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RehabMeasures Instrument

Test of Grocery Shopping Skills

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Purpose

A 10-item performance measure used to assess clients’ ability to efficiently and effectively locate and select specific items at the lowest price within the natural environment of the grocery store. 

Link to Instrument

Acronym TOGGS

Area of Assessment

Cognition
Communication
Executive Functioning
Activities of Daily Living
Life Participation
Mental Health
Occupational Performance
Processing Speed
Reasoning/Problem Solving
Word Finding

Administration Mode

Paper & Pencil

Cost

Not Free

Cost Description

AOTA website Member Price: $69.00, Non-Member Price: $98.00
And Cost of Manual and Administration Materials

Populations

Key Descriptions

  • 10-item measure
  • Total accuracy scores range from 0-30. Redundancy scores vary depending upon the number of aisles in the store.
  • The accuracy score is determined by issuing one point for each grocery item obtained correctly. A second point for correct size. A third point for lowest cost. A redundancy score is calculated by adding the number of excess aisles visited divided by the number of aisles in the store. A lower redundancy score signifies greater efficiency.
  • Develop a store map and provide the client with instructions before starting the timer and beginning the test.

Number of Items

10

Equipment Required

  • stopwatch
  • 2 pencils
  • 2 clipboards
  • Money for grocery items (if purchasing)
  • Store map
  • TOGSS grocery list (Form 1 or Form 2)
  • TOGSS scoring sheet (Form 1 or Form 2)

Time to Administer

20-30 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Instrument Reviewers

Sandy Harrer, OTS University of Illinois at Chicago

Julia Majkut, OTS University of Illinois at Chicago

Keyla Rivera, OTS University of Illinois at Chicago

ICF Domain

Body Function
Activity
Participation

Measurement Domain

Activities of Daily Living
Cognition

Considerations

The TOGSS may be best suited to assess individuals with serious mental illness. It could also be used with populations with cognitive impairments such as those associated with traumatic brain injury, stroke, early dementia, and developmental disabilities.

Mental Health

back to Populations

Test/Retest Reliability

Schizophrenia: (Hamera & Brown, 2000, n = 26, Mean Age = 40.5 (range 22 - 57) years)

  • Adequate test-retest reliability between forms 1 and 2 of TOGSS (0.64 ≤ r ≤ 0.84 across all scales) administered over two different testing periods in a test-retest design

Interrater/Intrarater Reliability

Interrater Reliability:

Schizophrenia

  • Excellent Intercoder reliability assessed between two independent raters (85.7%) for responses during semi-structured interviews (Hamera & Brown, 2000)
  • Excellent interrater reliability for TOGSS for both forms 1 (r = 0.99) and 2 (r = 1.00) (Hamera & Brown, 2000)

Criterion Validity (Predictive/Concurrent)

Predictive Validity:

Serious Mental Illness(Schizophrenia-spectrum, bipolar disorder, or other depression/anxiety diagnoses and accompanying functional disability): (Faith & Rempfer, 2018, n = 59; Mean Age = 43.19 (9.72) years; Of these, n = 21 schizophrenia or schizoaffective disorder, n = 15 bipolar disorder, n = 23 other depressive and/or anxiety disorders)

TOGSS accuracy scores provide incremental predictive value that self-report alone cannot provide in predicting real-world shopping skills (R2 change = 0.07, F (1,49) = 4.37, p < 0.05)

Construct Validity

Convergent validity:

Schizophrenia:

 

(Greenwood, 2005; n = 75; Of these, n= 28 with negative symptoms, Mean Age = 35.1 (8.8) years, n=25 without negative symptoms, Mean Age = 35.3 (10.6), n= 22 healthy control, Mean Age = 36.2 (12.9))

  • TOGGS accuracy was significantly correlated to Key Search Task for Spatial Strategies (z = 2.48, p < 0.05)
  • TOGGS accuracy was significantly correlated to Letter Number Span Task for Working Memory (z = 0.48, p < 0.001) 
  • TOGGS redundancy was significantly correlated to Phonological Fluency Test for Response Initiation (z = 4.02, p < 0.01)

 

(Hamera & Brown, 2000)

