311 research outputs found

    Design and delivery of a national pilot survey of capabilities

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    Understanding the numbers of people with different levels of ability in the population is important for informing design decisions for mainstream products, but a survey dataset for this purpose does not exist. This paper describes a key step towards obtaining such data. It describes a pilot survey of 362 people across England and Wales in preparation for a full national survey. Information was gathered on vision, hearing, hand and arm function, mobility, cognitive function, product use, psychological characteristics, anthropometrics and demographics. An interesting finding is that of those participants who reported any limitations in daily activities due to capability loss, 44% reported limitations due to loss of more than one capability. This finding highlights the importance of measuring multiple capabilities in a single survey. Top-level lessons learnt include: simplifying vision tests; reducing exclusion criteria for some of the tests; adopting a stratified sampling approach; and allocating more training for interviewers.This research was funded by the Engineering and Physical Sciences Research Council grant (Award Number: RG45089).This is the accepted version of the article. The final version is available fro Inderscience at http://inderscience.metapress.com/content/fk41618325n25741/

    Brief cognitive assessment in a UK population sample – distributional properties and the relationship between the MMSE and an extended mental state examination

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    BACKGROUND: Despite the MMSE's known flaws, it is still used extensively as both a screening instrument for dementia and a population measure of cognitive ability. The aim of this paper is to provide data on the distribution of MMSE scores in a representative sample from the UK population and to compare it with an extended cognitive assessment (EMSE) which covers a wider range of cognitive domains and provides a wider range of difficulty levels. METHODS: The MMSE and the EMSE were administered to over 12,000 participants at the screening stage of the MRC Cognitive Function and Ageing Study (MRC CFAS). MRC CFAS is a multi-centre population-based study in England and Wales with respondents aged 65 years and older. RESULTS: Normative values on the MMSE and EMSE are presented by age group, sex and level of education. There are very large differences between age groups, with smaller differences seen between the sexes and by level of education. The EMSE extends the scores at the high end of the ability range, but is no better than the MMSE at differentiating between dementia and non-dementia. CONCLUSION: Population-derived norms are valuable for comparing an individual's score to the score that would be expected among the general population, given the individual's specific demographic characteristics

    Wellbeing: The Challenge of ‘Operationalising’ an Holistic Concept within a Reductionist Public Health Programme

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    Background Wellbeing is a concept that, whilst contested, recognises individual and wider social, economic, political and environmental contextual influences – and is of growing interest and relevance locally and globally. In this paper, we report on one aspect of an evaluative research study conducted on a public health programme in North West England. Aims Within the context of a process evaluation that explored the delivery of a public health programme and sought to increase understanding of how and why different approaches worked well or not so well, this paper focuses specifically on the concept of wellbeing, examining perceptions of multiple stakeholders. Methods Interviews and focus groups were undertaken with 52 stakeholders involved in managing and facilitating the programme and its composite projects and with 90 community members involved as project participants. Data were subjected to thematic analysis, cross‐check and refining. Findings Findings highlight stakeholders’ diverse understandings of wellbeing, the complex relationship between health and wellbeing, and the perceived dissonance between the holistic concept of wellbeing and the reductionist design of the programme. Conclusions Wellbeing was understood to be ‘more than health’ and ‘more than happiness’, concerned with effective functioning, sense of purpose and flourishing. Essentially holistic, wellbeing offers opportunities to transcend clinical/pathogenic conceptions of ‘health’ and resonate with individuals, communities and local authorities. This raises concerns about how wellbeing can be meaningfully realised without compromising the concept, particularly when programmes are structured in reductionist ways requiring monitoring against discrete outcomes. Implications for practice include: utilising wellbeing as a driver for cross‐cutting public health in challenging economic and organisational contexts; acknowledging that wellbeing is essentially social as well as individual; appreciating that wellbeing is experienced in relation to contexts and surroundings; and recognising that wellbeing defined in terms of individual happiness risks compromising the future wellbeing of societies and the planet

    Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a Rasch analysis using data from the Scottish Health Education Population Survey

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    Background: The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) was developed to meet demand for instruments to measure mental well-being. It comprises 14 positively phrased Likert-style items and fulfils classic criteria for scale development. We report here the internal construct validity of WEMWBS from the perspective of the Rasch measurement model. Methods: The model was applied to data collected from 779 respondents in Wave 12 (Autumn 2006) of the Scottish Health Education Population Survey. Respondents were aged 16–74 (average 41.9) yrs. Results: Initial fit to model expectations was poor. The items 'I've been feeling good about myself', 'I've been interested in new things' and 'I've been feeling cheerful' all showed significant misfit to model expectations, and were deleted. This led to a marginal improvement in fit to the model. After further analysis, more items were deleted and a strict unidimensional seven item scale (the Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS)) was resolved. Many items deleted because of misfit with model expectations showed considerable bias for gender. Two retained items also demonstrated bias for gender but, at the scale level, cancelled out. One further retained item 'I've been feeling optimistic about the future' showed bias for age. The correlation between the 14 item and 7 item versions was 0.954. Given fit to the Rasch model, and strict unidimensionality, SWEMWBS provides an interval scale estimate of mental well-being. Conclusion: A short 7 item version of WEMWBS was found to satisfy the strict unidimensionality expectations of the Rasch model, and be largely free of bias. This scale, SWEMWBS, provides a raw score-interval scale transformation for use in parametric procedures. In terms of face validity, SWEMWBS presents a more restricted view of mental well-being than the 14 item WEMWBS, with most items representing aspects of psychological and eudemonic well-being, and few covering hedonic well-being or affect. However, robust measurement properties combined with brevity make SWEMWBS preferable to WEMWBS at present for monitoring mental well-being in populations. Where face validity is an issue there remain arguments for continuing to collect data on the full 14 item WEMWBS

    The use of happiness research for public policy

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    Research on happiness tends to follow a "benevolent dictator" approach where politicians pursue people's happiness. This paper takes an antithetic approach based on the insights of public choice theory. First, we inquire how the results of happiness research may be used to improve the choice of institutions. Second, we show that the policy approach matters for the choice of research questions and the kind of knowledge happiness research aims to provide. Third, we emphasize that there is no shortcut to an optimal policy maximizing some happiness indicator or social welfare function since governments have an incentive to manipulate this indicator

    An Evaluation of the Precision of Measurement of Ryff’s Psychological Well-Being Scales in a Population Sample

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    The aim of this study is to assess the effective measurement range of Ryff’s Psychological Well-being scales (PWB). It applies normal ogive item response theory (IRT) methodology using factor analysis procedures for ordinal data based on a limited information estimation approach. The data come from a sample of 1,179 women participating in a midlife follow-up of a national birth cohort study in the UK. The PWB scales incorporate six dimensions: autonomy, positive relations with others, environmental mastery, personal growth, purpose in life and self-acceptance. Scale information functions were calculated to derive standard errors of measurement for estimated scores on each dimension. Construct variance was distinguished from method variance by inclusion of method factors from item wording (positive versus negative). Our IRT analysis revealed that the PWB measures well-being most accurately in the middle range of the score distribution, i.e. for women with average well-being. Score precision diminished at higher levels of well-being, and low well-being was measured more reliably than high well-being. A second-order well-being factor loaded by four of the dimensions achieved higher measurement precision and greater score accuracy across a wider range than any individual dimension. Future development of well-being scales should be designed to include items that are able to discriminate at high levels of well-being
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