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Validation of the Centers for Disease Control and Prevention's Healthy Days measures (abstract)

Moriarty D, Zack M. Quality of Life Research, Abstracts Issue, 6th Annual Conference of the International Society for Quality of Life Research, Barcelona, Spain, 1999;8(7):617.

Background: Since January 1993, questions on self-rated general health and recent physical health, mental health, and activity limitation have been asked of a random sample of adults in the State-based Behavioral Risk Factor Surveillance System (BRFSS), an ongoing telephone survey coordinated by the U.S. Centers for Disease Control and Prevention. Respondents in some States were also asked a set of conceptually-related HRQOL questions addressing the main cause, duration, and extent of any perceived activity limitation, and data on recent pain, depression, anxiety, sleeplessness, and vitality. These "healthy days" measures track the number of days during the past 30 days when respondents experienced particular health symptoms and conditions. This presentation reviews the overall strategy for validating these measures, key findings, and work in progress.

Methods: 1993–1997 BRFSS healthy days data acquired nationwide from 576,367 adults—including 42,632 persons in 13 States who answered the full set of HRQOL questions—were analyzed for construct validity. Other community-based validation studies examined how the healthy days measures compared concurrently with established HRQOL measures such as the Short Form 36. Studies are also underway in two older adult populations to examine the ability of the healthy days measures to predict morbidity and mortality.

Results: The healthy days measures are internally consistent and identify known or suspected groups with unmet health-related needs, including persons with disabilities or with low socioeconomic status, e.g., adults with personal care needs reported 9.8 mean healthy days versus 26.2 such days for persons with no reported disability. In a general community population and a population of persons with known disabilities, the healthy days measures were found to have reasonably good criterion validity with respect to the SF-36 scales, with correlations consistently as expected.

Conclusions: Results indicate that the compact set of healthy days measures—complemented by public-domain population surveillance data are sufficiently valid for use in community health surveys.

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