CONTENT VALIDITY OF THE EQ-HWB-9, EQ-5D-5L, AND SIX BOLT-ONS IN OLDER ADULTS
Author(s)
Hilary Short, MSc1, Wenting Yan, MPH1, Thao Nguyen, BSc1, Allyson Jones, PhD2, Arto Ohinmaa, PhD1, Fatima Al Sayah, PhD1.
1School of Public Health, University of Alberta, Edmonton, AB, Canada, 2Faculty of Rehabilitation Medicine - Physical Therapy, University of Alberta, Edmonton, AB, Canada.
1School of Public Health, University of Alberta, Edmonton, AB, Canada, 2Faculty of Rehabilitation Medicine - Physical Therapy, University of Alberta, Edmonton, AB, Canada.
OBJECTIVES: This study examined the content validity of the EQ-HWB-9, EQ-5D-5L, and six EQ-5D-5L "bolt-on" dimensions (cognition, vision, hearing, sleep, fatigue, and social relationships) for use among older adults.
METHODS: Qualitative cognitive debriefing interviews with older adults (65+) from Edmonton, Alberta were conducted. Using purposive quota sampling, the sample was recruited evenly between community-dwelling and assisted-living residents with representation across sex and age groups. Participants described their health status and personal meaning of health-related quality of life (HRQL) before completing the EQ-HWB-9, EQ-5D-5L, and six bolt-ons. Participants were asked to provide feedback on the relevance, importance, and clarity of each item. Socio-demographic and medical history data were also collected. Interviews were transcribed and analyzed using the Framework Analysis method via ATLAS.ti 26.
RESULTS: We conducted 25 interviews with community-dwelling (n=12) and assisted-living (n=13) older adults who had a mean age of 78.9 (SD = 8.4; range 66-92) and were 64% female. Across all measures, participants most frequently identified mobility (87.5%), cognition (70.8%), and sleep (66.7%) as the most relevant dimensions. However, community-dwelling participants prioritized social relationships and ability to perform daily activities as key HRQL domains, while assisted-living participants emphasized mobility and functioning. Both groups noted that short recall periods failed to capture health fluctuations. Most found the EQ-5D-5L relevant and easy to understand, though nearly all endorsed at least one bolt-on, particularly cognition and social relationships. On the EQ-HWB-9, the "getting around inside or outside" item was widely problematic due to differing indoor and outdoor difficulty levels, and "lacked control over day-to-day life" was confusing to community-dwelling participants but not to those in assisted-living.
CONCLUSIONS: Preliminary findings indicate EQ instruments capture domains considered most relevant to older adults. However, the EQ-HWB-9 may be better suited for assisted-living settings, whereas the EQ-5D-5L (with potential bolt-ons) may be more relevant for community-dwelling older adults.
METHODS: Qualitative cognitive debriefing interviews with older adults (65+) from Edmonton, Alberta were conducted. Using purposive quota sampling, the sample was recruited evenly between community-dwelling and assisted-living residents with representation across sex and age groups. Participants described their health status and personal meaning of health-related quality of life (HRQL) before completing the EQ-HWB-9, EQ-5D-5L, and six bolt-ons. Participants were asked to provide feedback on the relevance, importance, and clarity of each item. Socio-demographic and medical history data were also collected. Interviews were transcribed and analyzed using the Framework Analysis method via ATLAS.ti 26.
RESULTS: We conducted 25 interviews with community-dwelling (n=12) and assisted-living (n=13) older adults who had a mean age of 78.9 (SD = 8.4; range 66-92) and were 64% female. Across all measures, participants most frequently identified mobility (87.5%), cognition (70.8%), and sleep (66.7%) as the most relevant dimensions. However, community-dwelling participants prioritized social relationships and ability to perform daily activities as key HRQL domains, while assisted-living participants emphasized mobility and functioning. Both groups noted that short recall periods failed to capture health fluctuations. Most found the EQ-5D-5L relevant and easy to understand, though nearly all endorsed at least one bolt-on, particularly cognition and social relationships. On the EQ-HWB-9, the "getting around inside or outside" item was widely problematic due to differing indoor and outdoor difficulty levels, and "lacked control over day-to-day life" was confusing to community-dwelling participants but not to those in assisted-living.
CONCLUSIONS: Preliminary findings indicate EQ instruments capture domains considered most relevant to older adults. However, the EQ-HWB-9 may be better suited for assisted-living settings, whereas the EQ-5D-5L (with potential bolt-ons) may be more relevant for community-dwelling older adults.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MSR71
Topic
Methodological & Statistical Research, Patient-Centered Research
Disease
Geriatrics