Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104583

Richard D. Hector, MA, MPH, Health Services Research, University of California, Los Angeles, PO Box 951772, Los Angeles, CA 90095-1772, (310) 439 - 2724, rhectori@ucla.edu and John P. Anderson, PhD, Family and Preventive Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0622.

Evidence for validity of the Quality of Well-being Scale (QWB) is developed in a probability survey of Trinidad and Tobago. QWB scores range from 0.0 for dead to 1.0 for asymptomatic full function. QWB results were compared with a US probability sample. This Caribbean nation has a population of Indian and African descent. Most persons reside in three locations: Port of Spain in the north, Chaguanas (centrally located) and San Fernando in the south.

The Central Statistical Office (CSO) of Trinidad and Tobago developed the sampling frame and provided interviewers for this cross-sectional study. The Ministry of Health (MOH) provided interviewers and data management staff. Interviewers administered the QWB, obtained data for local preference weights and obtained demographic information from one adult respondent per household. Multivariable linear regression (MLR) was used for statistical adjustment. Committees for the Protection of Human Subjects at San Diego State University and the MOH approved the study.

Two hundred and forty-three households were surveyed. The demographic breakdown was similar to the census of Trinidad and Tobago, but very different from that of the US. The overall QWB average for adults was 0.769, as compared to 0.784 for the San Diego population. The regression model had an R-square of 0.29. Grouped t-tests showed the US and Trinidad and Tobago samples were not different on QWB score (two-tailed p=0.165), or its component parts -- Symptom/Problem Complex weight (p=0.177) or Dysfunction weight (p=0.331). Income was positively related to average QWB. Younger respondents had higher a QWB average than older respondents. With each 10-year increase in age the average QWB decreased by 0.03. The mean QWB did not differ by type of interviewer, by education, location or race. These findings did not change with adjustment. Local preference weights were not calculated.

The study provides evidence for the validity of QWB results in this setting. The QWB showed similar relations with population variables that it has displayed in US applications. In both samples the HRQL was statistically similar, indicating that persons in Trinidad and Tobago enjoy similar HRQOL as persons in the US. As in other settings, average QWB scores increased with income and decreased with age. Policy makers in this country can use the QWB for cost-effectiveness analysis and to prioritize programs. Future work will calculate local preference weights to determine whether different decisions might be made.

Learning Objectives:

• List the steps to establish evidence for validity of the QWB in Trinidad & Tobago.
• Articulate the procedures for evidence of validity of the QWB in a developing country.
• Apply the QWB to cost-effectiveness analyses in Trinidad and Tobago.
• Compare HRQOL in the US and Trinidad and Tobago.

Keywords: Outcomes Research, Health Service

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.