Health and Quality of Life Outcomes最新文献

{"title":"Time-dependent analysis of HUS change in older patients aged > 75 years with head and neck cancer.","authors":"Danni Cheng, Katrina Hueniken, Andrew Hope, Shao Hui Huang, Anna Spreafico, David P Goldstein, Scott V Bratman, Yu Zhao, Jianjun Ren, John R de Almeida, Wei Xu, Geoffrey Liu","doi":"10.1186/s12955-026-02551-7","DOIUrl":"https://doi.org/10.1186/s12955-026-02551-7","url":null,"abstract":"<p><strong>Background: </strong>Previous longitudinal evidence has suggested that patients aged > 75 years may be associated with a poorer Health Utility Index Mark 3 (HUI-3) trajectory. We compared the longitudinal health utility scores (HUS) of older (>75 years) versus younger patients with head and neck cancers across various clinical subgroups and identified factors associated with decline in quality of life.</p><p><strong>Methods: </strong>The study prospectively collected clinical information and follow-up data from head and neck cancer patients. The HUI-3 scale was used to assess changes in health-related quality of life at baseline, post-surgery, mid-radiation therapy, and at 3, 6, and 12 months. A linear mixed model was employed to evaluate the changes in HUS and age categories over time.</p><p><strong>Results: </strong>We included 859 patients with head and neck cancer, of whom 647 were included in the longitudinal analytic cohort. In descriptive analyses, patients aged > 75 years showed less complete recovery in mean HUS after early treatment-related decline compared with younger patients. In the primary mixed-effects model, younger age groups had more positive average HUS slopes than patients aged > 75 years. However, these age-related differences were attenuated and were no longer statistically supported after adjustment for clinical stage, Eastern Cooperative Oncology Group (ECOG) performance status, and treatment modality. Subgroup findings were exploratory and were not consistently supported across all model-based comparisons.</p><p><strong>Conclusion: </strong>Patients aged > 75 years may be at risk for slower or incomplete post-treatment recovery in HUI-3-derived health utility. These findings should be interpreted cautiously given potential selection bias, missing data, and attenuation after covariate adjustment. Larger studies with detailed geriatric and domain-specific functional measures are needed to confirm these patterns.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":"24 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of reallocating time between physical activity, sedentary behavior, and sleep with mental health among Chinese adolescents: an isotemporal substitution analysis.","authors":"Jian Wu, Yongji Gao, Xuejun Chi, Haiyang Feng, Qiurui Yu, Yongjin Chen, Jieqiong Qin, Yinmei Yang","doi":"10.1186/s12955-026-02611-y","DOIUrl":"10.1186/s12955-026-02611-y","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are important adolescent mental health concerns and may be linked to modifiable movement behaviors, including physical activity (PA), sedentary behavior (SB), and sleep. As mental health outcomes depend not only on time spent in specific behaviors but also on the trade-offs between them, this study examined the associations of reallocating 30 min between these behaviors with adolescent psychological symptoms.</p><p><strong>Methods: </strong>This cross-sectional study included 7,767 adolescents from Henan Province, Central China, in 2023. Daily PA, SB, and sleep duration were self-reported. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale, and anxiety symptoms were measured with the 7-item Generalized Anxiety Disorder Scale. Isotemporal substitution models estimated the associations of 30-minute reallocations with depressive and anxiety symptoms. Interaction tests and subgroup analyses were conducted according to sleep status.</p><p><strong>Results: </strong>Replacing 30 min of SB with sleep or PA was associated with lower levels of depression (sleep, B = -0.47, 95%CI = -0.53~-0.41; PA, B = -0.12, 95%CI = -0.16~-0.08) and anxiety (sleep, B = -0.31, 95%CI = -0.36~-0.25; PA, B = -0.07, 95%CI = -0.10~-0.04). Reallocating PA to sleep also related to reduced depressive symptoms (B = -0.35, 95%CI = -0.42~-0.28) and anxiety symptoms (B = -0.24, 95%CI = -0.30~-0.18). Among adolescents with insufficient sleep, the associations were stronger when reallocating SB to sleep (for depression: B = -0.52, 95%CI = -0.64~-0.39; for anxiety: B = -0.40, 95%CI = -0.50~-0.28) or PA to sleep (for depression: B = -0.39, 95%CI = -0.50~-0.25; for anxiety: B = -0.32, 95%CI = -0.41~-0.19). Among those with sufficient sleep, reallocating SB to PA or sleep remained associated with lower depressive symptoms, but no significant association was observed for anxiety.