Abstract
BackgroundHealth-related quality of life (HRQOL) is a multi-dimensional concept commonly used to examine the impact of health status on quality of life. HRQOL is often measured by four core questions that asked about general health status and number of unhealthy days in the Behavioral Risk Factor Surveillance System (BRFSS). Use of these measures individually, however, may not provide a cohesive picture of overall HRQOL. To address this concern, this study developed and tested a method for combining these four measures into a summary score.MethodsExploratory and confirmatory factor analyses were performed using BRFSS 2013 data to determine potential numerical relationships among the four HRQOL items. We also examined the stability of our proposed one-factor model over time by using BRFSS 2001–2010 and BRFSS 2011–2013 data sets.ResultsBoth exploratory factor analysis and goodness of fit tests supported the notion that one summary factor could capture overall HRQOL. Confirmatory factor analysis indicated acceptable goodness of fit of this model. The predicted factor score showed good validity with all of the four HRQOL items. In addition, use of the one-factor model showed stability, with no changes being detected from 2001 to 2013.ConclusionInstead of using four individual items to measure HRQOL, it is feasible to study overall HRQOL via factor analysis with one underlying construct. The resulting summary score of HRQOL may be used for health evaluation, subgroup comparison, trend monitoring, and risk factor identification.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-016-0091-3) contains supplementary material, which is available to authorized users.
Highlights
Health-related quality of life (HRQOL) is a multi-dimensional concept commonly used to examine the impact of health status on quality of life
This study proposes a method for creating a summary score of overall HRQOL based solely on Centers for Disease Control and Prevention (CDC) HRQOL-4
The Cronbach’s alpha value of the CDC HRQOL-4 was 0.76, which was within the acceptable range [16]
Summary
Health-related quality of life (HRQOL) is a multi-dimensional concept commonly used to examine the impact of health status on quality of life. HRQOL is often measured by four core questions that asked about general health status and number of unhealthy days in the Behavioral Risk Factor Surveillance System (BRFSS) Use of these measures individually, may not provide a cohesive picture of overall HRQOL. To assess and measure HRQOL at the state and national levels, the Centers for Disease Control and Prevention (CDC) developed a set of four “core” questions (CDC HRQOL-4): (1) Would you say that in general your health These four items, which have demonstrated good retest reliability, validity, and responsiveness [6,7,8], have been included in the Behavioral Risk Factor Surveillance System (BRFSS) in all 50 states since 1993. The CDC items appear more appropriate for assessing burden of disease for chronic conditions and are brief and interpretable [11]
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