Measure of Processes of Care

The purpose of the Measure of Processes of Care, or MPOC, is to assess parents' perceptions of the care they and their children receive from children's rehabilitation treatment centres. It is a means to assess family-centred behaviours of health care providers.

It has been validated on samples of parents whose children range in age from 0 to 17+ years and who had a variety of neurodevelopmental disabilities or maxillofacial disorders.

The following video provides an introduction to CanChild's Measure of Processes of Care (MPOC), which looks at families' perceptions on the care they and their child receive, and highlights MPOC's relationship to family-centred service. 

MPOC contains 56 items which have five factor analytically determined scales:

  • Enabling and Partnership
  • Providing General Information
  • Providing Specific Information about the Child
  • Coordinated and Comprehensive Care for the Child and Family
  • Respectful and Supportive Care

Various studies of MPOC-56's reliability and validity have been conducted. These demonstrated good internal consistency (Cronbach's alpha ranging from .63 to .96) and test-retest reliability (intraclass correlation coefficients ranging from .78 to .88). Validity has been shown with: (a) positive correlations between MPOC scale scores and a measure of satisfaction, and (b) negative correlations between MPOC scale scores and a measure of the stress experienced by parents when dealing with their child's treatment centre. Also, responses to MPOC indicate that various components of service provision are experienced differently by parents, with data showing variations across scale scores by both individuals and groups of parent respondents.

For each item parents respond to a common question: "To what extent do the people who work with your child...".A 7-point response scale is used, with the following response options available: 7 indicated that the service provider engaged in this behaviour "to a very great extent", 6 = "to a great extent", 5 = "to a fairly great extent", 4 = "to a moderate extent", 3 = "to a small extent", 2 = "to a very small extent", and 1 = "not at all". A score of 0 indicated that the item was "not applicable".

A respondent's data yield five scores, one for each of the factors or scales. There is no total score. A scale score is obtained by computing the average of the items' ratings. Instructions for scoring are included in the manual. Programming statements for use with SPSS-PC+ are available for individuals/groups who have a license.

The MPOC survey takes 15-20 minutes for most parents to complete.

  • Reliability and validity of MPOC-56 as a discriminative measure have been demonstrated.
  • MPOC measures parents' perceptions of important aspects of care on a specific behavioural level, and is a very useful tool for program evaluation.
  • It is a theoretically sound measure of family-centred service. The scales fit well with the key constructs about caregiving found in the literature that are fundamental to family-centredness and are associated with client outcomes.
  • MPOC has wide applicability. Over 1600 parents from across the province of Ontario have been involved in its development. Both mothers and fathers have participated, and their children were receiving a variety of services and were not limited to any specific diagnostic categories.
  • Parents have found MPOC to be user-friendly with simple instructions and lay language.
  • As a self-administered questionnaire, it is very suitable for mailed surveys and use in clinic settings, without the need of an interviewer.

You may also be interested in viewing the following journal articles:

King, S., Rosenbaum, P., & King, G. (1996). Parents' perceptions of care-giving: Development and validation of a measure of processes. Developmental Medicine and Child Neurology, 38, 757-772.

King, S., King, G., & Rosenbaum, P. (2004). Evaluating Health Service Delivery to Children With Chronic Conditions and Their Families: Development of a Refined Measure of Processes of Care (MPOC-20). Children's Health Care, 33(1), 35-57.

Reference for the manual

King, S., Rosenbaum, P., & King, G. (1995). The Measure of Processes of Care: A means to assess family-centred behaviours of health care providers. Hamilton, ON: McMaster University, Neurodevelopmental Clinical Research Unit

MPOC-56 & MPOC-20

The Measure of Processes of Care (pronounced "em-pock") is a well-validated and reliable self-report measure of parents' perceptions of the extent to which the health services they and their child(ren) receive are family-centred. The original version of MPOC is a 56-item questionnaire; as of 1999 there is a shorter, 20-item version. MPOC has been used internationally in many evaluations of family-centred service.

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MPOC-SP

The MPOC-SP is a self-assessment tool for pediatric service providers that measures the extent to which the services they provide are family-centred.

This outcome measure is based on the Measure of Processes of Care (MPOC) and comprises 4 scales and 27 items. MPOC has been used internationally in many evaluations of family-centred service.