</p><p><strong>Conclusions: </strong>Reallocating time toward sleep and PA was associated with reduced depressive and anxiety symptoms, particularly among adolescents with insufficient sleep. Accounting for sleep status may help advance understanding of the associations between movement behavior reallocations and adolescent mental health.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":"24 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral health-related quality of life in patients receiving dental treatment from dental therapists.","authors":"Emma Louwagie, Michelle C Arnett, Aparna Ingleshwar, Mike T John, Danna R Paulson, Yvette G Reibel, Phonsuda Chanthavisouk","doi":"10.1186/s12955-026-02572-2","DOIUrl":"https://doi.org/10.1186/s12955-026-02572-2","url":null,"abstract":"<p><strong>Purpose: </strong>Oral health-related quality of life (OHRQoL) measured by the 5-item Oral Health Impact Profile (OHIP-5) allows characterization of patients' oral health impact into normative values in a university setting. This study aims to derive OHIP-5 normative values for patients seeking care from the dual degree student provider of the dental hygienist and dental therapist in Minnesota.</p><p><strong>Methods: </strong>Normative OHIP-5 values were determined in n = 2,835 patients at the University of Minnesota School of Dentistry, representing sample-based reference distributions. Summary scores were analysed using an empirical cumulative distribution function, with the 90th percentile threshold indicating typical versus elevated impact, while dimensional scores (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) assessed as elevated impact were considered frequent item response categories \"fairly often\" or \"very often\".</p><p><strong>Results: </strong>The vast majority (90%) of patients seeking care from the dual degree student providers presented an OHIP-5 score of 6 or less, characterizing OHIP-5 scores of 7-20 points as \"non-typically elevated\". The \"non-typically elevated\" dimension scores occurred in 7% of patients for Oral Function, 6% for Orofacial Pain, 11% for Orofacial Appearance, and 2% for Psychosocial Impacts.</p><p><strong>Conclusion: </strong>Understanding normative OHIP-5 values in patient populations treated by dual degree student providers in dental school settings supports clinical decision-making by guiding diagnostic, referral, and treatment pathways. Their role in preventive and restorative care advances patient-centered outcomes, aligning with the quadruple aim of healthcare.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in health-related quality of life across sociodemographic groups, health conditions, and modifiable risk factors: a population-based EQ-5D-3L study.","authors":"Mihretab Gebreslassie, Stefan Fors, Per Tynelius, Mathieu F Janssen, Sofia Sveréus, Emelie Heintz","doi":"10.1186/s12955-026-02587-9","DOIUrl":"10.1186/s12955-026-02587-9","url":null,"abstract":"<p><strong>Background: </strong>EQ-5D is widely used in economic evaluations and population health assessments. This study used a large population-based cohort with EQ-5D-3L data to describe the health-related quality of life (HRQoL) of the general population in Stockholm County and investigate potential inequalities and variations in HRQoL.</p><p><strong>Methods: </strong>This study analysed data from 52,714 respondents aged 23-104 years from the 2021 Stockholm Public Health Cohort (SPHC). Calibration weights were used to address non-response bias and improve representativeness. Differences in mean EQ-VAS and EQ-5D-3L index values were analyzed using multivariable regressions, and modified poison regression was used to explore the likelihood of reporting problems across the EQ-5D dimensions. Splines were used to flexibly model the nonlinear relationship between age and HRQoL.