5.8 What are rehabilitation-related outcome measures that can be useful for people living with HIV?

This section provides information about outcome measures that are relevant for rehabilitation providers to use when providing care to people living with HIV. The measures are organized by the construct that they measure. Detailed information about each is provided including a description and references.

5.8.1 Activities of Daily Living (ADL)

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Assessment of Motor and Process Skills (AMPS)^1,2	Generic Evaluative and Descriptive	Performance-based/observation 36 items (16 ADL motor skills and 20 ADL process skills) 2 domains (ADL Motor Ability and ADL Process Ability)	Reliability: Good internal consistency (multi-faceted Rasch equivalent of Cronbach’s alpha > 0.90)³ High interrater reliability (r > 0.90)⁴ High test-retest reliability (r > 0.90)⁵ Validity: Construct validity in a sample of people living with HIV⁶ Numerous studies demonstrating cross- cultural validity.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Assessment of Motor and Process Skills (AMPS)^1,2

Generic

Evaluative and Descriptive

Performance-based/observation 36 items

(16 ADL motor skills and 20 ADL process skills)

2 domains

(ADL Motor Ability and ADL Process Ability)

Reliability: Good internal consistency (multi-faceted Rasch equivalent of Cronbach’s alpha > 0.90)³

High interrater reliability (r > 0.90)⁴

High test-retest reliability (r > 0.90)⁵

Validity: Construct validity in a sample of people living with HIV⁶

Numerous studies demonstrating cross- cultural validity.

¹ Fisher A.G., Bray Jones K: Assessment of Motor and Process Skills. Vol. 1: Development, Standardization, and Administration Manual (7th ed.) Fort Collins, CO: Three Star Press; 2010a.

² Fisher A.G., Bray Jones K. Assessment of Motor and Process Skills. Vol. 2: User Manual (7th ed.) Fort Collins, CO: Three Star Press; 2010b.

³ Fisher, A.G. (1990, April). Assessing motor and process skills in the elderly. Paper presented at the annual Conference of the American Occupational Therapy Association.

⁴ Fisher AG, Liu Y, Velozo CA, Pan AW. Cross-cultural assessment of process skills. Am J Occup Ther. 1992 Oct;46(10):876-85. doi: 10.5014/ajot.46.10.876. PMID: 1463059.

⁵ Fisher A.G., Bray Jones K: Assessment of Motor and Process Skills. Vol. 1: Development, Standardization, and Administration Manual (7th ed.) Fort Collins, CO: Three Star Press; 2010a.

⁶ Merritt BK, Gahagan J, Kottorp A. HIV and disability: A pilot study exploring the use of the Assessment of Motor and Process Skills (AMPS) to measure daily life performance.(PDF) Journal of the International AIDS Society. 2013;16:1-8.

5.8.2 Coping Response

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Brief COPE Scale^1,2	HIV-specific Descriptive	Self-reported questionnaire 28 items 14 domains and 2 summary scores (maladaptive coping and adaptive coping)	Reliability: Adequate internal reliability (Cronbach’s alpha ≥ 0.50) among the general population. Validity: Construct validity demonstrated among the general population.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Brief COPE Scale^1,2

HIV-specific

Descriptive

Self-reported questionnaire

28 items

14 domains and 2 summary scores (maladaptive coping and adaptive coping)

Reliability: Adequate internal reliability (Cronbach’s alpha ≥ 0.50) among the general population.

Validity: Construct validity demonstrated among the general population.

¹ Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92-100. PubMed PMID: 16250744.

² Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 1989 Feb;56(2):267-83. PubMed PMID: 2926629.

5.8.3 Depression

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Centres for Epidemiologic Studies Depression Scale (CES-D)¹	Generic Descriptive	Self-reported questionnaire 20 items 8 domains	Reliability: high internal reliability (α ≥ 0.85) and adequate test-retest reliability on a general adult population. Validity: Concurrent construct validity on a general adult population. Demonstrated predictive construct validity and high internal consistency reliability on a population with Hepatitis C.²

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Centres for Epidemiologic Studies Depression Scale (CES-D)¹

Generic

Descriptive

Self-reported questionnaire

20 items

8 domains

Reliability: high internal reliability (α ≥ 0.85) and adequate test-retest reliability on a general adult population.

Validity: Concurrent construct validity on a general adult population.

Demonstrated predictive construct validity and high internal consistency reliability on a population with Hepatitis C.²

¹ Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl. Psychol. Measure. 1977;1(3):385-401.

