Development and content validity of the Abilitator: a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position

Abstract

Background: The unemployed have lower work ability and poorer health than the employed. This situation deteriorates when unemployment continues. The long-term unemployed often have co-morbidities and face many other challenges. This increases the need for a multidimensional assessment of work ability and functioning in different service settings. In this study, we describe the development and analyse the content validity of the Abilitator, a self-report questionnaire on work ability and functioning for those in a weak labour market position. Methods: The Abilitator was developed in 2014-2017. Its construct was assessed by members of academic expert panels (n = 30), practical expert panels of professionals (n = 700) and target group clients (n = 28). The structure and the content of the questionnaire was co-developed in 29 workshops and adjusted twice based on the expert panels' feedback. The Abilitator was also implemented among target group clients (n = 3360) in different services and projects. During its development the Abilitator was linked to the International Classification of Functioning, Disability and Health (ICF). The content validation process followed the guidelines recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel. Results: The construct of the Abilitator combines the multidimensional and biopsychosocial models of work ability and functioning. It also includes aspects of social inclusion and employability. It evaluates social, psychological, cognitive and physical functioning, and the ability to cope with everyday life. The content of these concepts was validated by the academic and practical expert panels. The Abilitator's 79 ICF codes covered 57% of the Generic, 77% of the Brief Vocational Rehabilitation, and 8% of the Minimal Environmental ICF Core Sets. When compared with the Work Ability Index (WAI) and the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the direct equivalences of the ICF codes were 36 and 44%, respectively. Conclusion: The Abilitator sufficiently comprehensively covers the relevant aspects to enable the assessment of the overall work ability and functioning of the population in a weak labour market position.

The concurrent validity of the Abilitator: a self-assessment questionnaire on functioning and work ability

“…Üstün et al (2010) emphasize that all standard instruments for measuring disability and health need to be linked both conceptually and operationally to the ICF to allow comparisons across different cultures and populations. The content of the Abilitator has been linked to ICF codes to enable these juxtapositions (Wikström et al 2020).…”

“…In this study, we assessed the relationships between four similar measures of interest. To ascertain the concurrent validity of the Abilitator, a cross-sectional study was conducted that compared the measures of functioning of the Abilitator (Wikström et al 2020) with those obtained by the HAD scale, RAND-36, EQ-5D, and WHODAS 2.0 (short version). We also wanted to determine whether the correlations differed according to gender and age group.…”

“…The Abilitator was developed in 2015-2018 as part of a European Social Fund coordination project called Social Inclusion and Changes in Work Ability and Functioning (Solmu). The Abilitator is a self-assessment method that comprises questions grouped into well-being categories, including perceived work ability and different aspects of functioning (psychological, cognitive and social functioning, physical condition, and ability to cope with everyday activities) (Wikström et al 2020). Because it is not a diagnostic method, it has no golden standard or specific cut-off values.…”

“…However, functioning has multidimensional exposures and it is difficult to find exact, absolute measures for them. Although the results concerning the content validity of the Abilitator have been promising (Wikström et al 2020), the Abilitator needs further evaluation of its concurrent validity and its suitability for use in research in particular. We hypothesized that the Abilitator's social inclusion aspect would correlate strongly with the social functioning aspect of the RAND-36-item Health Survey 1.0 (RAND-36), and its psychological functioning aspect with the anxiety and depression aspects of the Hospitality Anxiety and Depression (HAD).…”

Intrarater reliability of the Abilitator—a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position: a test–retest study

“…The Abilitator is a generic, multidimensional PROM for measuring the self-reported work ability and functioning of the population in a weak labour market position. 33 34 It consists of a digital questionnaire 34 ( online supplemental file 1 ), analyses the responses and produces two kinds of reports: an individual written feedback report for the respondent ( online supplemental file 2 ) and a group-level report ( online supplemental file 3 ). The group-level report can be constructed by the user organisation from their accumulated data in the Abilitator’s digital service, in either a cross-sectional or longitudinal setting.…”