Comparison of EQ Health and Well-Being Long and Short (EQ-HWB/EQ-HWB-S) with Other Preference-Based Measures Among United States Informal Caregivers

Several measures have been used or developed to capture the health and well-being of caregivers, including the EQ Health and Well-being (EQ-HWB) and its short form, EQ-HWB-S. This study aimed to evaluate the psychometric properties and construct validity of the EQ-HWB/EQ-HWB-S in a US caregiver population. A cross-sectional survey was conducted involving 504 caregivers. Eligible participants were 18+ years old, provided unpaid care to a relative/friend aged 18+ in the past six months, and spent on average of at least one hour per week caregiving. Survey included the following measures: EQ-HWB, ASCOT-Carer, CarerQol and EQ-5D-5L. Psychometric properties were assessed using response distributions, floor/ceiling effects, Spearman's correlation for convergent validity, and effect sizes (ES) for known group validity (KGV) based on caregiving situations and intensity. The average age of caregivers was 49.2 (SD=15.4), with 57.5% being female. More than half (54.4%) reported high caregiving intensity, and 68.3% lived with the care recipient. The EQ-HWB-S index showed a strong positive correlation with the EQ-5D-5L (r =0.72), ASCOT (r =0.54), and CarerQol (r =0.54) indices. Notably, the EQ-HWB-S index showed the largest ES among measures in differentiating caregiving scenarios with a large ES for caregiver's general health (d=1.00) and small ES for caregiving intensity (d=0.39). Results support construct validity of EQ-HWB and EQ-HWB-S as measures for assessing health and well-being of adult informal caregivers in comparison with other validated instruments. Differing levels of KGV across anchors emphasize the importance of selecting appropriate measures for caregivers, depending on research question and/or intervention aims.