² Clark CH, Mahoney JS, Clark DJ, Eriksen LR. Screening for depression in a hepatitis C population: the reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D). J Adv Nurs. 2002 Nov;40(3):431-9. PubMed PMID: 12383188.

5.8.4 Fatigue

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
HIV Fatigue Scale¹	HIV-specific Descriptive	Self-reported questionnaire 56 items 3 domains	Reliability: High internal consistency reliability. Cronbach’s alpha was >0.90 on all domains among people living with HIV-related fatigue. Cronbach’s alpha for the entire tool was 0.94. Test-retest reliability was moderate with a correlation coefficient of 0.43. Validity: Good convergent construct validity among people living with HIV-related fatigue.²

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

HIV Fatigue Scale¹

HIV-specific

Descriptive

Self-reported questionnaire

56 items

3 domains

Reliability: High internal consistency reliability.

Cronbach’s alpha was >0.90 on all domains among people living with HIV-related fatigue. Cronbach’s alpha for the entire tool was 0.94. Test-retest reliability was moderate with a correlation coefficient of 0.43.

Validity: Good convergent construct validity among people living with HIV-related fatigue.²

¹ Barroso J, Lynn MR. Psychometric properties of the HIV-Related Fatigue Scale. J Assoc Nurses AIDS Care. 2002 Jan-Feb;13(1):66-75. PubMed PMID: 11828861.

² Pence BW, Barroso J, Leserman J, Harmon JL, Salahuddin N. Measuring fatigue in people living with HIV/AIDS: psychometric characteristics of the HIV-related fatigue scale. AIDS Care. 2008 Aug;20(7):829-44. PubMed PMID: 18608084; PubMed Central PMCID: PMC2586613.

5.8.5 Health-related Quality of Life

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Functional Assessment of HIV Infection (FAHI)¹	HIV-specific Descriptive and Evaluative	Self-reported questionnaire 47 items 5 domains	Reliability: Internal consistency reliability (>0.73 Cronbach’s alpha for all domains) Validity: Convergent and discriminant validity among adults living with HIV. Responsiveness: responsive to change among adults living with HIV.²
Medical Outcomes Study Short Form (SF-36) Questionnaire^{3, 4}	Generic Descriptive	Self-reported questionnaire 36 items 8 domains and 2 summary scores (physical component and mental component, summary scores)	Demonstrated reliability and validity among people living with HIV. Reliability: Good internal consistency reliability among people living with HIV (all Cronbach alpha values typically > 0.80) and good test-retest reliability. Validity: Demonstrated content validity, criterion validity, construct validity with people living with HIV.^{5, 6}
Medical Outcomes Study-HIV Health Survey (MOS-HIV)^7-9	HIV-specific Descriptive	Self-reported questionnaire 35 items 10 domains and 2 summary scores (Mental Component Summary (MCS) and Physical Component Summary (PCS) scores)	Reliability: Good internal consistency (>0.75 Cronbach’s alpha) for all dimensions for people living with HIV. Validity: Convergent and discriminant construct validity with people living with HIV.^{8, 10}
Multidimensional QOL Questionnaire for HIV/AIDS (MQoL-HIV)¹¹	HIV-specific Descriptive and Evaluative	Self-reported questionnaire 40 items 10 domains	Reliability: Good internal consistency reliability (>0.70 Cronbach’s alpha for 8 out of 10 domains) and test-retest reliability (correlation coefficient >0.70 for all domains except cognitive functioning) among people with asymptomatic and symptomatic HIV infection. Validity: Discriminative construct validity among people with asymptomatic and symptomatic HIV infection. Responsiveness: Responsive to change in a number of symptoms, viral load and CD4 count during a 3 month period for people living with HIV starting or changing an antiretroviral therapy regimen.¹⁰
WHO QOL-HIV^{11, 12}	HIV-specific Descriptive	Self-reported questionnaire 120 items 6 domains	Reliability: Good internal consistency reliability for all domains with Cronbach’s alpha between 0.70 and 0.90 among people living with HIV from seven culturally diverse centres. Validity: Good discriminant validity among people living with HIV in diverse cultural settings.^{13, 14}
Patient Reported Outcomes Quality of Life-HIV (PROQOL- HIV) Questionnaire^{15, 16}	HIV-specific Descriptive	Self-reported questionnaire 43 items 8 domains and 1 global health item	Reliability: Good internal consistency reliability with Cronbach alphas on domains ranging from 0.77–0.89. Test–retest reliability demonstrated consistency of the measure over time (intraclass correlation coefficient = 0.86). Validity: Good convergent and discriminant validity. Correlations with EQ-5D and Medical Outcomes Study–HIV questionnaires complied with concurrent validity expectations; as well as correlations with self- reported symptom and depression questionnaires.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Functional Assessment of HIV Infection (FAHI)¹

HIV-specific

Descriptive and Evaluative

Self-reported questionnaire

47 items

5 domains

Reliability: Internal consistency reliability (>0.73 Cronbach’s alpha for all domains)

Validity: Convergent and discriminant validity among adults living with HIV.

