Initial Development and Content Validity of an Occupation-Focused Assessment: Occupations in Higher Education Transitions Inventory.

University students face occupational disruption during post-secondary transitions, yet existing campus screening tools leave occupational challenges largely unassessed. No comprehensive, occupation-focused screening instrument exists for this population. To describe the theoretical development and content validation of the Occupations in Higher Education Transitions Inventory (OHETI), a screening tool assessing university student adaptation across 10 domains of occupation grounded in the Theory of Occupational Adaptation (OA) a five-phase iterative development process was used: (a) initial item generation; (b) preliminary expert review for face validity (N = 3 occupational therapists with expertise in OA theory); (c) tool reconceptualization based on expert feedback; (d) cognitive interviews with undergraduate students for face validity and comprehensibility (N = 10); and (e) formal content validation using a Content Validity Index (CVI) rating procedure with (N = 6) occupational therapy professionals with clinical and academic experience with emerging adult students. Initial item generation yielded 68 items across seven OA constructs. Expert feedback prompted a fundamental restructuring, producing 116 items across 10 occupations, covering aspects of relative mastery: satisfaction, effectiveness, and efficiency. Revision based on student cognitive interviews resulted in 122 items. Formal content validation produced I-CVI scores ranging from 0.667 to 1.0, with S-CVI scores of 0.9516 for clarity and 0.9435 for relevance. Two items were removed, resulting in a final tool of 120 scorable items across 10 occupations. The OHETI demonstrates strong content and face validity as a theoretically grounded, occupation-focused screening tool for university students. Online administration and individualized feedback distinguish it from existing instruments. Psychometric validation is needed before broad implementation.