020). Association of the Global Activity Limitation Indicator with specific measures of disability in adults aged below 65. European Journal of Public Health, 30(6), 1225\u20131230. https:\/\/doi.org\/10.1093\/eurpub\/ckaa066","journal-title":"European Journal of Public Health"},{"issue":"5","key":"3057_CR13","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1080\/09638288.2016.1198433","volume":"41","author":"CS Ballert","year":"2019","unstructured":"Ballert, C. S., Hopfe, M., Kus, S., Mader, L., & Prodinger, B. (2019). Using the refined ICF linking rules to compare the content of existing instruments and assessments: A systematic review and exemplary analysis of instruments measuring participation. Disability and Rehabilitation, 41(5), 584\u2013600. https:\/\/doi.org\/10.1080\/09638288.2016.1198433","journal-title":"Disability and Rehabilitation"},{"issue":"9","key":"3057_CR14","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.1016\/j.apmr.2010.07.011","volume":"91","author":"S Magasi","year":"2010","unstructured":"Magasi, S., & Post, M. W. (2010). A comparative review of contemporary participation measures\u2019 psychometric properties and content coverage. Archives of Physical Medicine and Rehabilitation, 91(9), S17\u2013S28. https:\/\/doi.org\/10.1016\/j.apmr.2010.07.011","journal-title":"Archives of Physical Medicine and Rehabilitation"},{"issue":"1","key":"3057_CR15","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s13690-018-0270-8","volume":"76","author":"H van Oyen","year":"2018","unstructured":"van Oyen, H., Bogaert, P., Yokota, R. T. C., & Berger, N. (2018). Measuring disability: A systematic review of the validity and reliability of the global activity limitations indicator (GALI). Archives of Public Health, 76(1), 25. https:\/\/doi.org\/10.1186\/s13690-018-0270-8","journal-title":"Archives of Public Health"},{"issue":"5\u20136","key":"3057_CR16","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/096382899297729","volume":"21","author":"ML Verbrugge","year":"1999","unstructured":"Verbrugge, M. L., Merrill, S. S., & Liu, X. (1999). Measuring disability with parsimony. Disability and Rehabilitation, 21(5\u20136), 295\u2013306. https:\/\/doi.org\/10.1080\/096382899297729","journal-title":"Disability and Rehabilitation"},{"key":"3057_CR17","volume-title":"Social integration and health survey. Results","author":"INE","year":"2015","unstructured":"INE. (2015). Social integration and health survey. Results. INE."},{"issue":"Suppl 4","key":"3057_CR18","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1186\/1471-2458-11-S4-S4","volume":"11","author":"JH Madans","year":"2011","unstructured":"Madans, J. H., Loeb, M. E., & Altman, B. M. (2011). Measuring disability and monitoring the UN convention on the rights of persons with disabilities: The work of the Washington group on disability statistics. BMC Public Health, 11(Suppl 4), S4. https:\/\/doi.org\/10.1186\/1471-2458-11-S4-S4","journal-title":"BMC Public Health"},{"issue":"3","key":"3057_CR19","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1093\/ije\/dyu029","volume":"43","author":"CJ Muller","year":"2014","unstructured":"Muller, C. J., & MacLehose, R. F. (2014). Estimating predicted probabilities from logistic regression: Different methods correspond to different target populations. International Journal of Epidemiology, 43(3), 962\u2013970. https:\/\/doi.org\/10.1093\/ije\/dyu029","journal-title":"International Journal of Epidemiology"},{"issue":"4","key":"3057_CR20","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/j.jclinepi.2014.12.012","volume":"68","author":"I Shrier","year":"2015","unstructured":"Shrier, I., & Pang, M. (2015). Confounding, effect modification, and the odds ratio: Common misinterpretations. Journal of Clinical Epidemiology, 68(4), 470\u2013474. https:\/\/doi.org\/10.1016\/j.jclinepi.2014.12.012","journal-title":"Journal of Clinical Epidemiology"},{"issue":"4","key":"3057_CR21","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1177\/1094428114544509","volume":"17","author":"JN Luchman","year":"2014","unstructured":"Luchman, J. N. (2014). Relative importance analysis with multicategory dependent variables. Organisational Research Methods, 17(4), 452\u2013471. https:\/\/doi.org\/10.1177\/1094428114544509","journal-title":"Organisational Research Methods"},{"issue":"152","key":"3057_CR22","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.socscimed.2016.01.046","volume":"1982","author":"AN Lamu","year":"2016","unstructured":"Lamu, A. N., & Olsen, J. A. (2016). The relative importance of health, income and social relations for subjective well-being: An integrative analysis. Social Science & Medicine, 1982(152), 176\u2013185. https:\/\/doi.org\/10.1016\/j.socscimed.2016.01.046","journal-title":"Social