Responsiveness: responsive to change among adults living with HIV.²

Medical Outcomes Study Short Form (SF-36) Questionnaire^{3, 4}

Generic

Descriptive

Self-reported questionnaire

36 items

8 domains and 2 summary scores (physical component and mental component, summary scores)

Demonstrated reliability and validity among people living with HIV.

Reliability: Good internal consistency reliability among people living with HIV (all Cronbach alpha values typically > 0.80) and good test-retest reliability.

Validity: Demonstrated content validity, criterion validity, construct validity with people living with HIV.^{5, 6}

Medical Outcomes Study-HIV Health Survey (MOS-HIV)^7-9

HIV-specific

Descriptive

Self-reported questionnaire

35 items

10 domains and 2 summary scores (Mental Component Summary (MCS) and Physical Component Summary (PCS) scores)

Reliability: Good internal consistency (>0.75 Cronbach’s alpha) for all dimensions for people living with HIV.

Validity: Convergent and discriminant construct validity with people living with HIV.^{8, 10}

Multidimensional QOL Questionnaire for HIV/AIDS (MQoL-HIV)¹¹

HIV-specific

Descriptive and Evaluative

Self-reported questionnaire

40 items

10 domains

Reliability: Good internal consistency reliability (>0.70 Cronbach’s alpha for 8 out of 10 domains) and test-retest reliability (correlation coefficient

>0.70 for all domains except cognitive functioning) among people with asymptomatic and symptomatic HIV infection.

Validity: Discriminative construct validity among people with asymptomatic and symptomatic HIV infection.

Responsiveness: Responsive to change in a number of symptoms, viral load and CD4 count during a 3 month period for people living with HIV starting or changing an antiretroviral therapy regimen.¹⁰

WHO QOL-HIV^{11, 12}

HIV-specific

Descriptive

Self-reported questionnaire

120 items

6 domains

Reliability: Good internal consistency reliability for all domains with Cronbach’s alpha between 0.70 and 0.90 among people living with HIV from seven culturally diverse centres.

Validity: Good discriminant validity among people living with HIV in diverse cultural settings.^{13, 14}

Patient Reported Outcomes Quality of Life-HIV (PROQOL- HIV) Questionnaire^{15, 16}

HIV-specific

Descriptive

Self-reported questionnaire

43 items

8 domains and 1 global health item

Reliability: Good internal consistency reliability with Cronbach alphas on domains ranging from 0.77–0.89.

Test–retest reliability demonstrated consistency of the measure over time (intraclass correlation coefficient = 0.86).

Validity: Good convergent and discriminant validity.

Correlations with EQ-5D and Medical Outcomes Study–HIV questionnaires complied with concurrent validity expectations; as well as correlations with self- reported symptom and depression questionnaires.

¹ Cella DF, McCain NL, Peterman AH, Mo F, Wolen D. Development and validation of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Qual Life Res. 1996 Aug;5(4):450-63. PubMed PMID: 8840825.

² Peterman AH, Cella D, Mo F, McCain N. Psychometric validation of the revised Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Qual Life Res. 1997 Aug;6(6):572-84. PubMed PMID: 9330556.

³ Ware JE Jr, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998 Nov;51(11):903-12. PubMed PMID: 9817107.

⁴ Ware JE Jr. SF-36 health survey update. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3130-9. Review. PubMed PMID: 11124729.

⁵ McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993 Mar;31(3):247-63. Pub Med PMID8450681.

⁶ McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-Item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994 Jan; 32(1):40-66. Pub Med PMID: 8277801.

⁷ Wu AW, Hays RD, Kelly S, Malitz F, Bozzette SA. Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS. Qual Life Res. 1997a Aug;6(6):531-54. Review. PubMed PMID: 9330553.

⁸ Wu AW, Revicki DA, Jacobson D, Malitz FE. Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Qual Life Res. 1997b Aug;6(6):481-93. Review. PubMed PMID: 9330549.