The MPOC and resources developed by CanChild researchers are protected by copyright. Effective immediately, use of this measure by organizations, services or companies within their clinical services, electronic health systems or within electronic records requires permission from CanChild and a paid licensing agreement that can be purchased through the CanChild Shop.

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More information about the MPOC-SP:

MPOC-SP is a self-assessment questionnaire for pediatric service providers, designed to measure their implementation of family-centred service in caring for children with chronic health or development problems (and their families). It is a discriminative tool that is expected to contribute to initiatives of professional development, program evaluation, and research in the field of health service delivery.

The MPOC-SP is a service provider version of the MPOC, a well-validated and reliable parent questionnaire of family-centred service (FCS). Various studies of MPOC-SP's reliability and validity as a discriminative measure have been conducted. These analyses demonstrated good internal consistency (Cronbach's alpha ranging from .76 to .88), test-retest reliability (intraclass correlation coefficients ranging from .79 to .99), and validity (i.e., including cross-disciplinary scale score comparisons and real-ideal comparison testing).

For each item, service providers respond to a common question: "In the past year, to what extent did you ...". A 7-point response scale is used, with the following response options available: 7 indicated that the service provider engaged in this behaviour "to a very great extent", 6 = "to a great extent", 5 = "to a fairly great extent", 4 = "to a moderate extent", 3 = "to a small extent", 2 = "to a very small extent", and 1 = "not at all". A score of 0 indicated that the item was "not applicable".

A respondent's data yield 4 scores, one for each of the factors or scales. There is no total score. Each scale score is obtained by computing the average of the relevant items' ratings.

The MPOC survey takes 10-15 minutes for most service providers to complete.

Can be paired with Parent Questionnaire, the MPOC, and thereby allow users to gain multiple perspectives on service delivery in a clinical setting.


  • The MPOC-SP measures the perceptions of service providers - this is an important aspect of health service delivery effectiveness.
  • Wide applicability - the MPOC-SP is useful across long-term pediatric settings. It is not limited in applicability to any specific diagnostic category or form of health care.
  • User-friendly and short.
  • Self-administered - This feature of the MPOC-SP makes it suitable for mailed surveys and in-clinic settings, without the need for an interviewer.


MPOC-SP does not measure service provider behaviours, in the objective sense of the word, but rather it measures the service provider's perceptions of his or her behaviours. It would thus be useful to pair the MPOC-SP with other FCS measurement tools when seeking a multi-perspective, exhaustive analysis of health care delivery.

The following journal article provides information on the development of the MPOC-SP:

Woodside, J. M., Rosenbaum, P. L., King, S. M., & King, G. A. (2001). Family-centered service: Developing and validating a self-assessment tool for pediatric service providers. Children's Health Care, 30(3), 237-252

Reference for the MPOC-SP:

Woodside, J., Rosenbaum, P., King, S., & King, G. (1998). The Measure of Processes of Care for Service Providers (MPOC-SP). © CanChild Centre for Childhood Disability Research, McMaster University.


Measurement and Analysis Service for Measures of Processes of Care (MPOC)

CanChild is pleased to announce the launch of our new Measurement and Analysis Service. In response to the needs and requests of organizations, we are initiating this new service with the Measure of Processes of Care (MPOC-20).

The MPOC-20 is used world-wide to evaluate the extent to which parents perceive the services that they are receiving as family-centred. Family-centre service (FCS) is recognized as a 'best-practice' approach to service delivery in children's rehabilitation. This new service will provide data about the characteristics and perceptions of the care that the children and families within your organization receive. The perspectives of parents will also ensure that the services you provide are responsive to families' needs.

  • Through the CanChild Measurement and Analysis Service, you will receive:
  • A consultation with a CanChild member to ensure that your data is being collected with minimal bias;
  • Access to our online survey system reducing administration costs to your organization;
  • Analysis of your organization's data by CanChild researchers;
  • A standardized or customized report detailing the results of your survey as well as recommendations on how to improve services to children with disabilities and their families.

As per our long standing commitment to providing knowledge and resources for families and children, all revenue generated by this service will be used to improve and expand the information on the CanChild website for families.