Development of a self-report measure of capability wellbeing for adults: the ICECAP-A

TLDR

Health and social care benefits extend beyond patient health, indicating that broader wellbeing measures are useful for economic evaluation. The study develops a simple adult capability wellbeing measure, ICECAP‑A. Eighteen semi‑structured repeat interviews with 36 purposively sampled UK adults were used to iteratively create the ICECAP‑A descriptive system. The analysis identified five capability attributes—stability, attachment, achievement, autonomy, and enjoyment—and produced one four‑category item for each to form the ICECAP‑A descriptive system. Further work is needed to value, validate, and test the sensitivity of ICECAP‑A to healthcare interventions.

Abstract

The benefits of health and social care are not confined to patient health alone and therefore broader measures of wellbeing may be useful for economic evaluation. This paper reports the development of a simple measure of capability wellbeing for adults (ICECAP-A).In-depth, informant-led, interviews to identify the attributes of capability wellbeing were conducted with 36 adults in the UK. Eighteen semi-structured, repeat interviews were carried out to develop a capability-based descriptive system for the measure. Informants were purposively selected to ensure variation in socio-economic status, age, sex, ethnicity and health. Data analysis was carried out inductively and iteratively alongside interviews, and findings were used to shape the questions in later interviews.Five over-arching attributes of capability wellbeing were identified for the measure: "stability", "attachment", "achievement", "autonomy" and "enjoyment". One item, with four response categories, was developed for each attribute for the ICECAP-A descriptive system.The ICECAP-A capability measure represents a departure from traditional health economics outcome measures, by treating health status as an influence over broader attributes of capability wellbeing. Further work is required to value and validate the attributes and test the sensitivity of the ICECAP-A to healthcare interventions.