⁹ Wu AW, Rubin HR, Mathews WC, Ware JE Jr, Brysk LT, Hardy WD, Bozzette SA, Spector SA, Richman DD. A health status questionnaire using 30 items from the Medical Outcomes Study.

Preliminary validation in persons with early HIV infection. Med Care. 1991 Aug;29(8):786-98. PubMed PMID: 1875745.

¹⁰ Badia X, Podzamczer D, Casado A, Lopez-Lavid C, Garcia M. Evaluating changes in health status in HIV-infected patients: Medical Outcomes Study-HIV and Multidimensional Quality of Life-HIV quality of life questionnaires. Spanish MOS-HIV and MQoL-HIV Validation Group. AIDS. 2000 Jul 7;14(10):1439-47. PubMed PMID: 10930160.

¹¹ Avis NE. Development of the MQoL-HIV: the multi-dimensional quality of life questionnaire with HIV/ AIDS (PDF). Quality of Life Newsletter, 17: 3-4.

¹² O’Connell K, Skevington S, Saxena S; WHOQOL HIV Group. Preliminary development of the World Health Organsiation’s Quality of Life HIV instrument (WHOQOL-HIV): analysis of the pilot version. Soc Sci Med. 2003 Oct;57(7):1259-75. PubMed PMID:12899909.

¹³ World Health Organization’s Quality of Life Instrument HIV Group. WHOQOL-HIV for quality of life assessment among people living with HIV and AIDS: results from the field test. AIDS Care. 2004 Oct;16(7):882-9. PubMed PMID: 15385243.

¹⁴ Fang CT, Hsiung PC, Yu CF, Chen MY, Wang JD. Validation of the World Health Organization quality of life instrument in patients with HIV infection. Qual Life Res. 2002 Dec;11(8):753-62. PubMed PMID: 12482159.

¹⁵ Duracinsky M, Herrmann S, Berzins B, Armstrong AR, Kohli R, Le Coeur S, Diouf A, Fournier I, Schechter M, Chassany O. The development of PROQOL-HIV: an international instrument to assess the health-related quality of life of persons living with HIV/AIDS. J Acquir Immune Defic Syndr. 2012 Apr 15;59(5):498-505. doi: 10.1097/QAI.0b013e318245cafe. PubMed PMID: 22205438.

¹⁶ Duracinsky M, Lalanne C, Le Coeur S, Herrmann S, Berzins B, Armstrong AR, Lau JT, Fournier I, Chassany O. Psychometric validation of the PROQOL-HIV questionnaire, a new health-related quality of life instrument-specific to HIV disease. J Acquir Immune Defic Syndr. 2012 Apr 15;59(5):506-15. doi: 10.1097/QAI.0b013e31824be3f2. PubMed PMID: 22293550.

5.8.6 HIV-related Disability

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
HIV Disability Questionnaire^1-5	HIV-specific Descriptive	Self-reported questionnaire 69 items Presence, severity and episodic nature of HIV-related disability in adults living with HIV	Reliability: Excellent internal consistency and test-retest reliability among people living with HIV on combination antiretroviral therapy.⁴ Validity: Excellent construct validity among people living with HIV on combination antiretroviral therapy.⁴

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

HIV Disability Questionnaire^1-5

HIV-specific

Descriptive

Self-reported questionnaire

69 items

Presence, severity and episodic nature of HIV-related disability in adults living with HIV

Reliability: Excellent internal consistency and test-retest reliability among people living with HIV on combination antiretroviral therapy.⁴

Validity: Excellent construct validity among people living with HIV on combination antiretroviral therapy.⁴

¹ O’Brien KK, Davis AM, Gardner S, Bayoumi AM, Rueda S, Hart TA, Cooper C, Solomon P, Rourke SB, Hanna S; OHTN Cohort Study Team. Relationships Between Dimensions of Disability Experienced by Adults Living with HIV: A Structural Equation Model Analysis. AIDS Behav. 2012 Nov 7. [Epub ahead of print] PubMed PMID: 23132208.

² O’Brien KK, Bayoumi AM, Bereket T, Swinton M, Alexander R, King K, Solomon P. Sensibility assessment of the HIV Disability Questionnaire. Disabil Rehabil. 2013 Apr;35(7):566-77. doi: 10.3109/ 09638288.2012.702848. Epub 2012 Jul 21. PubMed PMID: 22816434.

