APO Research Project / Official English information
APO-15
Assessment of Positive Occupation
An occupation-focused approach to understanding positive occupational engagement and well-being, informed by research and occupational therapy practice.
01 / Featured publication
Research and Clinical Information Guide
English Edition · Vol. 4.0 · October 2026
The official APO-15 information guide introduces its conceptual framework, 15-item structure, scoring and interpretation, clinical context, evidence base, and limitations.
For occupational therapists, researchers, educators, and professionals exploring positive occupational engagement.
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02 / Assessment overview
What is APO-15?
The Assessment of Positive Occupation 15 (APO-15) was developed in Japan to examine people's participation in occupations that can contribute positively to well-being. Its findings are intended to support a broader occupation-focused assessment, not replace clinical judgment.
Positive relationships
Participation in occupations linked to supportive relationships with others.
Achievement
Occupations associated with accomplishment and positive progress.
Engagement
Occupations involving involvement, interest, or absorption.
Meaning
Occupations connected to meaning and purpose.
The Japanese APO-15 contains 15 self-report items rated on a four-point response scale (total score: 15–60). Research has addressed mental health, physical illness, and older adult clinical contexts. The four factors draw on positive psychology but are not identical to all five elements of PERMA.
03 / Occupational therapy
Clinical interpretation in context
APO-15 is one source of information in a comprehensive occupational therapy evaluation. Scores can prompt conversation about occupational strengths and possibilities; they do not specify a diagnosis or an intervention.
APO-15, interview, observation, occupational history, context, and other measures.
Explore meaning, participation barriers, client priorities, and shared goals.
Plan individualized occupational therapy; consider POBP where appropriate and reassess.
Population-specific cutoff values in Japanese research
Previously reported thresholds are study-specific reference points, not diagnostic criteria.
| Studied population / source | Reported cutoff | Interpretive caution |
|---|---|---|
| Mental health contexts (Japanese research) | 43 | Not a diagnostic threshold for depression or other psychiatric conditions. |
| Physical disability / older adult contexts (earlier Japanese resources) | 51 | Reported in earlier source materials; not a universal threshold or replacement for later score-interpretation research. |
Five latent ranks
Japanese research has also examined a five-level latent-rank classification. These are approximate English descriptions of the Japanese rank labels—not a standalone English-language scoring standard.
Latent-rank membership probabilities describe uncertainty about a person's current classification; they do not predict the probability of future improvement. Latent-rank classifications should not be conflated with later T-score-based five-level descriptions.
04 / Publication library · 2016–2026
Research evidence
The following 16 publications are organized by research focus. Select “Read study summary” to expand the descriptions. DOI and source links remain directly accessible on every record.
Measurement development and psychometrics
Studies of scale development, latent structure, reliability, and score properties.
Development of the Assessment of Positive Occupation (APO) Participation to Promote Well-Being
Noguchi, T., Kyougoku, M., & Teraoka, M. (2016).
Japanese Journal of Comprehensive Rehabilitation, 44 (12), 1097–1106. [In Japanese]
Read study summary
This study examined the initial development of the Assessment of Positive Occupation, focusing on participation in occupations that promote well-being among individuals with mental illness.
It provided a foundation for the subsequent development and psychometric investigation of APO-15.
Psychometric Properties of the Assessment of Positive Occupation 15 Final Version in Individuals with Mental Illness
Noguchi, T., & Kyougoku, M. (2021).
Hong Kong Journal of Occupational Therapy, 34 (1), 3–12.
Read study summary
This study examined the reliability and validity of APO-15 in 408 individuals with mental illness.
Confirmatory factor analysis and item response theory provided evidence supporting the measurement properties of the final 15-item instrument.
The study reported satisfactory internal consistency and supported the potential clinical utility of APO-15 in mental health occupational therapy.
Key Finding: Cronbach's alpha = 0.89.
Latent Rank Structure in the Assessment of Positive Occupation 15 (APO-15)
Noguchi, T. (2021).
Japanese Journal of Clinical Occupational Therapy, 8 , 57–64. [In Japanese]
Read study summary
This study investigated the latent rank structure of APO-15 using data from 4,159 individuals with mental, physical, or geriatric conditions.
The findings supported a five-level latent rank classification, enabling interpretation of different levels of engagement in positive occupations.
This classification may assist occupational therapists in understanding individual assessment results and planning occupation-focused interventions.
Cross-Regional Validation of the Assessment of Positive Occupation 15: Differential Item and Test Functioning Analysis
Noguchi, T., Kyougoku, M., & Teraoka, M. (2023).
Asian Journal of Occupational Therapy, 19 (1), 46–54.
Read study summary
This study examined differential item functioning (DIF) and differential test functioning (DTF) using data from 3,003 participants with mental, physical, and geriatric conditions.
