HPRHealth Psychology ResearchTBA2420-8124Health Psychology Research10.4081/hpr.2018.6496GeneralFace and content validity and acceptability of the Swedish ICECAP-O  capability measure: Cognitive interviews with 70-year-old personshttps://healthpr.org/journal/HPR/6/1/10.4081/hpr.2018.6496GustafssonSusanne,HörderHelena,HammarIsabelle Ottenvall,SkoogIngmar2018612018-05-08This study is part of a project that aims to culturally adapt the Investigating Choice Experiments for the Preferences of Older People-CAPability Index (ICECAP-O) for use in research and health and social care in Sweden. The objective was to evaluate face and content validity and acceptability. Eighteen 70-year-old community-dwelling persons participated in cognitive interviews. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants’ perceptions of included attributes and experiences of completing the measure. The results show that three participants (18%) had problems completing ICECAP-O, and that judged problems occurred for five (6%) of participants responses in the standardized classification scheme. Most partici pants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O seems to measure what it is supposed to measure, quality of life (QoL) with a capability approach, and acceptability is satisfactory. ICE CAP-O has potential for becoming a valuable addition to the sup ply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older persons.Quality of life; Older adults; Elderly; Geriatric assessment; Self-assessment

1. Baltes, P. B., & Smith, J. (2003). New frontiers in the future of aging: From successful aging of the young old to the dilemmas of the fourth age. Gerontology, 49(2), 123-135. 2. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.3. Coast, J., Flynn, T. N., Natarajan, L., Sproston, K., Lewis, J., Louviere, J. J., & Peters, T. J. (2008). Valuing the ICECAP capability index for older people. Social Science and Medicine, 67(5), 874-882. 4. Coast, J., Peters, T. J., Natarajan, L., Sproston, K., & Flynn, T. (2008). An assessment of the construct validity of the descriptive system for the ICECAP capability measure for older people. Quality of Life Research, 17(7), 967-976. 5. Couzner, L., Ratcliffe, J., Lester, L., Flynn, T., & Crotty, M. (2013). Measuring and valuing quality of life for public health research: Application of the ICECAP-O capability index in the Australian general population. International Journal of Public Health, 58(3), 367-376. 6. Drennan, J. (2003). Cognitive interviewing: Verbal data in the design and pretesting of questionnaires. Journal of Advanced Nursing, 42(1), 57-63. 7. Ekelund, C., Dahlin-Ivanoff, S., & Eklund, K. (2014). Self-determination and older people-A concept analysis. Scandinavian Journal of Occupational Therapy, 21(2), 116-124. 8. Fitzpatrick, R., Davey, C., Buxton, M. J., & Jones, D. R. (1998). Evaluating patient-based outcome measures for use in clinical trials. Health Technology Assessment, 2(14), i-74. 9. García, A. A. (2011). Cognitive Interviews to Test and Refine Questionnaires. Public Health Nursing, 28(5), 444-450. 10. Garratt, A., Schmidt, L., Mackintosh, A., & Fitzpatrick, R. (2002). Quality of life measurement: Bibliographic study of patient assessed health outcome measures. British Medical Journal, 324(7351), 1417-1419. 11. Grewal, I., Lewis, J., Flynn, T., Brown, J., Bond, J., & Coast, J. (2006). Developing attributes for a generic quality of life measure for older people: Preferences or capabilities? Social Science and Medicine, 62(8), 1891-1901. 12. Guillemin, F., Bombardier, C., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 46(12), 1417-1432. 13. Hammell, K. W. (2015). Quality of life, participation and occupational rights: A capabilities perspective. Australian Occupational Therapy Journal, 62(2), 78-85. 14. Horwood, J., Sutton, E., & Coast, J. (2014). Evaluating the Face Validity of the ICECAP-O Capabilities Measure: A “Think Aloud” Study with Hip and Knee Arthroplasty Patients. Applied Research in Quality of Life, 9(3), 667-682. 15. Hörder, H., Gustafsson, S., Rydberg, T., Skoog, I., & Waern, M. (2016). A Cross-Cultural Adaptation of the ICECAP-O: Test–Retest Reliability and Item Relevance in Swedish 70-Year-Olds. Societies, 6(4), 30. 16. Lee, J. (2014). Conducting Cognitive Interviews in Cross-National Settings. Assessment, 21(2), 227-240. 17. Makai, P., Brouwer, W. B. F., Koopmanschap, M. A., Stolk, E. A., & Nieboer, A. P. (2014). Quality of life instruments for economic evaluations in health and social care for older people: A systematic review. Social Science and Medicine, 102, 83-93. 18. McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia Media (Zagreb), 22(3), 276-282. 19. Onwuegbuzie, A. J., Johnson, R. B., & Collins, K. M. T. (2011). Assessing legitimation in mixed research: A new framework. Quality and Quantity, 45(6), 1253-1271. 20. Prah Ruger, J. (2010). Health Capability: Conceptualization and Operationalization. American Journal of Public Health, 100(1), 41-49. 21. Rinder, L., Roupe, S., Steen, B., & Svanborg, A. (1975). Seventy year old people in Gothenburg. A population study in an industrialised Swedish city. I. General presentation of the study. Acta Medica Scandinavica, 198(5), 397-407. 22. Sen, A. (1993). Capability and well-being (A. Sen Ed.). Oxford: Clarendon. 23. Sen, A. (2009). The idea of justice. Belknap Press of Harvard University Press. 24. Svensson, E. (2001). Guidelines to statistical evaluation of data from rating scales and questionnaires. J Rehabil Med, 33(1), 47-48. 25. Van Leeuwen, K. M., Jansen, A. P. D., Muntinga, M. E., Bosmans, J. E., Westerman, M. J., Van Tulder, M. W., & Van Der Horst, H. E. (2015). Exploration of the content validity and feasibility of the EQ-5D-3L, ICECAP-O and ASCOT in older adults. BMC Health Services Research, 15(1). 26. Willis, G. B., & Miller, K. (2011). Cross-cultural cognitive interviewing: Seeking comparability and enhancing understanding. Field Methods, 23(4), 331-341.