³ O’Brien KK, Solomon P, Bayoumi AM. Measuring disability experienced by adults living with HIV: assessing construct validity of the HIV Disability Questionnaire using confirmatory factor analysis. BMJ Open. 2014 Sep 1;4(8):e005456. doi: 10.1136/bmjopen-2014-005456. PubMed PMID: 25180054; PubMed Central PMCID:PMC4156819.

⁴ O’Brien KK, Solomon P, Bergin C, O’Dea S, Stratford P, Iku N, Bayoumi AM. Reliability and validity of a new HIV-specific questionnaire with adults living with HIV in Canada and Ireland: the HIV Disability Questionnaire (HDQ). Health Qual Life Outcomes. 2015 Aug 12;13:124. doi: 10.1186/s12955-015-0310-9. PubMed PMID: 26263898; PubMed Central PMCID: PMC4542093.

⁵ O’Brien KK, Bayoumi AM, Stratford P, Solomon P. Which dimensions of disability does the HIV Disability Questionnaire (HDQ) measure? A factor analysis. Disabil Rehabil. 2015;37(13):1193-201. doi: 10.3109/09638288.2014.949358. Epub 2014 Aug 13. PubMed PMID: 25116628.

5.8.7 Pain

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Brief Pain Inventory – Short Form^1,2	Generic Descriptive	Self-reported questionnaire 11 items 2 domains (pain severity and pain interference)	Reliability: Excellent internal consistency and good to excellent test-retest reliability in patients with inflammatory bowel disease and COPD.^3,4 Validity: Convergent construct validity in chronic non-cancer patients.⁵

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Brief Pain Inventory – Short Form^1,2

Generic

Descriptive

Self-reported questionnaire

11 items

2 domains (pain severity and pain interference)

Reliability: Excellent internal consistency and good to excellent test-retest reliability in patients with inflammatory bowel disease and COPD.^3,4

Validity: Convergent construct validity in chronic non-cancer patients.⁵

¹ Cleeland CS, Ryan KM. The brief pain inventory. Pain Research Group. 1991 Mar 20:143-7.

² Cleeland CS. The Brief Pain Inventory: User Guide.(PDF)

³ Jelsness-Jørgensen LP, Moum B, Grimstad T, Jahnsen J, Opheim R, Prytz Berset I, Hovde Ø, Torp R, Frigstad SO, Huppertz-Hauss G, Bernklev T. Validity, Reliability, and Responsiveness of the Brief Pain Inventory in Inflammatory Bowel Disease. Can J Gastroenterol Hepatol. 2016;2016:5624261. doi: 10.1155/2016/5624261. Epub 2016 Jun 19. PMID: 27446848; PMCID: PMC4930809.

⁴ Chen YW, HajGhanbari B, Road JD, Coxson HO, Camp PG, Reid WD. Reliability and validity of the Brief Pain Inventory in individuals with chronic obstructive pulmonary disease. Eur J Pain. 2018 Nov;22(10):1718-1726. doi: 10.1002/ejp.1258. Epub 2018 Jun 22. PMID: 29883526.

⁵ Keller S, Bann CM, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain. 2004 Sep-Oct;20(5):309-18. doi: 10.1097/00002508-200409000-00005. PMID: 15322437.

5.8.8 Physical Performance Measures

While none of these outcome measures have been validated in the HIV positive population, some studies are starting to explore this important topic.¹

¹ Quigley A, MacKay-Lyons M. Physical deficits among people living with HIV: a review of the literature and implications for rehabilitation.

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Short Physical Performance Battery (SPPB)¹	Generic Descriptive	Performance based/observation	Reliability: High test-retest reliability in two cohorts of older adults.² Validity: Strong and consistent association with health status measures in two cohorts of older adults.²
Five(5)-repetition Sit-to-stand (5-STS) test	Generic Descriptive	Performance based/observation	Reliability: Excellent intrarater reliability, interrater reliability, and test-retest reliability in three subject populations.⁴ Validity: Significant association association with muscle strength of affected and unaffected knee flexors.⁴
Timed Up and Go Test (TUG)⁵	Generic Descriptive	Performance based/observation	Reliability: Excellent reliability in two groups of older adults.⁶ Validity: Good correlation with balance, gait speed and safety in elderly patients.⁵
Six Minute Walk Test (SMWT)⁷	Generic Descriptive	Performance based/observation	Reliability: Good test-retest reliability as a measure of physical endurance in older adults.⁸ Validity: Good convergent validity with treadmill performance in older adults.⁸
Community Balance and Mobility Scale (CBMS)⁹	Generic Descriptive	Performance based/observation	Reliability: Interrater and intrarater reliability were excellent and internal consistency was good in a cohort of young-older adults.¹⁰ Validity: Concurrent validity was moderate to good when compared to other measures in a cohort of young-older adults.¹⁰

¹ Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31. doi: 10.1093/gerona/55.4.m221. PMID: 10811152.

