Psychometric properties of the WHOQOL-BREF in a population of older adults in prison: measuring quality of life in a carceral setting

Abstract

Purpose Valid and reliable measurement is critical to the assessment and evaluation of health interventions. However, few scholars have examined the psychometric properties of “gold standard” measures in carceral settings, and no research has explored the reliability, validity and factor structure of the 26-item World Health Organization Quality of Life (WHOQOL) BREF among older adults incarcerated in prison, a large and growing population marked by substantial chronic and life-limiting illness. This study aims to examine the reliability, validity and factor structure of the WHOQOL-BREF. Design/methodology/approach Secondary data from a large-scale study with older adults (age 45+) incarcerated in a Midwestern state were used (N = 499). Floor and ceiling effects were examined, as was the reliability of the measure (Cronbach's alpha). The structural validity of a four-factor and second-order four-factor model of the WHOQOL-BREF was examined using confirmatory factor analysis. Model data fit was examined using chi-square, standardized root mean square residual, comparative fit indices, Akaike information criterion and the Bayesian Information Criterion. Pearson product-moment correlation coefficients were also used to assess validity. Findings Results indicate adequate construct validity and reliability for the WHOQOL-BREF using the current sample. Model-data fit indexes also reveal adequate structure of the measure relative to other older adult samples. Non-random data and item exclusion are noteworthy limits, and future researchers are encouraged to co-conceptualize and operationalize life quality with older adults who are incarcerated. Originality/value To the best of the authors’ knowledge, this is the first study to explore the psychometric properties of the WHOQOL-BREF among older adults incarcerated in prison.