</p><p><strong>Results: </strong>A total of 169 health states were observed, with 37% of the respondents reporting \"no problems\" in all dimensions (\"11111\"). Further, 0.05% (n = 14) respondents reported the worst possible health state (\"33333\"). The HRQoL of the general population was generally good but variations across sociodemographic and risk factor groups were observed. HRQoL demonstrated a non-linear relationship with age, with relatively lower scores observed among the youngest adults, increasing through midlife, followed by a marked decline in older age, particularly among those aged 80 years and above. The mean EQ-5D-3 L index was lower among females (0.79 [95% CI: 0.79-0.80]) than males (0.83 [95% CI: 0.83-0.84]), and a similar pattern was observed for the mean EQ-VAS scores (75.96 [95% CI: 75.59-76.33] vs. 78.3 [95% CI: 77.62-78.42], respectively). People with lower education, low disposable income as well as those born outside of the European union and UK reported relatively lower HRQoL. Adjusting for age attenuated but did not eliminate these demographic and socioeconomic differences. Persistent associations between behavioural risk factors and HRQoL were also observed. Similarly, people with chronic health conditions, particularly those with long-term illness or multiple health conditions, exhibited markedly lower HRQoL.</p><p><strong>Conclusion: </strong>This study demonstrated substantial variations in HRQoL across sociodemographic groups, behavioural risk factors, and self-reported health conditions, providing insights that can inform healthcare planning and future investments in health and research. The results may also serve as reference values in clinical and economic evaluations, and for comparing outcomes from specific patient subgroups with the general population.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":"24 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowerment and quality of life through cancer prevention in people experiencing homelessness: evaluating the Health Navigator Model.","authors":"Tobias Fragner, Tamara Alhambra-Borrás, Ascensión Doñate-Martínez, Vicent Blanes-Selva, Juan M García-Gómez, Julia Gawronska, Maria Moudatsou, Ioanna Tabaki, Katerina Belogianni, Pania Karnaki, Miguel Rico Varadé, Rosa Gómez Trenado, Jaime Barrio-Cortes, Lee Smith, Alejandro Gil-Salmeron, Igor Grabovac","doi":"10.1186/s12955-026-02588-8","DOIUrl":"https://doi.org/10.1186/s12955-026-02588-8","url":null,"abstract":"<p><strong>Background: </strong>People experiencing homelessness (PEH) face significant barriers to accessing cancer prevention services. The CANCERLESS project co-developed and implemented the Health Navigator Model (HNM) - a person-centred approach using trained health navigators to provide tailored support, promote cancer awareness, and facilitate access to preventive services - in Austria, Greece, Spain, and the UK. This study examined the HNM's impact on healthcare empowerment, health-related quality of life (HRQoL), and self-rated health among PEH.</p><p><strong>Methods: </strong>This non-randomised, single-arm study included 652 PEH from 16 pilot sites in four European countries between June 2022 and December 2023. Healthcare empowerment, HRQoL, and self-rated health were assessed using the healthcare empowerment questionnaire and the EQ-5D-5L (including the EQ Visual Analogue Scale) when participants entered and completed the intervention. A per-protocol analysis with repeated measures ANOVA revealed changes over time and between countries.</p><p><strong>Results: </strong>Participants were predominantly male (64.1%) and middle-aged (mean 47.4, SD 13.8), with secondary education (58.0%), and varied legal status and experiences of homelessness. Despite a drop-out rate of 57.5%, significant improvements in overall healthcare empowerment (F = 44.325, p<.001, η²=0.026), HRQoL (F = 4.421, p = .036, η²=0.002), and self-rated health (F = 16.945, p<.001, η²=0.011) were observed, particularly in Austria and the UK.</p><p><strong>Conclusions: </strong>The HNM holds promise for improving healthcare empowerment and HRQoL among PEH, but context-specific factors and a considerable drop-out pose challenges.