Psychometric evaluation of the functional assessment of HIV Infection (FAHI) questionnaire and its usefulness in clinical trials

Viala-Danten, Muriel; Dubois, Dominique; Gilet, Hélène; Martin, S.; Peeters, Katrien; Cella, David

doi:10.1007/s11136-010-9674-9

Cited by 21 publications

(27 citation statements)

References 43 publications

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“…Compared to other studies which utilized FAHI [19, 24, 25], the baseline levels of HRQoL were relatively high in our study. This may have been explained by the fact that baseline assessments were conducted during the acute infection phase and participants had already been receiving care in prevention studies while HIV uninfected.…”

Section: Discussioncontrasting

confidence: 70%

Health-Related Quality of Life Dynamics of HIV-positive South African Women up to ART Initiation: Evidence from the CAPRISA 002 Acute Infection Cohort Study

et al. 2013

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Few studies have investigated the long-term dynamics in health-related quality of life (HRQoL) among HIV-positive persons from acute infection. From 2004, 160 women were enrolled into the CAPRISA 002 Acute Infection study at two sites in the province of KwaZulu-Natal and underwent 3–6 monthly HRQoL assessments using the functional assessment of HIV infection (FAHI) instrument. Overall and 5 sub-scale FAHI scores [physical well-being (PWB), emotional well-being (EWB), functional and global well-being (FGWB), social well-being (SWB) and cognitive functioning (CF)] were calculated up to antiretroviral therapy (ART) initiation and scores at enrollment were compared to the acute, early and established infection phases. Mixed-effects regression models adjusting for behavioral and clinical factors were applied to assess HRQoL trends and the proportion of women meeting minimally important differences was calculated. Our analyses revealed that overall/sub-scale scores improved over time, except from PWB and CF. A higher educational status, contraceptive use and a higher BMI were the strongest predictors of higher overall/sub-scale FAHI scores. CD4 count and HIV viral load were strongly associated with PWB and CF, but not overall FAHI and other sub-scales. Women newly diagnosed with acute HIV infection face profound HRQoL challenges. While early ART delivery may be important for PWB and CF, factors such as education, contraception provision and good nutritional status should be promoted to maximize HRQoL in HIV positive individuals.

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Section: Discussioncontrasting

confidence: 70%

Health-Related Quality of Life Dynamics of HIV-positive South African Women up to ART Initiation: Evidence from the CAPRISA 002 Acute Infection Cohort Study

et al. 2013

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“…Although Cronbach’s alpha estimates higher than 0.7 are recommended for group comparison [13, 44], our alpha estimates in the SWB and EWB (0.66, 0.67 respectively) were slightly below the 0.70 estimate, yet remain within the acceptable range. Good alpha estimates were observed in the PWB, FWB and the overall scale.…”

Section: Discussioncontrasting

confidence: 55%

“…The internal consistency of the total scale in these studies was invariably excellent (Cronbach’s α range 0.91–0.92) [17, 22, 30–32]. The subscale α coefficients ranged from 0.72–0.92 with the exception of the cognitive function (CF) domain in two studies from South Africa whose α coefficients were slightly below the recommended 0.70 (Cronbach’s α values of 0.65 and 0.60) [13, 17, 22, 30–33]. None of these seven studies reported the test-retest reliability of the FAHI.…”

Section: Resultsmentioning

confidence: 99%

“…Evaluating HRQoL of patients in HIV clinical trials and practice may provide important complementary information to disease parameters like CD4 cell count or viral load that evaluate HIV progression but do not capture the patient’s experience of treatment benefit [13]. To do this requires adequately validated and psychometrically sound measures of HRQoL in areas with a high HIV burden.…”

Section: Introductionmentioning

confidence: 99%

“…We selected FAHI as our preferred measure among the HRQoL assessment instruments. The FAHI questionnaire is an HIV specific adaptation of the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire [13, 17]. It is a 47-item self-report questionnaire that assesses HIV-specific quality of life in five domains: Physical Well Being (PWB), Emotional Well Being (EWB), Functional and Global Well Being (FWB), Social Well Being (SWB), and Cognitive Functioning (CF).…”

Section: Introductionmentioning

confidence: 99%

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A mixed methods approach to adapting and evaluating the functional assessment of HIV infection (FAHI), Swahili version, for use with low literacy populations

et al. 2017

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BackgroundDespite bearing the largest HIV-related burden, little is known of the Health-Related Quality of Life (HRQoL) among people living with HIV in sub-Saharan Africa. One of the factors contributing to this gap in knowledge is the lack of culturally adapted and validated measures of HRQoL that are relevant for this setting.AimsWe set out to adapt the Functional Assessment of HIV Infection (FAHI) Questionnaire, an HIV-specific measure of HRQoL, and evaluate its internal consistency and validity.MethodsThe three phase mixed-methods study took place in a rural setting at the Kenyan Coast. Phase one involved a scoping review to describe the evidence base of the reliability and validity of FAHI as well as the geographical contexts in which it has been administered. Phase two involved in-depth interviews (n = 38) to explore the content validity, and initial piloting for face validation of the adapted FAHI. Phase three was quantitative (n = 103) and evaluated the internal consistency, convergent and construct validities of the adapted interviewer-administered questionnaire.ResultsIn the first phase of the study, we identified 16 studies that have used the FAHI. Most (82%) were conducted in North America. Only seven (44%) of the reviewed studies reported on the psychometric properties of the FAHI. In the second phase, most of the participants (37 out of 38) reported satisfaction with word clarity and content coverage whereas 34 (89%) reported satisfaction with relevance of the items, confirming the face validity of the adapted questionnaire during initial piloting. Our participants indicated that HIV impacted on their physical, functional, emotional, and social wellbeing. Their responses overlapped with items in four of the five subscales of the FAHI Questionnaire establishing its content validity. In the third phase, the internal consistency of the scale was found to be satisfactory with subscale Cronbach’s α ranging from 0.55 to 0.78. The construct and convergent validity of the tool were supported by acceptable factor loadings for most of the items on the respective sub-scales and confirmation of expected significant correlations of the FAHI subscale scores with scores of a measure of common mental disorders.ConclusionThe adapted interviewer-administered Swahili version of FAHI questionnaire showed initial strong evidence of good psychometric properties with satisfactory internal consistency and acceptable validity (content, face, and convergent validity). It gives impetus for further validation work, especially construct validity, in similar settings before it can be used for research and clinical purposes in the entire East African region.

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Longitudinal assessment of health related quality of life of HIV infected patients treated for tuberculosis and HIV in a high burden setting

Mthiyane

Pym²,

Dheda

et al. 2016

Qual Life Res

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Psychometric evaluation of the functional assessment of HIV Infection (FAHI) questionnaire and its usefulness in clinical trials

Abstract: The FAHI demonstrated acceptable psychometric properties in two independent populations. HRQL assessment enabled detection of changes in patients' health status not revealed by traditional efficacy endpoints.

Cited by 21 publications

References 43 publications

Health-Related Quality of Life Dynamics of HIV-positive South African Women up to ART Initiation: Evidence from the CAPRISA 002 Acute Infection Cohort Study

Health-Related Quality of Life Dynamics of HIV-positive South African Women up to ART Initiation: Evidence from the CAPRISA 002 Acute Infection Cohort Study

A mixed methods approach to adapting and evaluating the functional assessment of HIV infection (FAHI), Swahili version, for use with low literacy populations

Longitudinal assessment of health related quality of life of HIV infected patients treated for tuberculosis and HIV in a high burden setting

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