Experiential Aspects of Participation for People with Serious Mental Illnesses: Measure Validation and Preliminary Findings from Clubhouses in Hawai'i.
Heldevam Pereira, Kimiko Tanaka, Joy L Agner
The 12-item MeEAP scale validated well in 206 Clubhouse members with serious mental illness.
Members scored high on all six participation areas, but those with physical activity limitations scored significantly lower across the board.
Key findings
1The MeEAP demonstrated good psychometric properties in this population: the six-factor model fit the data well (CFA p = 0.449, CFI = 0.980, TLI = 0.966, RMSEA = 0.063), all factor loadings exceeded 0.7, and reliability was high (Cronbach's alpha 0.708–0.937, McDonald's omega 0.938, composite reliability 0.718–0.868).
2Clubhouse members reported high experiential participation scores, with subscale means ranging from 3.91 to 4.41 on a 5-point scale. No significant differences were found by race, ethnicity, age, or psychiatric diagnosis.
3Members with activity limitations (62.1% of the sample) reported significantly lower scores across all six subscales compared to those without, the most pronounced subgroup difference in the study.
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What it does not show
Cross-sectional design: the factor structure and participation scores are a single snapshot; the authors note they cannot say whether the model holds over time or whether scores change as members progress. Highly skewed data: most participants rated high on all items, which the authors acknowledge may have inflated factor loadings and produced the unexpected perfect correlation (r = 1) between engagement and mastery. Single geographic and cultural context (Hawai'i, nine Clubhouses): the authors note that collectivist cultural values and the specific Clubhouse model may shape how participation is experienced, limiting generalisability to other settings. The secondary findings are descriptive and exploratory; the authors explicitly state they do not establish causality between Clubhouse services and the high participation scores. 217 were recruited and 11 were removed for incomplete responses, leaving 206 for analysis.
The easy way to misread this
Do not read the high participation scores as evidence that Clubhouses improve well-being or recovery — the study is cross-sectional and descriptive, and the authors explicitly state these findings do not establish causality. Additionally, most participants rated high on every item, which limits the measure's ability to detect meaningful differences in this sample and may have inflated the factor loadings and produced the perfect engagement–mastery correlation.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →