Use of relevancy ratings by target respondents to develop health-related quality of life measures: An example with African-American elderly

Background: Health-related quality of life (HRQOL) instruments assess funct ioning and well-being. Generic HRQOL measures are intended to be relevant t o everyone whereas population-targeted measures are designed to be relevant to a particular population. Methods: We asked 99 African-American elderly (mean age 72, 33% female, 47% less than high school education) to rate the relevancy of 33 HRQOL items drawn largely from existing instruments. We ass essed the reliability of the relevancy ratings across respondents, rank-ord ered the items by relevancy, and tested the significance of difference in r elevancy ratings for each item compared to the average of all other items. We also examined the associations of the relevancy ratings with sociodemogr aphic and clinical characteristics. Results: The relevancy ratings were rel iable (intraclass correlation = 0.71) and relevancy was generally distinct from HRQOL and demographic characteristics. Items assessing spirituality an d weight-related health status were rated as significantly more relevant th an other types of items. Generic HRQOL items were not rated as highly relev ant. Conclusions: HRQOL measures assessing spirituality and weight-related concepts are important for future studies of HRQOL in African-American elde rly. The method of identifying these concepts used in this study should be valuable in developing new measures targeted to other sociodemographically or clinically defined subgroups.