  • Excellent convergent validity between forms 1 and 2 of TOGSS (r ≥ 0.60 across all scales)
  • Excellent convergent validity between TOGSS and Drug Store Shopping Skills (r ≥ 0.65 across subscales, p < 0.001)

 

(Rempfer et al., 2003, n = 73; Mean Age = 39.46 (9.9) years)

  • Adequate convergent validity between redundancy and increased time (r = 0.35, p < 0.01).
  • Adequate correlation between TOGGS redundancy and Wisconsin Card Sorting Task (WCST) total (r = - 0.39, p<0.01)
  • Adequate correlation between TOGGS redundancy with Rey Auditory Verbal Learning Test (RVLT) verbal recall total (r = -0.34, p<0.01)
  • Adequate correlation between TOGGS accuracy and Stroop word trial (r = 0.32, p<0.05)
  • Poor correlations between TOGGS accuracy (r = 0.29, p<0.01) and redundancy (r = -0.20, p<0.05) with Stroop color trial
  • Poor correlation between TOGGS redundancy and FAS verbal fluency (r = -0.27, p<0.05)
  • Poor correlation between TOGGS redundancy and Stroop color-word trial (r = -0.26, p<0.05)
  • Poor correlation between TOGGS time and RVLT learning (r = 0.24, p<0.05)
  • Poor correlation between TOGGS redundancy and Allen Cognitive Levels Test (ACL) letter cancellation time (r = 0.24, p<0.05)
  • Poor correlations between TOGGS accuracy (r = - 0.23) and redundancy (r = 0.23) with WCIST perseverative errors (p<0.05)

 

(Rempfer, McDowd, & Brown, 2017, n = 81 Mean Age = 41.27 (8.6) years)

  • Adequate correlations comparing the TOGGS with the learning potential measure WCST in the Post training group (r = .305, p < 0.01)
  • Poor correlations comparing the TOGGS with the learning potential measure Rey Osterrieth Complex Figure Test (ROCFT) in the Post training group (r = .259, p < 0.05)
  • Poor correlations comparing the TOGGS with the learning potential measure WCST in the Categorical group (tau b = .209, p < 0.05)
  • Poor correlations comparing the TOGGS with the learning potential measure ROCFT in the Post training group (?? = .234, p < 0.05)
  • Poor correlations comparing the TOGGS with the learning potential measure WCST in Regression residual group ( ?? = .247, p < 0.05)

(Zayat et al., 2011, n = 80; Mean Age = 42.67 (8.47) years)

  • Adequate correlations comparing the TOGGS redundancy outcome with the neurocognitive measure Wisconsin Card Sorting Task (WCST) perseverative error (r = .382, p < 0.01)
  • Adequate correlations comparing the TOGGS redundancy outcome with the neurocognitive measure WCST (r = .323, p < 0.01)
  • Adequate correlations comparing the TOGGS redundancy outcome with the neurocognitive measures WCST Total Correct (r = -.313, p < 0.05)
  • Adequate correlations comparing the TOGGS redundancy outcome with the neurocognitive measure Letter Numbering Sequence (LNS) (r = -.323, p < 0.01)
  • Adequate correlations comparing the TOGGS accuracy outcome with the neurocognitive measure Trail Making Test (TMT) (r = -.325, p < 0.05)
  • Poor correlations comparing TOGGS accuracy to the neurocognitive measure: WCST Total Correct (r=.222, p < 0.05)
  • Adequate correlations comparing the TOGGS accuracy outcome with the neurocognitive measure LNS (r = -.385, p < 0.01)
  • Adequate correlations comparing the TOGGS accuracy outcome with the neurocognitive measure Digital Span Backward (DSB) (r = -.339, p < 0.01)
  • Adequate correlations comparing the TOGGS accuracy outcome with the neurocognitive measure Months Ordering Test of Working Memory (MO) (r = .422, p < 0.01)

 

 

Discriminant Validity:

Schizophrenia:

  • Excellent discriminant validity, where there were no significant relations between outcomes of accuracy and redundancy (r = -0.22), or accuracy and time (r = -0.09). (Rempfer et al., 2003)

 

Serious Mental Illness:

(Faith & Rempfer, 2018)

