Purpose
Our aim was to assess the content validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) social
health item banks by comparing a prespecified conceptual model with concepts that focus-group participants identified as important
social-health-related outcomes. These data will inform the process of improving health-related quality-of-life measures.
Methods
Twenty-five patients with a range of social limitations due to chronic health conditions were recruited at two sites; four
focus groups were conducted. Raters independently classified participants’ statements using a hierarchical, nested schema
that included health-related outcomes, role performance, role satisfaction, family/friends, work, and leisure.
Results
Key themes that emerged were fulfilling both family and work responsibilities and the distinction between activities done
out of responsibility versus enjoyment. Although focus-group participants identified volunteerism and pet ownership as important
social-health-related concepts, these were not in our original conceptual model. The concept of satisfaction was often found
to overlap with the concept of performance.
Conclusion
Our conceptual model appears comprehensive but is being further refined to more appropriately (a) distinguish between responsibilities
versus discretionary activities, and (b) situate the outcome of satisfaction as it relates to impairment in social and other
domains of health.
Keywords Epidemiologic measurements - Focus groups - Outcome assessment (health care) - Qualitative research - Quality of life
L. D. Castel, R. F. DeVellis, D. A. DeWalt, D. E. Irwin, and K. Williams conceived of and designed the study. L. D. Castel,
D. E. Irwin, A. Stover, and K. A. Williams conducted the data collection. H. B. Bosworth, L. D. Castel, D. A. DeWalt, E.
A. Hahn, S. V. Eisen, M. A. R. Kelly, D. E. Irwin, A. Stover, J. Morse, and K. A. Williams carried out analysis and interpretation.
L. D. Castel created the initial draft of the article. H. B. Bosworth, R. F. DeVellis, D. A. DeWalt, E. A. Hahn, S. V. Eisen,
D. E. Irwin, M. A. R. Kelly, A. Stover, J. Morse, and K. A. Williams aided in subsequent drafting and critical revision.
D. A. DeWalt and R. F. DeVellis obtained funding. L. D. Castel held overall responsibility for this work. All authors read
and approved the final manuscript.