The results suggested that the measurement properties of APO-15 were relatively robust across the examined subgroups of illness, gender, and age.
The findings provide evidence relevant to the application of APO-15 across different clinical populations in Japan.
Psychometric Properties of the Assessment of Positive Occupation 15 for Individuals with Physical Illness
Noguchi, T., & Kyougoku, M. (2025; first published online in 2024).
Hong Kong Journal of Occupational Therapy, 38 (1), 3–14.
Read study summary
This study evaluated the psychometric properties of the Japanese APO-15 in 1,259 individuals with physical illness.
The analyses addressed structural validity, concurrent validity, internal consistency, item difficulty, and score interpretability.
The results supported the reliability and validity of APO-15 in the population studied, extending previous research in mental health settings.
Key Finding: Cronbach's alpha = 0.914.
Reliability of the Assessment of Positive Occupation 15
Noguchi, T., & Kyougoku, M. (2026; first published online in 2025).
Occupational Therapy in Mental Health, 42 (2), 155–167.
Read study summary
This study evaluated the test–retest reliability of APO-15 among 561 adults receiving services in various clinical and care settings in Japan.
Reliability was examined using intraclass correlation coefficients, standard error of measurement, minimal detectable change, and Bland–Altman analysis.
The findings provided further evidence of the temporal stability of APO-15 scores.
Key Finding: ICC = 0.74.
Cross-cultural adaptation
Turkish-language studies in the populations examined; validation evidence is language- and sample-specific.
Validity and Reliability of the Turkish Adaptation of the Assessment of Positive Occupation-15 (APO-15) in Serious Mental Illness
Özkan, E., Ercan Doğu, S., Noguchi, T., & Örsel, S. (2025; first published online in 2024).
OTJR: Occupational Therapy Journal of Research, 45 (2), 179–188.
Read study summary
This study investigated the validity, reliability, and cutoff score of the Turkish APO-15 among 106 individuals with serious mental illness.
Confirmatory factor analysis and reliability analyses provided evidence supporting the Turkish adaptation.
- Total-scale Cronbach's alpha = 0.924.
- Cutoff score = 49.50 in the studied population.
This research represents an important step in the international adaptation of APO-15.
Psychometric Validation of Turkish Assessment of Positive Occupation-15 in Individuals with Schizophrenia
Şengül, F., & Abaoğlu, H. (2025, online publication).
OTJR: Occupational Therapy Journal of Research. Advance online publication.
Read study summary
This study examined the Turkish adaptation of APO-15 using data from 263 participants, including 97 individuals with schizophrenia and 166 healthy adults.
The results supported its four-factor structure, internal consistency, and test–retest reliability.
- Cronbach's alpha = 0.818.
- Test–retest ICC = 0.814.
- Cutoff score = 47.5 in the studied sample.
This study provides additional evidence for the use of a Turkish APO-15 in schizophrenia-related research and practice.
Clinical applications and intervention research
Program development, quasi-experimental work, case reports, and a small uncontrolled intervention study.
Program Development and Preliminary Methods of Applying Positive Occupation-Based Practice to Clients with Mental Disabilities
Noguchi, T., & Kyougoku, M. (2019).
Japanese Occupational Therapy Research, 38 (1), 54–63. [In Japanese]
Read study summary
This study developed a Positive Occupation-Based Practice (POBP) program and explored its preliminary clinical application.
APO-15 was used as one of the outcome measures.
The study provides early evidence relevant to connecting positive occupational assessment with occupation-based interventions.
Effect of Occupational Therapy Program to Promote Well-Being in People with Experiences of Mental Illness: Quasi-Experimental Study
Noguchi, T., Kyougoku, M., Kawakami, T., Nishimoto, Y., & Kashihara, K. (2021).
Occupational Therapy in Mental Health, 37 (4), 386–402.
Read study summary
This multicenter quasi-experimental study investigated an occupational therapy program designed to promote well-being among individuals with mental illness.
APO-15 was included as a measure of positive occupational engagement.
The study contributes to intervention research examining the relationship between occupation-focused practice and well-being.
Occupational Therapy Using the Assessment of Positive Occupation in a Long-Term Hospitalized Patient with Schizophrenia: A Case Report
Yorozu, T., & Noguchi, T. (2022).
Japanese Occupational Therapy Research, 41 (2), 254–260. [In Japanese]
Read study summary
This case report described occupational therapy using APO-15 with a long-term hospitalized individual with schizophrenia.
The assessment findings were used to identify strengths and support habitual engagement in occupations associated with well-being.
Clinical Usefulness of Occupational Therapy Practice Using the Level of Engagement Estimation System in APO-15: A Case Study
Noguchi, T., & Kyougoku, M. (2022).
Japanese Occupational Therapy Research, 41 (5), 592–601. [In Japanese]
Read study summary
This case study explored the clinical usefulness of the APO-15 Engagement Estimation System (EES).
