{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T02:10:54Z","timestamp":1788660654838,"version":"build-2803163510"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":60,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000858","name":"University of Sheffield","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["218462\/Z\/19\/Z"],"award-info":[{"award-number":["218462\/Z\/19\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006419","name":"EuroQol Research Foundation","doi-asserted-by":"publisher","award":["EQ Research Project 1892-RA"],"award-info":[{"award-number":["EQ Research Project 1892-RA"]}],"id":[{"id":"10.13039\/501100006419","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Health Qual Life Outcomes"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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 EMV2.1 (experimental modified, 2025). This study aimed to assess the content validity of this version in individuals with mobility problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 EMV2.1 item, and compared potential further modifications to the \u2018mobility\u2019 item wording and \u2018cognition\u2019 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants (age 35\u201379 years) reported 35 health conditions. Eight items were understood as intended by all participants. The \u2018mobility\u2019 item presented varied interpretations (home-based limitations, daily activities, or aid use, n\u2009=\u20094), highlighting the need for an illustrative example, though no single wording was universally preferred. For \u2018cognition\u2019, participants understood both frequency and difficulty response scales; preferences were split, indicating no required modifications. Some overlap between items was noted (\u2018mobility\u2019-\u2018activities\u2019, \u2018cognition\u2019-\u2018exhaustion\u2019\/\u2019anxiety\u2019\/\u2019pain\u2019), 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The EQ-HWB EMV2.1 demonstrates good content validity in a sample of patients with mobility problems, with most items comprehensible and relevant. The \u2018mobility\u2019 item would benefit from an example to reduce interpretive variability, while \u2018cognition\u2019 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12955-026-02577-x","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:48:43Z","timestamp":1783417723000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative testing of potential modifications to the EQ-HWB EMV2.1 in adults with mobility problems in the United Kingdom"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-5389","authenticated-orcid":false,"given":"Aisha","family":"Moolla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Carlton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Peasgood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"issue":"4","key":"2577_CR1","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/j.jval.2022.01.009","volume":"25","author":"J Brazier","year":"2022","unstructured":"Brazier J, Peasgood T, Mukuria C, Marten O, Kreimeier S, Luo N, et al. The EQ-HWB: Overview of the Development of a Measure of Health and Wellbeing and Key Results. Value Health. 2022;25(4):482\u201391. https:\/\/doi.org\/10.1016\/j.jval.2022.01.009 . PubMed PMID: 35277337.","journal-title":"Value Health"},{"issue":"4","key":"2577_CR2","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/j.jval.2021.12","volume":"25","author":"J Carlton","year":"2022","unstructured":"Carlton J, Peasgood T, Mukuria C, Connell J, Brazier J, Ludwig K, et al. Generation, Selection, and Face Validation of Items for a New Generic Measure of Quality of Life: The EQ-HWB. Value Health. 2022;25(4):512\u201324. https:\/\/doi.org\/10.1016\/j.jval.2021.12. .007 PubMed PMID: 35227597.","journal-title":"Value Health"},{"issue":"4","key":"2577_CR3","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.jval.2021.11.1361","volume":"25","author":"T Peasgood","year":"2022","unstructured":"Peasgood T, Mukuria C, Brazier J, Marten O, Kreimeier S, Luo N, et al. Developing a New Generic Health and Wellbeing Measure: Psychometric Survey Results for the EQ-HWB. Value Health. 2022;25(4):525\u201333. .1361 PubMed PMID: 35365299.","journal-title":"Value Health"},{"issue":"5","key":"2577_CR4","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1007\/s11136-018-1829-0","volume":"27","author":"CB Terwee","year":"2018","unstructured":"Terwee CB, Prinsen CAC, Chiarotto A, Westerman MJ, Patrick DL, Alonso J, et al. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. 2018;27(5):1159\u201370. https:\/\/doi.org\/10.1007\/s11136-018-1829-0.","journal-title":"Qual Life Res"},{"issue":"9","key":"2577_CR5","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","volume":"89","author":"BC O\u2019Brien","year":"2014","unstructured":"O\u2019Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245\u201351. 10. 1097\/ACM.0000000000000388 PubMed PMID: 24979285.","journal-title":"Acad Med"},{"issue":"9","key":"2577_CR6","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.1093\/pm\/pnx310","volume":"19","author":"R Kendall","year":"2018","unstructured":"Kendall R, Wagner B, Brodke D, Bounsanga J, Voss M, Gu Y, et al. The Relationship of PROMIS Pain Interference and Physical Function Scales. Pain Med. 2018;19(9):1720\u20134. https:\/\/doi.org\/10.1093\/pm\/pnx310 . PubMed PMID: 29228284; PubMed Central PMCID: PMC6127232.","journal-title":"Pain Med"},{"issue":"8","key":"2577_CR7","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1111\/j.1365-2850.2011.01735.x","volume":"18","author":"D Stevanovic","year":"2011","unstructured":"Stevanovic D. Quality of Life Enjoyment and Satisfaction Questionnaire \u2013 short form for quality of life assessments in clinical practice: a psychometric study. J Psychiatr Ment Health Nurs. 2011;18(8):744\u201350. https:\/\/doi.org\/10.1111\/j.1365-2850.2011.01735.x.","journal-title":"J Psychiatr Ment Health Nurs"},{"issue":"7","key":"2577_CR8","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1177\/0269216310373166","volume":"24","author":"S Aoun","year":"2010","unstructured":"Aoun S, Bird S, Kristjanson LJ, Currow D. Reliability testing of the FAMCARE-2 scale: measuring family carer satisfaction with palliative care. 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J Pain Symptom Manag. 2002;23(6):458\u201370. https:\/\/doi.org\/10.1016\/S0885-3924(02)00409-8.","journal-title":"J Pain Symptom Manag"}],"container-title":["Health and Quality of Life Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12955-026-02577-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-026-02577-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-026-02577-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T02:02:29Z","timestamp":1788660149000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12955-026-02577-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2577"],"URL":"https:\/\/doi.org\/10.1186\/s12955-026-02577-x","relation":{},"ISSN":["1477-7525"],"issn-type":[{"value":"1477-7525","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"31 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval was granted by the University of Sheffield (approval number: 064729). All participants provided electronic informed consent prior to participation.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants have consented for this work to be published.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"TP is a member of the EuroQoL Group and part of the EuroQoL EQ-HWB Working Group. TP and JC have received funding from the EuroQol Research Foundation.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"110"}}