How will the sustainable development goals deliver changes in well-being? A systematic review and meta-analysis to investigate whether WHOQOL-BREF scores respond to change

Abstract

IntroductionThe Sustainable Development Goals (SDGs) 2015 aim to ‘…promote well-being for all’, but this has raised questions about how its targets will be evaluated. A cross-cultural measure of subjective perspectives is needed to complement objective indicators in showing whether SDGs improve well-being. The WHOQOL-BREF offers a short, generic, subjective quality of life (QoL) measure, developed with lay people in 15 cultures worldwide; 25 important dimensions are scored in environmental, social, physical and psychological domains. Although validity and reliability are demonstrated, clarity is needed on whether scores respond sensitively to changes induced by treatments, interventions and major life events. We address this aim.MethodsThe WHOQOL-BREF responsiveness literature was systematically searched (Web of Science, PubMed, EMBASE and Medline). From 117 papers, 15 (24 studies) (n=2084) were included in a meta-analysis. Effect sizes (Cohen’s d) assessed whether domain scores changed significantly during interventions/events, and whether such changes are relevant and meaningful to managing clinical and social change.ResultsScores changed significantly over time on all domains: small to moderate for physical (d=0.37; CI 0.25 to 0.49) and psychological QoL (d=0.22; CI 0.14 to 0.30), and small for social (d=0.10; CI 0.05 to 0.15) and environmental QoL (d=0.12; CI 0.06 to 0.18). More importantly, effect size was significant for every domain (p<0.001), indicating clinically relevant change, even when differences are small. Domains remained equally responsive regardless of sample age, gender and evaluation interval.ConclusionInternational evidence from 11 cultures shows that all WHOQOL-BREF domains detect relevant, meaningful change, indicating its suitability to assess SDG well-being targets.

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Does Subjective Health Affect the Association between Biodiversity and Quality of Life? Insights from International Data

“…It is therefore plausible that both life qualities are linked to objectively poor material conditions ( (Chambers, 2003); p170), so underscoring the need to compare subjective and objective indictors. These results signal that environmental QoL may be especially responsive to poverty impact, rather than flagging a potential measurement problem for this internationally validated environmental QoL domain (Skevington & Epton, 2018), but this should be monitored. We recommend that self-assessed poverty is routinely collected alongside subjective QoL and health, in future environment and conservation studies.…”