The system was used to assess the client's level of engagement in positive occupations and inform intervention planning.
The report suggested potential benefits for well-being and social participation.
Clinical Utility of Positive Occupation-Based Practices Applying an Engagement Estimation System: A Case Study
Goto, K., & Noguchi, T. (2023).
Japanese Occupational Therapy Research, 42 (5), 678–686. [In Japanese]
Read study summary
This report described Positive Occupation-Based Practice incorporating an Engagement Estimation System in two individuals with mental illness.
The findings suggested potential improvements in positive emotional experiences and psychological stability.
Clinical Utility of Positive Occupation-Based Practices Applying an Engagement Estimation System: A Single-Group Pre/Post-Comparison Study
Noguchi, T., Yorozu, T., Hashizume, S., Kawakami, T., Nishimoto, Y., & Hosokawa, K. (2024).
Asian Journal of Occupational Therapy, 20 (1), 1–11.
Read study summary
This multicenter study investigated the clinical effects of POBP incorporating the APO-15 Engagement Estimation System among 18 individuals with mental illness.
The intervention was implemented in five clinical facilities over five months, followed by an additional one-month follow-up.
The results suggested improvements in several outcomes related to subjective well-being and emotional experiences.
As a single-group study without a control group, the findings should be interpreted as preliminary evidence rather than definitive proof of intervention effectiveness.
Positive occupation and well-being
Related observational research on psychosocial experiences and well-being.
Impact of the “Sense of Ibasho” and Positive Occupation on Subjective Well-Being: Insights from Users of a Psychiatric Day Hospital in Japan
Urakawa, M., Noguchi, T., & Ogawa, Y. (2026; first published online in 2025).
Occupational Therapy in Mental Health, 42 (3), 353–366.
Read study summary
This study investigated relationships among a sense of ibasho (a place of belonging and acceptance), positive occupation, and subjective well-being among 78 psychiatric day-hospital users.
The research expands understanding of the relationship between positive occupational engagement and the social and psychological experiences associated with well-being.
Structural Relationships Among Positive Occupations, Psychological Distress, Life Functioning, and Well-Being in Community Mental Health
Noguchi, T., & Kyougoku, M. (2026, online publication).
OTJR: Occupational Therapy Journal of Research. OnlineFirst.
Read study summary
This cross-sectional study investigated structural relationships among positive occupational engagement, psychological distress, life functioning, subjective well-being, and interpersonal difficulties in 276 adults with mental illness.
Greater positive occupational engagement was associated with lower psychological distress, better life functioning, and higher subjective well-being.
The findings support further research into the role of positive occupations in community mental health and recovery-oriented occupational therapy.
Because of the cross-sectional design, causal relationships cannot be established.
05 / Positive Occupation-Based Practice
Assessment and occupation-based intervention
Positive Occupation-Based Practice (POBP) is an occupation-focused approach that emphasizes participation in occupations that may support well-being. APO-15 may contribute assessment information to clinical reasoning, while POBP may be considered as one practice option when appropriate to the individual and clinical setting.
Existing intervention research includes preliminary, quasi-experimental, case-based, and single-group studies. Findings should not be presented as proof that APO-15 scores directly prescribe a particular intervention or that POBP will be effective for every client.
06 / Assessment materials
Resources and language availability
Official information guide
English-language scientific and clinical background; not an administration form.
Open the guide ↗Japanese APO-15 resources
Japanese-language assessment resources, including assessment forms, user guidance, and data-entry sheets.
Visit the Japanese APO-15 page ↗Future research directions
- Development and validation of an English-language APO-15 assessment instrument.
- Cross-cultural adaptation in additional countries and settings.
- Measurement invariance between appropriately validated language versions.
- Clinical responsiveness and score interpretability.
- Further research on APO-15 and Positive Occupation-Based Practice interventions.
- Further study in neurological and physical rehabilitation and older adult care.
Further publications
For Japanese case reports, preliminary investigations, and related publications, see Takuya Noguchi — researchmap, Research Publications — Noguchi Laboratory, and the official Japanese APO-15 website.
07 / International research
Research collaboration
International research collaboration is welcome. Possible areas include:
Language and culture
Translation, cultural adaptation, and psychometric validation in new languages and settings.
Measurement research
Reliability, validity, responsiveness, and comparisons across relevant clinical populations.
Clinical research
Assessment-informed occupational therapy and intervention research, including POBP.
Well-being science
Positive occupation, occupational engagement, life functioning, and subjective well-being.
08 / Contact & permissions
Contact the APO Research Project
For research collaboration, permission to use APO-15, or questions about the availability of assessment materials, please contact:
Takuya Noguchi
APO Research Project
n.takuya19780822@gmail.com
Please describe the intended language, country, population, and research or clinical purpose in your message.
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