Quality of Life Research

, Volume 24, Issue 10, pp 2375–2384 | Cite as

Measurement invariance of English and French Health Education Impact Questionnaire (heiQ) empowerment scales validated for cancer

  • Jennifer Brunet
  • Sophie Lauzier
  • H. Sharon Campbell
  • Lise Fillion
  • Richard H. Osborne
  • Elizabeth Maunsell



If measurement invariance (MI) is demonstrated for a scale completed by respondents from two different language groups, it means that the scale measures the same construct in the same way in both groups. We assessed MI of the French- and English-language versions of the five Health Education Impact Questionnaire (heiQ) empowerment scales validated for the cancer setting.


Data came from two cross-sectional studies of Canadian cancer survivors (704 English, 520 French). Single-group confirmatory factor analysis (CFA) was used to test whether the hypothesized factor structure of the French-language heiQ empowerment scales fit the data. Multi-group CFAs were conducted to assess different levels of MI conditions (configural, metric, scalar, strict, as well as MI of factor variances, covariances, and latent means) of the French- and English-language heiQ empowerment scales.


The correlated five-factor model showed good fit in both language groups (goodness-of-fit indices: CFI ≥ .97; RMSEA ≤ .07). Goodness-of-fit indices and tests of differences in fit between models supported MI of the five-factor model across the two language groups (∆CFI ≤ −.010 combined with ∆RMSEA ≤ .015).


The French- and English-language heiQ empowerment scales measure the same five dimensions of empowerment in the same way across both language groups. Thus, any observed similarities or differences between French- and English-speaking respondents completing these scales are valid and reflect similarities or differences in empowerment across language groups, not measurement artifact. Consequently, heiQ empowerment data from English- and French-speaking respondents can be directly pooled or contrasted in data analyses.


Empowerment Cancer Language invariance Validation studies Outcome assessment (health care) Translation 



This study was supported by grants to HSC from the Canadian Institutes for Health Research (CIHR) [# KAL-82607], to EM from the National Cancer Institute of Canada (NCIC) [# 010498, #010499] via the Propel Centre for Population Health Impact, and to LF from the Canadian Partnership against Cancer (Cancer Journey Portfolio 2007–2012). This manuscript was prepared while JB was supported by a Canadian Cancer Society Career Development Award in Prevention, and SL by a Chercheur-boursier Award from the Fonds de recherche du Québec—Santé in partnership with the l’Institut National d’Excellence en Santé et en Services Sociaux (INESSS). This work was conducted while SL was supported by a Post-doctoral Fellowship Award from the CIHR-funded Strategic Training Initiative in Health Research (STIHR) Psychosocial Oncology Research Training program (PORT). RHO is funded in part through a National Health and Medical Research Council Senior Research Fellowship #APP1059122.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Jennifer Brunet
    • 1
  • Sophie Lauzier
    • 2
    • 3
  • H. Sharon Campbell
    • 4
    • 5
  • Lise Fillion
    • 6
    • 10
  • Richard H. Osborne
    • 7
  • Elizabeth Maunsell
    • 8
    • 9
    • 10
  1. 1.School of Human KineticsUniversity of OttawaOttawaCanada
  2. 2.Faculty of PharmacyUniversité LavalQuébecCanada
  3. 3.Axe Santé des populations et pratiques optimales en santéCentre de recherche du Centre Hospitalier Universitaire de QuébecQuébecCanada
  4. 4.Faculty of Applied Health Sciences, School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada
  5. 5.Propel Centre for Population Health ImpactUniversity of WaterlooWaterlooCanada
  6. 6.Faculté des sciences infirmièresUniversité Laval, QuébecQuébecCanada
  7. 7.Public Health Innovation, Population Health Strategic Research CentreDeakin University, Burwood CampusMelbourneAustralia
  8. 8.Département de médecine sociale et préventive, Faculté de médecineUniversité LavalQuébecCanada
  9. 9.Centre des maladies du sein Deschênes-FabiaHôpital du Saint-SacrementQuébecCanada
  10. 10.Axe OncologieCentre de recherche du Centre Hospitalier Universitaire de QuébecQuébecCanada

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