</p><p><strong>Trial registration: </strong>This study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EQ-5D vision bolt-on in macular degeneration: associations with visual measures and effect on utility differences and cost-effectiveness of stereotactic radiotherapy.","authors":"Xuemin Zhu, Sarah Wordsworth, Chan Ning Lee, Hatem A Wafa, Yanzhong Wang, Riti Desai, Lisa Ramazzotto, Barnaby C Reeves, Timothy L Jackson, Helen Dakin","doi":"10.1186/s12955-025-02457-w","DOIUrl":"10.1186/s12955-025-02457-w","url":null,"abstract":"<p><strong>Background: </strong>The UK STAR trial [Stereotactic Radiotherapy (SRT) for neovascular age-related macular degeneration (nAMD)] compared 16-Gray SRT (n = 274) with double-masked sham SRT (n = 137) in participants with chronic active nAMD. SRT reduced intravitreal anti-vascular endothelial growth factor (VEGF) re-treatments over two years of pro re nata ranibizumab, followed by two years of routine care. However, this resulted in worse best-corrected visual acuity (BCVA) in Years 3 and 4. This paper describes: associations between the EQ-5D vision bolt-on and visual acuity and patient-reported outcome measures; the impact of SRT on utilities with and without vision bolt-on; how the vision bolt-on affects the cost-effectiveness of SRT plus anti-VEGF versus anti-VEGF alone.</p><p><strong>Methods: </strong>Using data from the entire STAR trial cohort, we compared mean BCVA, EQ-5D-5L, and Visual Function Questionnaire-25 (VFQ-25) scores across the three levels of the EQ-5D vision bolt-on. We examined the relationship between BCVA and EQ-5D (with/without the bolt-on) and VFQ-25. An economic evaluation estimated the cost-effectiveness of SRT from a UK national health service perspective over two years and over four years. This used prospective data on EQ-5D-5L and eye-related direct healthcare use.</p><p><strong>Results: </strong>Participants reporting vision problems on the bolt-on had significantly worse BCVA, EQ-5D-5L, and VFQ-25 scores than those who did not. EQ-5D utilities (with and without the bolt-on) increased with BCVA but showed weaker correlations than VFQ-25 composite scores. Quality-adjusted life years (QALYs) did not differ significantly between treatment groups, with or without the bolt-on. The economic evaluation suggested SRT would reduce healthcare costs by £404 (95% CI: -£1282 to £2092) per patient at a four-year time horizon. The probability of SRT plus anti-VEGF being cost-effective at a £20,000 per QALY threshold was 65% at a four-year time horizon. Sensitivity analyses confirmed the robustness of incorporating the vision bolt-on did not alter the cost-effectiveness conclusion.</p><p><strong>Conclusions: </strong>Resource use data from the trial and routine follow-up could be used for future economic models. The vision bolt-on captured quality of life differences between participants but may not be sufficiently responsive to visual acuity decline in trials where only one eye is treated.</p><p><strong>Trial registration: </strong>ISRCTN12884465, registration date 01/12/2014.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":"24 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative testing of potential modifications to the EQ-HWB-9 in the United Kingdom.","authors":"Tessa Peasgood, Victoria Gale, Aisha Moolla, Jill Carlton, Clara Mukuria","doi":"10.1186/s12955-026-02578-w","DOIUrl":"https://doi.org/10.1186/s12955-026-02578-w","url":null,"abstract":"<p><strong>Background: </strong>The Experimental EQ Health and Wellbeing 9 (EQ-HWB-9) is a generic measure developed to assess the impact of health, social care and informal caregiving on quality of life. Several modifications have been proposed based on emerging evidence. This study aimed to assess the content validity of these modifications and user preferences.</p><p><strong>Method: </strong>Individuals with a long-standing physical or mental health condition or disability were invited from an online panel ensuring gender balance and age coverage. Two interviewers conducted semi-structured cognitive interviews to assess comprehensibility, relevance, and comprehensiveness of the modified experimental EQ-HWB-9 v1.2. Participants' views on differences between the modified and original experimental versions, as well as their preferences, were explored. Interviews were conducted via videoconferencing, recorded and transcribed verbatim. Framework analysis was used to code interviews, with themes drawn from the literature and data.</p><p><strong>Results: </strong>Twenty-six interviews were completed. Half the participants were female; participant age ranged from 24 to 68 years. Six of the nine items ('activities', 'exhausted', 'lonely', 'difficulty concentrating/thinking clearly', 'anxious', 'sad/depressed') were understood as intended by all participants. Some comprehension issues arose with the 'mobility' and 'pain_severity' items. Participants generally preferred the modified version, though a clear majority was not always observed. Justifications focused on item appropriateness, readability and distress.