ArticleHealth and quality of life outcomes2026
Content validity of the modified EQ-HWB-9 in a sample of Argentinean patients, informal caregivers, and members of the general public.
Article in Health and quality of life outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn response to the challenge of measuring the impact of health, social care, and informal caregiving on quality of life, the EuroQol Group developed the Experimental EuroQol Health and Wellbeing (EQ-HWB-9). Evidence from preliminary testing informed a series of revisions to improve the instrument's performance. This study aimed to assess the content validity of the Argentina (Spanish) EQ-HWB-9 Experimental Modified Paper Self-Complete v1.2 (modified EQ-HWB-9), to explore whether its modifications represented an improvement over the earlier experimental version, and to examine how participants ranked the frequency scale response options.
methodsQualitative cognitive interviews were conducted using a semi-structured guide with open-ended questions and targeted probes to assess comprehensibility, relevance, and comprehensiveness of the modified EQ-HWB-9. Participants were recruited through purposive sampling via patient associations, retirement centers, and social media. Thematic content analysis was guided by an a priori framework. Participants also completed a response option ordering exercise to compare their rankings with the instrument's frequency scale.
resultsTwenty participants were included: patients (n = 12), informal carers (n = 4), and members of the general public (n = 4); nine were also social care users. The median age was 64.5 years (range 25-88) and 12 were women. All participants found the questionnaire easy to understand, items were deemed relevant, and response options appropriate. Some participants noted missing content related to leisure, social relationships, financial situation, and environment, and suggested minor wording revisions. The modified EQ-HWB-9 was generally preferred over the earlier version, supporting better comprehension and alignment with local language and context. In the frequency scale task, "none of the time" and "most or all of the time" were consistently placed at the expected extremes (90% and 85%, respectively), while intermediate labels showed greater variability, with overall ordering showing good alignment with the instrument's scale.
conclusionThis study, conducted as part of an international multi-language effort, represents the first content validity assessment of the modified EQ-HWB-9 in Spanish and Latin America. Findings support the instrument's utility, though further refinements to item wording are recommended. Ongoing iterative testing will help ensure the tool reliably measures health and wellbeing to inform policy and practice.
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