Science & Medicine"},{"issue":"8","key":"3057_CR23","doi-asserted-by":"publisher","first-page":"679","DOI":"10.2340\/16501977-2363","volume":"50","author":"D van de Velde","year":"2018","unstructured":"van de Velde, D., Coussens, M., De Baets, S., Sabbe, L., Vanderstraeten, G., Vlerick, P., et al. (2018). Application of participation in clinical practice: Key issues. Journal of Rehabilitation Medicine, 50(8), 679\u2013695. https:\/\/doi.org\/10.2340\/16501977-2363","journal-title":"Journal of Rehabilitation Medicine"},{"issue":"9","key":"3057_CR24","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1007\/s11136-006-0017-9","volume":"15","author":"R Wilkie","year":"2006","unstructured":"Wilkie, R., Peat, G., Thomas, E., & Croft, P. (2006). The prevalence of person-perceived participation restriction in community-dwelling older adults. Quality of Life Research, 15(9), 1471\u20131479. https:\/\/doi.org\/10.1007\/s11136-006-0017-9","journal-title":"Quality of Life Research"},{"issue":"9","key":"3057_CR25","doi-asserted-by":"publisher","first-page":"2553","DOI":"10.1007\/s11136-020-02501-w","volume":"29","author":"T Gamst-Klaussen","year":"2020","unstructured":"Gamst-Klaussen, T., & Lamu, A. N. (2020). Does the EQ-5D usual activities dimension measure what it intends to measure? The relative importance of work, study, housework, family or leisure activities. Quality of Life Research, 29(9), 2553\u20132562. https:\/\/doi.org\/10.1007\/s11136-020-02501-w","journal-title":"Quality of Life Research"},{"issue":"3","key":"3057_CR26","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.socscimed.2009.05.013","volume":"69","author":"M Jylha","year":"2009","unstructured":"Jylha, M. (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science & Medicine, 69(3), 307\u2013316. https:\/\/doi.org\/10.1016\/j.socscimed.2009.05.013","journal-title":"Social Science & Medicine"},{"key":"3057_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.socscimed.2020.112913","volume":"267","author":"P Lazarevi\u010d","year":"2020","unstructured":"Lazarevi\u010d, P., & Brandt, M. (2020). Diverging ideas of health? Comparing the basis of health ratings across gender, age, and country. Social Science & Medicine, 267, 1\u20138. https:\/\/doi.org\/10.1016\/j.socscimed.2020.112913","journal-title":"Social Science & Medicine"},{"issue":"2","key":"3057_CR28","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1037\/a0039111","volume":"30","author":"SM Spuling","year":"2015","unstructured":"Spuling, S. M., Wurm, S., Tesch-R\u00f6mer, C., & Huxhold, O. (2015). Changing predictors of self-rated health: Disentangling age and cohort effects. Psychology and Aging, 30(2), 462\u2013474. https:\/\/doi.org\/10.1037\/a0039111","journal-title":"Psychology and Aging"},{"issue":"25","key":"3057_CR29","doi-asserted-by":"publisher","first-page":"6440","DOI":"10.1073\/pnas.1800028115","volume":"115","author":"JP Mackenbach","year":"2018","unstructured":"Mackenbach, J. P., Valverde, J. R., Artnik, B., Bopp, M., Br\u00f8nnum-Hansen, H., Deboosere, P., et al. (2018). Trends in health inequalities in 27 European countries. Proceedings of the National Academy of Sciences, 115(25), 6440\u20136445.","journal-title":"Proceedings of the National Academy of Sciences"},{"issue":"7","key":"3057_CR30","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1177\/0898264316656504","volume":"28","author":"E Cambois","year":"2016","unstructured":"Cambois, E., Grobon, S., van Oyen, H., & Robine, J. (2016). Impact of question wording on the measurement of activity limitation. Journal of Aging and Health, 28(7), 1315\u20131338. https:\/\/doi.org\/10.1177\/0898264316656504","journal-title":"Journal of Aging and Health"}],"container-title":["Quality of Life Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11136-021-03057-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11136-021-03057-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11136-021-03057-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T15:21:04Z","timestamp":1650554464000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11136-021-03057-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,9]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["3057"],"URL":"https:\/\/doi.org\/10.1007\/s11136-021-03057-z","relation":{},"ISSN":["0962-9343","1573-2649"],"issn-type":[{"value":"0962-9343","type":"print"},{"value":"1573-2649","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,9]]},"assertion":[{"value":"25 November 2021","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable. The data for this study were obtained from anonymised microdata files hosted on the INE website.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}