</p><p><strong>Discussion and conclusion: </strong>As a generic measure, EQ-HWB-9 v1.2 performed well for comprehension, relevance and comprehensiveness. Modifications were well accepted and, except for the use of item stem, preferred over the original version. These findings will be combined with other international evidence to support finalising the instrument.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cough burden in progressive pulmonary fibrosis: a systematic review with narrative synthesis.","authors":"Ningxia Yu, Shuguang Yang, Zhihui Liang, Haiyang Hu, Yi Zhang, Luguang Li, Xueqing Yu","doi":"10.1186/s12955-026-02585-x","DOIUrl":"https://doi.org/10.1186/s12955-026-02585-x","url":null,"abstract":"<p><strong>Background: </strong>Cough is a common and burdensome symptom in patients with progressive pulmonary fibrosis (PPF), yet existing evidence remains fragmented. This systematic review provides a synthesis of available evidence on cough in PPF, specifically examining its association with health-related quality of life (HRQoL), the instruments used to assess cough, current treatment evidence, and identifies priorities for future research.</p><p><strong>Methods: </strong>We searched the Embase, PubMed, Cochrane, and Web of Science (WOS) databases from their inception to January 12, 2026, for studies focusing on the burden of cough in patients with PPF. We extracted information on study details, participant features, and outcome measures, and assessed the risk of bias in the included studies. A narrative synthesis was then performed to summarize the evidence.</p><p><strong>Results: </strong>Of 11,683 records, 9 studies met inclusion criteria. Cough was most frequently assessed using VAS and LCQ, while HRQoL was primarily measured with SGRQ and L-PF. Two studies highlighted wearable devices for objective cough monitoring. Antifibrotic therapy showed no consistent or statistically significant benefit on cough in descriptive synthesis. Qualitative studies revealed substantial cough‑related burden, including daily activity limitations, fatigue, and social embarrassment. Regarding economic impact, although no dedicated studies exist, one study indicated that cough severity was associated with workplace productivity loss.</p><p><strong>Conclusions: </strong>Cough negatively impacts HRQoL in PPF, but evidence is limited by heterogeneous tools and lack of economic studies. Standardized assessment and targeted research on cough management and its economic impact are urgently needed.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual preferences for the design of a health coaching-based lifestyle promotion program among middle-aged adults in Hong Kong: a discrete choice experiment.","authors":"Kailu Wang, Cassie Cheuk Ling Lee, Gengcong Qu, Cyrus Tak Ka Tang, Hei Hang Edmund Yiu, Xue Yang, Carmen Ka Man Wong, Samuel Yeung-Shan Wong, Benjamin Hon Kei Yip","doi":"10.1186/s12955-026-02584-y","DOIUrl":"https://doi.org/10.1186/s12955-026-02584-y","url":null,"abstract":"<p><strong>Objectives: </strong>Health coaching is an effective approach to motivating lifestyle modifications and preventing the onset of non-communicable diseases. This study aims to examine middle-aged adults' preferences for health coaching programs to improve public acceptance of these programs.</p><p><strong>Methods: </strong>A discrete choice experiment (DCE) was conducted among adults aged 35-59 years in Hong Kong who were recruited from a population-based cohort established to evaluate outcomes related to long COVID. The DCE attributes and levels were selected based on a literature review and qualitative interviews (n = 10) with users and providers from a local health coaching program. The selected attributes included program duration, delivery mode of coaching sessions, frequency of coaching sessions, availability of blood tests, core program format, smartwatch usage, and out-of-pocket payment. An online survey with 10 choice sets was conducted to collect participants' choices regarding health coaching services with (copayment scenario, 10 choices) and without out-of-pocket payment (no copayment scenario, 10 choices). A mixed logit model and a latent class model were used for the analysis.