Psychometric evaluation of the hope, agency and opportunity (HAO); a brief measure of mental health recovery

Abstract

Background: The development of safe and effective mental health services is a priority. This requires valid measures of personal recovery, yet these tools are not embedded in routine clinical practice. Brief “patient reported measures” are most likely to be acceptable to service-users and clinicians. The 4-item “Hope, Agency and Opportunity” (HAO) was co-produced to assess recovery outcomes and experience of mental health services.

Aim: To evaluate the psychometric properties of the HAO.

Method: A clinical sample from secondary healthcare services and a non-clinical sample were assessed at baseline and two weeks, on measures of personal recovery.

Results: Factor analysis indicated goodness of fit for the HAO with both clinical and non-clinical samples. The measure demonstrated acceptable internal consistency, moderate to strong construct validity and substantial test-retest reliability over two weeks.

Conclusions: The HAO demonstrates satisfactory psychometric properties. Co-production of the measure confers clinical credibility. The brevity of the tool means it can be incorporated into routine clinical practice to drive improvements in service quality.

Keywords:

• Patient reported measures
• outcome evaluation
• PROMs
• PREMs
• psychometric evaluation
• recovery
• questionnaire validation

Acknowledgements

The authors are grateful to Charlotte Deveson, Southern Health NHS Foundation Trust, for her help with data collection; Elizabeth White-Ripley, Diane Hannon and David Watson from Solent Mind, for their support in recruiting participants; and Dr Claire Hart, University of Southampton, UK, for statistical guidance.

Declaration of interest

No potential conflict of interest was reported by the authors.

Notes

¹ Thanks to a blind reviewer for noting that this represents an acceptable level of consistency given length of scale.