Creating and using the CDC HRQOL healthy days index with fixed option survey responses

Zullig, Keith J.

doi:10.1007/s11136-010-9584-x

Cited by 10 publications

(6 citation statements)

References 22 publications

(20 reference statements)

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“…Health indicators : The Center for Disease Control (CDC) created four core measures to assess health-related quality of life (HRQOL) [41]. Specific wording and scoring for these self-reported HRQOL items are as follows:

Item 1: Would you say that in general your health is excellent, very good, good, fair or poor?

…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select

Akanni

Smith

Ory

2017

IJERPH

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The wide-spread dissemination of evidence-based programs that can improve health outcomes among older populations often requires an understanding of factors influencing community adoption of such programs. One such program is Texercise Select, a community-based health promotion program previously shown to improve functional health, physical activity, nutritional habits and quality of the life among older adults. This paper assesses the cost-effectiveness of Texercise Select in the context of supportive environments to facilitate its delivery and statewide sustainability. Participants were surveyed using self-reported instruments distributed at program baseline and conclusion. Program costs were based on actual direct costs of program implementation and included costs of recruitment and outreach, personnel costs and participant incentives. Program effectiveness was measured using quality-adjusted life year (QALY) gained, as well as health outcomes, such as healthy days, weekly physical activity and Timed Up-and-Go (TUG) test scores. Preference-based EuroQol (EQ-5D) scores were estimated from the number of healthy days reported by participants and converted into QALYs. There was a significant increase in the number of healthy days (p < 0.05) over the 12-week program. Cost-effectiveness ratios ranged from $1374 to $1452 per QALY gained. The reported cost-effective ratios are well within the common cost-effectiveness threshold of $50,000 for a gained QALY. Some sociodemographic differences were also observed in program impact and cost. Non-Hispanic whites experienced significant improvements in healthy days from baseline to the follow-up period and had higher cost-effectiveness ratios. Results indicate that the Texercise Select program is a cost-effective strategy for increasing physical activity and improving healthy dietary practices among older adults as compared to similar health promotion interventions. In line with the significant improvement in healthy days, physical activity and nutrition-related outcomes among participants, this study supports the use of Texercise Select as an intervention with substantial health and cost benefits.

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Item 1: Would you say that in general your health is excellent, very good, good, fair or poor?

…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select

Akanni

Smith

Ory

2017

IJERPH

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“…To assess HRQOL comprehensively, public health professionals have sought a means to summarize these HRQOL measures. To combine the information on physically and mentally unhealthy days, some researchers have summed the two measures in CDC HRQOL-4 to create an Unhealthy Days Index, with the sum of the two items being truncated at 30 days [ 3 , 14 , 15 ]. This approach assumes an independent relationship between the two kinds of days.…”

Section: Introductionmentioning

confidence: 99%

Summarizing health-related quality of life (HRQOL): development and testing of a one-factor model

Yin¹,

Njai

Barker

et al. 2016

Popul Health Metrics

177

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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.

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“…Self-reported health status (SRHS) asked respondents, “Compared to other people your own age, would you say that your health is …“ We grouped the responses by poor/fair versus good/excellent and treated SRHS as a dichotomous variable. Two items made up the Healthy Days Index (HDI), calculated using the method described in Zullig (2010). Higher HDI scores indicate more healthy days.…”

Section: Methodsmentioning

confidence: 99%

Risk and protective factors for health-related quality of life among persons aging with HIV

et al. 2017

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For persons living with HIV, health-related quality of life (HRQOL) may be threatened by physical and mental conditions but may be protected by positive psychological traits. We performed an exploratory look at the risk and protective factors for HRQOL in older adults living with HIV. Cross-sectional analyses of baseline data from the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA), a community-based cohort of persons ages ≥50 living with HIV (n = 176) were performed. Analyses examined the relationship between risk/protective factors and two outcomes (i.e., self-reported health status [SRHS] and the healthy days index [HDI]). Having good/excellent health was associated with being a non-smoker (p = 0.002), greater purpose in life (p = 0.006), higher education (p = 0.007), fewer depressive symptoms (p = 0.004), fewer disabilities (p = 0.000), and less loneliness (p = 0.002) in bivariate analyses. Males (p = 0.03) and African Americans/Blacks (p = 0.03) reported higher HDI. Fewer depressive symptoms (p = 0.000), disabilities (p = 0.002), adverse life events (p = 0.0103), and loneliness (p = 0.000) were associated with higher HDI in bivariate analyses. In a logistic regression model, greater purpose in life, fewer disabilities, and being a non-smoker were associated with better SRHS after adjusting for covariates. For African Americans/Blacks, having fewer depressive symptoms and disabilities were associated with higher HDI after adjusting for covariates. Disabilities, depression, smoking status, race/ethnicity, and purpose in life were significantly associated with HRQOL. Findings support the need for research to examine the influence of cultural interpretations of life quality and focus on promoting physical function, smoking cessation, and psychological wellness in persons aging with HIV.

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Creating and using the CDC HRQOL healthy days index with fixed option survey responses

Abstract: Preliminary evidence suggests the "healthy days" calculation is a valid approach with fixed option responses.

Cited by 10 publications

References 22 publications

Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select

Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select

Summarizing health-related quality of life (HRQOL): development and testing of a one-factor model

Risk and protective factors for health-related quality of life among persons aging with HIV

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