</p><p><strong>Results: </strong>A total of 912 responses were collected, of which 554 valid records were included in the analysis. In the copayment scenario, participants preferred programs that provided a smartwatch and a lower copayment rate. In the no copayment scenario, participants preferred a moderate coaching frequency, communication via phone calls or text messages, and provision of a smartwatch. Distinct preference groups were identified, including those who preferred face-to-face versus remote modes of delivery, high versus low contact frequency, and those who were sensitive versus insensitive to cost.</p><p><strong>Conclusions: </strong>Lower copayment and smartwatch provision improve acceptance of health coaching programs. Substantial preference heterogeneity for program duration, health coaching frequency, and delivery mode was found. While material incentives are important for improving acceptance of health coaching, considerable preference heterogeneity for non-monetary attributes suggests that options for health coaching program intensity can be offered along with subsidies or lower out-of-pocket payment to promote these services.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative testing of potential modifications to the EQ-HWB-9 v1.2 in adults with mobility problems in the United Kingdom.","authors":"Aisha Moolla, Jill Carlton, Tessa Peasgood","doi":"10.1186/s12955-026-02577-x","DOIUrl":"https://doi.org/10.1186/s12955-026-02577-x","url":null,"abstract":"<p><strong>Background: </strong>The EQ-Health and Wellbeing (EQ-HWB) is a generic measure assessing the impact of health, social care, and informal caregiving on quality of life. The 9-item short form, the EQ-HWB-9 v1.1 (experimental, 2022), underwent international validation, with subsequent modifications to item wording, response options, layout, and item order resulting in the EQ-HWB-9 v1.2 (experimental modified, 2024). This study aimed to assess the content validity of this version in individuals with mobility problems.</p><p><strong>Methods: </strong>Twelve adults in the UK with self-reported health conditions and mobility problems participated in semi-structured interviews. Participants described their health experiences, reviewed each EQ-HWB-9 v1.2 item, and compared potential further modifications to the 'mobility' item wording and 'cognition' response options. Comprehension, relevance, comprehensiveness and preferences were explored using verbal probing. Interviews were transcribed and analysed using framework analysis, guided by content validity domains, with double-coding for 25% of transcripts to ensure alignment.</p><p><strong>Results: </strong>Participants (age 35-79 years) reported 35 health conditions. Eight items were understood as intended by all participants. The 'mobility' item presented varied interpretations (home-based limitations, daily activities, or aid use, n = 4), highlighting the need for an illustrative example, though no single wording was universally preferred. For 'cognition', participants understood both frequency and difficulty response scales; preferences were split, indicating no required modifications. Some overlap between items was noted ('mobility'-'activities', 'cognition'-'exhaustion'/'anxiety'/'pain'), but participants did not perceive redundancy and valued separate items for nuanced measurement. Most items were considered relevant, and participants suggested additional content on medical management, support, mental health impact, and free-text contextualisation. The seven-day recall period and instructions were generally well understood.</p><p><strong>Conclusion: </strong>The EQ-HWB-9 v1.2 demonstrates good content validity in a sample of patients with mobility problems, with most items comprehensible and relevant. The 'mobility' item would benefit from an example to reduce interpretive variability, while 'cognition' response options are appropriate. Some item overlap is expected in complex health populations, yet distinctions between items are meaningful. Participants highlighted the importance of healthcare experiences in quality-of-life assessment. These results inform instrument refinement, but final changes should integrate broader evidence from global validation studies across other populations and languages.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}