The Activity Card Sort (ACS) is a valid and reliable measure of older adults' participation; however, cultural sensitivity issues are a limitation to its application in the United Kingdom. A content validity study was undertaken to identify culturally relevant activity items to be included in a United Kingdom version of the ACS (ACS-UK). For item generation, United Kingdom time-use studies, research related to other ACS versions, and expert opinions were used. A two-round survey of community-living United Kingdom older adults (aged 65 years and older; round 1, n = 177; round 2, n = 21) was used for item selection, clarifying the wording of activity labels, and agreeing activity domain classification. Ninety-one activities were identified for the ACS-UK and these were compared with items from other ACS versions. The ACS-UK is a culturally relevant measure that can provide useful insight into the participation of older adults for clinical practice and research.
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