The Dara Project: Assessing Health and Well-Being Measures in Economically Disadvantaged Families

OBJECTIVES: "The Dara Project" is a longitudinal study designed to assess the fitness of the EQ Health and Well-Being (EQ-HWB) instruments in evaluating the impact of health and social program on economically and educationally disadvantaged families with sick children. This analysis, based on project baseline data, primarily aims to examine the clarity and interpretability of the EQ-HWB within this specific demographic and to investigate the questionnaire's psychometric properties.

METHODS: Employing a mixed-methods approach, we collected data from 70 participants through an interviewer-assisted questionnaire, followed by cognitive debriefing interviews to qualitatively assess comprehension challenges in interpreting the questionnaire. This qualitative analysis was complemented by quantitative methods, including descriptive statistics, a Graded Response Model (GRM), and Confirmatory Factor Analysis (CFA).

RESULTS: Participants were predominantly female (94.29%) with an average age of 33.34 years. Cognitive debriefing identified "Feel you had nothing to look forward to?" as the most misunderstood item, with approximately 20% of individuals unable to comprehend it. Challenges were also noted in understanding questions related to feelings of exhaustion, lack of support, and control over life. Response patterns indicated a preference for extreme or neutral options on the Likert scale. The IRT analysis revealed high discrimination values for items related to emotional and psychological states (Items 6,7,8,9,12,13,14,15,17, and 18), while Items 2 and 19 had lower values. Item difficulty varied across the questionnaire, with Item 19 presenting anomalously high difficulty parameters. The CCCs suggested a pattern of ambivalence among participants, with a preference for extreme response options and less frequent selection of milder responses. The CFA revealed discrepancies, particularly with items 16 and 20, suggesting issues with their alignment in the questionnaire's structure.

CONCLUSIONS: The Dara Project's preliminary findings underscore the necessity of refining the EQ-HWB questionnaire, particularly for questions perceived as ambiguous or challenging, within the context of economically and educationally disadvantaged populations.