Comprehensibility of measures of health-related quality of life in minority and low-income patients.

Although the use of self-administered measures of health-related quality of life has increased, their performance in minorities and persons of low socioeconomic status is largely unknown. This cross-sectional study assessed participation rates, comprehensibility, and overall scores for three generic measures of health status--the Short Form-12, EuroQol EQ-5D, and Health Utilities Index Mark 2/3. Participants at an inner-city community health center completed demographic questions, the measures, and questions regarding the comprehensibility and relevance of the measures. Three hundred ninety-three persons were approached, and 301 (77%) agreed to participate: 51% were Latino and 32% were African American. Sixty-eight percent of participants earned $15,000 or less, and 46% had a high school education or lower. Seventeen percent of participants required assistance on one or more item, but most sought clarification for only one item. Participants' responses on similar questions from two different measures were consistent (kappa = .65), and overall scores for the three measures were moderately or strongly correlated, ranging from r = .41 to r = .69. Mean scores were lower than published population norms. Participants were able to complete the self-administered measures and appeared to comprehend the measures. Responses from the measures yielded apparently valid results, and scores are likely to be lower than higher socioeconomic status populations. Mean scores were comparable to scores of persons with chronic diseases. The results suggest that these measures may be successfully used in characterizing the health of minority and low-income populations.