Examine a factor structure for the World Health Organization quality of life measure among adults with ADL limitations in underserved neighborhoods in the United States.

BACKGROUND

The extent of the impact of Activity of daily living (ADL) limitations on Quality of Life is well documented. However, the validity of the World Health Organization's Quality of Life-BREF (WHOQOL-BREF) rarely focuses of residents living in underserved settings and on minority inclusion.

OBJECTIVE

to examine the structural validity of WHOQOL-BREF among adults with long-term ADL limitations residing in underserved communities.

METHODS

A cross-sectional survey of patients from underserved communities in the Midwestern United States was conducted between March 2019 and February 2021. Inclusion criteria included a minimum age of 19 years, ADL limitations for more than 5 years, English proficiency, and residence in the targeted zip code areas. A confirmatory factor analysis was conducted to determine the factor structure of the WHOQOL-BREF. The International Statistical Classification of Diseases and Related Health Problems 10 was used to identify individuals with ADL limitations.

RESULTS

A total of 290 people met the criteria. Four latent factors were extracted. However, compared to the original conceptual relationships between variables and latent factors, Physical health to leisure activities, social relationships to self-satisfaction, and environmental health to acceptance of body appearance were additional leadings beyond their conceptual group. This CFA final model fit the data well (ꭓ2 (df = 228) = 320.30, p < 0.001; RMSEA = 0.06; CFI = 0.95; TLI = 0.94).

CONCLUSIONS

These findings underscored the need for accessible environments in their communities. In addition, supportive intra- and interpersonal relationships are needed to improve the QOL for adults with long-term ADL limitations.