  • Adequate construct validity of the TOGSS regarding the accuracy outcome was significantly associated with both directly observed real-world shopping skills (r = 0.424, p < 0.01) and self-reported shopping skills (r = 0.444, p < 0.01) 
  • Naturalistic behavioral observation in real world settings is considered the best estimation of a person's real life functioning in absence of a gold standard for assessing real life functioning

 

(Hamera, Brown, Rempfer, & Davis, 2002, n = 64; Of these, n = 26 schizophrenia, Mean Age = 44.38 (11.19) years; n=19 bipolar disorder, Mean Age = 41.32 (9.32) years;  n = 19 no diagnosed mental illness, Mean Age = 34.63 (9.29) years)

  • Adequate construct validity for TOGGS accuracy:  Age is negatively correlated with accuracy in the group with schizophrenia and the group with bipolar disorder (r = -.36 and -.58, respectively) and positively correlated in the group without mental illness (r = .46) 
  • TOGGS redundancy:  Significant differences between the group with mental illness compared to the group without mental illness (F = 5.30, (2,60), p < .01)
  • TOGGS time: The group with mental illness required significantly more time compared to the group without mental illness (F = 6.14, (2,60), p < .01)

 

(Rempfer & Fowler, 2018, n = 49; Mean Age = 45.73 (10.69 years);  Of these, n = 22 schizophrenia, n = 7 schizoaffective disorder, n = 14 major depressive disorder, n = 6 bipolar disorder)

  • Excellent correlations with the neurocognitive measure California Verbal Learning Test-II (CVLT-II) (r = .62, p < 0.01)
  • Adequate correlations with the neurocognitive measure Knowledge of Grocery Shopping Skills (KOGSS) (r = .43, p < 0.01)
  • Adequate correlations with the neurocognitive measure UCSD Performance-based Skill Assessment (UPSA-B) (r = .57, p < 0.01)
  • Adequate correlations with the neurocognitive measure  Controlled Oral Word Association Test (COWAT) (r = .38, p < 0.05)
  • Adequate correlations with the neurocognitive measure  d2 Test of Attention (D2) (r = .53, p < 0.01)
  • Adequate correlations with the neurocognitive measure LNS (r = .44, p < 0.01)
  • Adequate correlation with the neurocognitive measure Trail Making Test, part B (Trails B) (r = .41  p < 0.01)

Bibliography

Brown, C., Rempfer, M., Hamera, E., 2009. The Test of Grocery Shopping Skills. AOTA Press, Bethesda, MA.

Faith, L. A., & Rempfer, M. V. (2018). Comparison of performance-based assessment and real world skill in people with serious mental illness: Ecological validity of the Test of Grocery Shopping Skills. Psychiatry Research, 266, 11-17.

Greenwood, K. E., Landau, S., & Wykes, T. (2005). Negative symptoms and specific cognitive impairments as combined targets for improved functional outcome within cognitive remediation therapy. Schizophrenia Bulletin, 31(4), 910-921.

Hamera, E., & Brown, C. E. (2000). Developing a context-based performance measure for persons with schizophrenia: the test of grocery shopping skills. The American Journal of Occupational Therapy, 54(1), 20-25.

Hamera, E. K., Brown, C., Rempfer, M., & Davis, N. C. (2002). Test of grocery shopping skills: discrimination of people with and without mental illness. Psychiatric Rehabilitation Skills, 6(3), 296-311.

Rempfer, M. V., & Fowler, C. A. (2018). Relationships among functional capacity, cognition, and naturalistic skill performance in people with serious mental illness. Psychiatry Research, 270, 453-458.

Rempfer, M. V., Hamera, E. K., Brown, C. E., & Cromwell, R. L. (2003). The relations between cognition and the independent living skill of shopping in people with schizophrenia. Psychiatry Research, 117(2), 103-112.

Rempfer, M. V., McDowd, J. M., & Brown, C. E. (2017). Measuring learning potential in people with schizophrenia: A comparison of two tasks. Psychiatry research, 258, 316-321.

Zayat, E., Rempfer, M., Gajewski, B., & Brown, C. E. (2011). Patterns of association between performance in a natural environment and measures of executive function in people with schizophrenia. Psychiatry research, 187(1-2), 1-5.