The HEAL Item Banks and Short Form questionnaires were developed using the rigorous instrument development methodology of PROMIS® (www.nihpromis.org ), funded by NCCIH (R01 AT006453).
All HEAL items were subjected to extensive psychometric evaluation procedures using both classical testing methods (e.g., exploratory and confirmatory factor analyses) and item response theory (IRT). In addition, the wording and response scales of all HEAL items were specifically vetted by a wide variety of patients. Therefore, it is essential that researchers use the exact wording of each item, the exact instructions, and the exact wording of the response scales. However, it is fine to give additional instructions, such as, “As you are answering the questions about your healthcare provider, please answer based upon your views of the person who is providing the treatment in the research study.”
There are two administration options for HEAL measures: short forms and computerized adaptive tests (CATs). When administering a short form, instruct participants to answer all the items (i.e., questions or statements) presented. With a CAT, participant responses guide the system’s choice of subsequent items (usually 3-6) from the full item banks (27 items for TEX, 57 items for PPC, etc.). Although items differ across respondents taking a CAT, scores are comparable across participants. Some administrators may prefer to ask the same question of respondents over time, to enable more direct comparability across people or time. In these cases, a short form would be more desirable than a CAT. Short forms are also best when paper administration is preferred.
HEAL measures can be administered together or individually, depending on what you want to assess.
Timing of HEAL Questionnaires:
- HEAL Patient-Provider Connection (PPC): can be administered early in treatment (e.g., within the first month), in the middle phases of treatment, or late in treatment. Predictive validity was established with early administration.
- HEAL Treatment Expectancy (TEX): should be administered early in treatment (ideally within the 1st couple of weeks, or the first month of a treatment program). This timing was used in our validation studies. However, it may be that HEAL Treatment Expectancy is appropriate for administration prior to the start of a research program.
- HEAL Healthcare Environment (HCE): In the validation studies we administered this early in the treatment (within the first month or so), and also at mid and late in treatment. Validation analyses were only conducted for early treatment (as of July 2015).
- HEAL Positive Outlook (POS): this is considered to be a ‘within-person’ characteristic that may contribute to treatment outcome. It is OK to administer before treatment or any other time in the study.
- HEAL Spirituality (SPT): this is considered to be a ‘within-person’ characteristic that may contribute to treatment outcome. It is OK to administer before treatment or any other time in the study.
- HEAL Attitude toward CAM (short form only)(CAM): this is considered to be a ‘within-person’ characteristic that may contribute to treatment outcome. It is OK to administer before treatment or any other time in the study.
Scoring: score each short form by summing the scores of each item to create a total score for each HEAL Questionnaire. After you fill out the registration from to request access to the HEAL measures, you will be given access to a table to convert these summed or ‘raw’ scores to t-scores. Calibration analyses for the conversion included over 1600 persons.