Three-phase development of the health capital questionnaire: a mixed methods operationalization study

Area of Science:

• Health Economics
• Sociology of Health
• Behavioral Science

Background:

• Health capital is an emerging framework for understanding health practices.
• Existing research lacks an instrument to measure health capital effectively.
• This gap limits the framework's potential in disease management and prevention.

Purpose of the Study:

• To operationalize the health capital conceptual framework.
• To develop a comprehensive questionnaire for assessing health capital components and interactions.
• To create a measurable instrument for health capital.

Main Methods:

• A three-phase development process was employed.
• Methods included a systematic literature review, expert focus groups, and projective techniques.
• The process synthesized evidence to create the Health Capital Questionnaire (HCQ).

Main Results:

• The Health Capital Questionnaire (HCQ) was developed with 56 questions across six sections.
• The instrument is available in five languages: English, Italian, Romanian, Slovak, and Spanish.
• A validation-by-design approach was used in the absence of a clear post hoc validation path.

Conclusions:

• The HCQ is a multi-purpose instrument assessing perceptions, behaviors, experiences, preferences, and attitudes.
• It captures sociocultural, economic, and behavioral aspects of health.
• The questionnaire is theoretically integrative, culturally adaptable, and contextually extensible.