Evidence map›Paper›PMID 42636186›Full record

ArticlePloS one2026

Stakeholder and end-user perspectives to refine the Context-sensitive Positive Health Questionnaire (CPHQ) to measure broad health.

Mirte Boelens, Cheryl Roumen, Esther J Bloemen-van Gurp, John Dierx, Lenny Nahar-van Venrooij, Tim van Zutphen, Pien M R Christiaanse, Jaron Schnitzer, M Elske van den Akker-van Marle, Miriam J J de Kleijn and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. [The Context-Sensitive Positive Health Questionnaire (CPHQTSG : tijdschrift voor gezondheidswetenschappen · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Mirte BoelensLeiden University Medical Center/Health Campus The Hague, Department of Public Health and Primary Care, The Hague, The Netherlands.ORCID https://orcid.org/0000-0003-4082-5237
Cheryl RoumenDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.ORCID https://orcid.org/0000-0002-2941-4632
Esther J Bloemen-van GurpZuyd University of Applied Sciences, Research Center of community care, Heerlen, The Netherlands.
John DierxAvans University of Applied Science, Centre of Expertise Perspective in Health, Research Group Equal Chances on Healthy Choices, Breda, Netherlands.ORCID https://orcid.org/0000-0001-7435-0183
Lenny Nahar-van VenrooijJeroen Bosch Academy Research, Jeroen Bosch Hospital, 's-Hertogenbosch, Netherlands.
Tim van ZutphenDepartment of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
Pien M R ChristiaanseDepartment of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
Jaron SchnitzerFontys University of Applied Sciences, Center of Expertise Health, Eindhoven, The Netherlands.
M Elske van den Akker-van MarleDepartment of Biomedical Data Sciences, Section of Medical Decision-Making, Leiden University Medical Center, Leiden, The Netherlands.
Miriam J J de KleijnInstitute for Positive Health, Utrecht, The Netherlands.
Marja van VlietInstitute for Positive Health, Utrecht, The Netherlands.
Jessica C Kiefte-de JongLeiden University Medical Center/Health Campus The Hague, Department of Public Health and Primary Care, The Hague, The Netherlands.ORCID https://orcid.org/0000-0002-8136-0918
Marieke D SpreeuwenbergDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBroad health concepts are increasingly embedded in healthcare and other domains. Therefore, in a previous study, we developed and validated the Context-Sensitive Positive Health Questionnaire (CPHQ). The CPHQ is based on Positive Health, the Capability Approach and on perspectives of stakeholders and end-users, including those with a lower socioeconomic position (SEP) with the aim to validly measure broad health. Stakeholders and end-users were involved in the development process. However, professionals working in healthcare, welfare or policy domain were not sufficiently involved, while their perspective on how to measure broad health is needed to support broader applicability and acceptability.

objectiveWe aimed to refine the 32-item CPHQ for cross-domain use through focus group discussions (FGDs) with stakeholders across healthcare, welfare and policy domains, researchers, as well as patients and citizens, including those from a lower SEP, expert review and a member check.

methodsWe conducted nine (FGDs) and one interview with stakeholders from healthcare, welfare, and policy domains, research, patients and (lower SEP) citizens (n = 76). An adapted COMET method analysis and qualitative analysis were used, followed by a member check to validate the changes.

resultsItems were omitted, merged or added, leading to a refined CPHQ (28 items). Main themes guiding edits were 1) the importance of avoiding normative phrasing and including subjectively interpretable items, 2) prioritization of items reflecting aspects of experienced health (e.g., "I feel happy" or "I feel healthy"), 3) relevance of functionings. At the same time, views diverged on the inclusion and wording of items related to exclusion, political representation and sense of belonging. These items were subsequently discussed by the core group and evaluated using the predefined decision rules and qualitative feedback.

conclusionThe CPHQ refinement involved a wide range of stakeholders, including end-users. This led to a 28-item CPHQ to measure broad health. Future research in different populations and settings is needed to validate and possibly shorten the refined CPHQ.

Indexed as

Health StatusStakeholder ParticipationAdultFemaleFocus GroupsHumansMaleMiddle AgedSurveys and Questionnaires

Identifiers

PMID42636186
PMCPMC13502646

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.