Positive Outcomes: Validity, Reliability and Responsiveness of a Novel Person-Centred Outcome Measure for People With HIV
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Harding, Richard
Jones, Christopher Iain
Bremner, Stephen
Bristowe, Katherine
West, Brian
Siegert, RJ
O'Brien, Kelly K
Whetham, Jennifer
EMERGE Consortium, Horizon 2020
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Wiley
Abstract
OBJECTIVES: Despite successful treatment, people living with HIV experience persisting and burdensome multidimensional problems. We aimed to assess the validity, reliability and responsiveness of Positive Outcomes, a patient-reported outcome measure for use in clinical practice. METHODS: In all, 1392 outpatients in five European countries self-completed Positive Outcomes, PAM-13 (patient empowerment), PROQOL-HIV (quality of life) and FRAIL (frailty) at baseline and 12 months. Analysis assessed: (a) validity (structural, convergent and divergent, discriminant); (b) reliability (internal consistency, test-retest); and (c) responsiveness. RESULTS: An interpretable four-factor structure was identified: 'emotional wellbeing', 'interpersonal and sexual wellbeing', 'socioeconomic wellbeing' and 'physical wellbeing'. Moderate to strong convergent validity was found for three subscales of Positive Outcomes and PROQOL (ρ = -0.481 to -0.618, all p < 0.001). Divergent validity was found for total scores with weak ρ (-0.295, p < 0.001). Discriminant validity was confirmed with worse Positive Outcomes score associated with increasing odds of worse FRAIL group (4.81-fold, p < 0.001) and PAM-13 level (2.28-fold, p < 0.001). Internal consistency for total Positive Outcomes and its factors exceeded the conservative α threshold of 0.6. Test-retest reliability was established: those with stable PAM-13 and FRAIL scores also reported median Positive Outcomes change of 0. Improved PROQOL-HIV score baseline to 12 months was associated with improved Positive Outcomes score (r = -0.44, p < 0.001). CONCLUSIONS: Positive Outcomes face and content validity was previously established, and the remaining validity, reliability and responsiveness properties are now demonstrated. The items within the brief 22-item tool are designed to be actionable by health and social care professionals to facilitate the goal of person-centred care.
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HIV, measurement, outcomes, person-centredness, self-report, EMERGE Consortium, Horizon 2020, Science & Technology, Life Sciences & Biomedicine, Infectious Diseases, Patient-reported outcomes, Quality-of-life, psychological symptoms, antiretroviral therapy, palliative care, health, questionnaire, definitions, consensus, 4203 Health Services and Systems, 32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, 42 Health Sciences, Clinical Research, HIV/AIDS, Behavioral and Social Science, Health Disparities and Racial or Ethnic Minority Health Research, Health Disparities, 7.1 Individual care needs, 3 Good Health and Well Being, 1103 Clinical Sciences, Virology, 3202 Clinical sciences, 4202 Epidemiology
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HIV Medicine, ISSN: 1464-2662 (Print); 1468-1293 (Online), Wiley, 23(6), 673-683. doi: 10.1111/hiv.13224
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© 2022 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association. This is an open access article.
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Except where otherwise noted, this item's license is described as Creative Commons Attribution-NonCommercial License