Quality of Life Research

, 17:737

Content validity in the PROMIS social-health domain: a qualitative analysis of focus-group data

  • Liana D. Castel
  • Kelly A. Williams
  • Hayden B. Bosworth
  • Susan V. Eisen
  • Elizabeth A. Hahn
  • Debra E. Irwin
  • Morgen A. R. Kelly
  • Jennifer Morse
  • Angela Stover
  • Darren A. DeWalt
  • Robert F. DeVellis

DOI: 10.1007/s11136-008-9352-3

Cite this article as:
Castel, L.D., Williams, K.A., Bosworth, H.B. et al. Qual Life Res (2008) 17: 737. doi:10.1007/s11136-008-9352-3



Our aim was to assess the content validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) social health item banks by comparing a prespecified conceptual model with concepts that focus-group participants identified as important social-health-related outcomes. These data will inform the process of improving health-related quality-of-life measures.


Twenty-five patients with a range of social limitations due to chronic health conditions were recruited at two sites; four focus groups were conducted. Raters independently classified participants’ statements using a hierarchical, nested schema that included health-related outcomes, role performance, role satisfaction, family/friends, work, and leisure.


Key themes that emerged were fulfilling both family and work responsibilities and the distinction between activities done out of responsibility versus enjoyment. Although focus-group participants identified volunteerism and pet ownership as important social-health-related concepts, these were not in our original conceptual model. The concept of satisfaction was often found to overlap with the concept of performance.


Our conceptual model appears comprehensive but is being further refined to more appropriately (a) distinguish between responsibilities versus discretionary activities, and (b) situate the outcome of satisfaction as it relates to impairment in social and other domains of health.


Epidemiologic measurements Focus groupsOutcome assessment (health care)Qualitative researchQuality of life



Family and friends


Health-related outcome(s)


Health-related quality of life




National Institutes of Health


Patient-reported outcome(s)


Patient-Reported Outcomes Measurement Information System


Role participation performance


Role participation satisfaction


University of North Carolina at Chapel Hill




World Health Organization


Western Psychiatric Institute and Clinic (University of Pittsburgh)

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Liana D. Castel
    • 1
  • Kelly A. Williams
    • 2
  • Hayden B. Bosworth
    • 3
  • Susan V. Eisen
    • 4
  • Elizabeth A. Hahn
    • 5
    • 6
    • 7
  • Debra E. Irwin
    • 8
  • Morgen A. R. Kelly
    • 9
  • Jennifer Morse
    • 9
  • Angela Stover
    • 9
  • Darren A. DeWalt
    • 1
    • 10
  • Robert F. DeVellis
    • 11
  1. 1.Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.School of Social Work Ph.D. ProgramUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Duke University Medical CenterDurhamUSA
  4. 4.Department of Health Policy & ManagementBoston University School of Public Health and Center for Health Quality, Outcomes & Economic Research, ENRM Veterans HospitalBedfordUSA
  5. 5.Center on Outcomes, Research and Education (CORE), Evanston Northwestern HealthcareEvanstonUSA
  6. 6.Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  7. 7.Institute for Healthcare Studies, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  8. 8.Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillUSA
  9. 9.Western Psychiatric Institute & ClinicUniversity of Pittsburgh Medical CenterPittsburghUSA
  10. 10.Division of General Medicine and Clinical EpidemiologyUniversity of North Carolina at Chapel HillChapel HillUSA
  11. 11.Department of Health Behavior and Health Education, School of Public HealthUniversity of North Carolina at Chapel Hill, Thurston Arthritis Research CenterChapel HillUSA