² Freire AN, Guerra RO, Alvarado B, Guralnik JM, Zunzunegui MV. Validity and reliability of the short physical performance battery in two diverse older adult populations in Quebec and Brazil. J Aging Health. 2012 Aug;24(5):863-78. doi: 10.1177/0898264312438551. Epub 2012 Mar 15. PMID: 22422762.

³ Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994 Mar;49(2):M85-94. doi: 10.1093/geronj/49.2.m85. PMID: 8126356.

⁴ Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity. Arch Phys Med Rehabil. 2010 Mar;91(3):407-13. doi: 10.1016/j.apmr.2009.10.030. PMID: 20298832.

⁵ Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991 Feb;39(2):142-8. doi: 10.1111/j.1532-5415.1991.tb01616.x. PMID: 1991946.

⁶ Kristensen MT, Bloch ML, Jønsson LR, Jakobsen TL. Interrater reliability of the standardized Timed Up and Go Test when used in hospitalized and community-dwelling older individuals. Physiother Res Int. 2019 Apr;24(2):e1769. doi: 10.1002/pri.1769. Epub 2019 Jan 18. PMID: 30657232.

⁷American Thoracic Society. ATS Statement: Guidelines for the Six-Minute Walk Test. (PDF) 2002.

⁸ Rikli RE, Jones CJ. The reliability and validity of a 6-minute walk test as a measure of physical endurance in older adults. J Aging Phys Act. 2020:6;363-375.

⁹ Howe JA, Inness EL, Venturini A, Williams JI, Verrier MC. The Community Balance and Mobility Scale–a balance measure for individuals with traumatic brain injury. Clin Rehabil. 2006 Oct;20(10):885-95. doi: 10.1177/0269215506072183. PMID: 17008340.

¹⁰ Weber M, Van Ancum J, Bergquist R, Taraldsen K, Gordt K, Mikolaizak AS, Nerz C, Pijnappels M, Jonkman NH, Maier AB, Helbostad JL, Vereijken B, Becker C, Schwenk M. Concurrent validity and reliability of the Community Balance and Mobility scale in young-older adults. BMC Geriatr. 2018 Jul 3;18(1):156. doi: 10.1186/s12877-018-0845-9. PMID: 29970010; PMCID: PMC6031142.

5.8.9 Presence and bothersome nature of symptoms

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
HIV Symptom Index¹	HIV-specific Descriptive	Self-reported questionnaire 20 items No domains	Validity: Good construct validity among people living with HIV on combination antiretroviral therapy.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

HIV Symptom Index¹

HIV-specific

Descriptive

Self-reported questionnaire

20 items

No domains

Validity: Good construct validity among people living with HIV on combination antiretroviral therapy.

¹ Justice AC, Holmes W, Gifford AL, Rabeneck L, Zackin R, Sinclair G, Weissman S, Neidig J, Marcus C, Chesney M, Cohn SE, Wu AW; Adult AIDS Clinical Trials Unit Outcomes Committee.
Development and validation of a self-completed HIV symptom index. J Clin Epidemiol. 2001 Dec;54 Suppl 1:S77-90. PubMed PMID: 11750213.

5.8.10 Self-management self-efficacy

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Perceived HIV Self-Management Scale (PHIVSMS)¹	HIV-specific Descriptive	Self-reported questionnaire 8 items 1 domain	Reliability: Good internal consistency reliability with Cronbach’s alpha 0.78 with adults (primarily men) living with HIV. Validity: Construct validity demonstrated in adults living with HIV with correlations to criterion measures of HRQL and depression ranging from 0.37- 0.66.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Perceived HIV Self-Management Scale (PHIVSMS)¹

HIV-specific

Descriptive

Self-reported questionnaire

8 items

1 domain

Reliability: Good internal consistency reliability with Cronbach’s alpha 0.78 with adults (primarily men) living with HIV.

Validity: Construct validity demonstrated in adults living with HIV with correlations to criterion measures of HRQL and depression ranging from 0.37- 0.66.

¹ Wallston KA, Osborn CY, Wagner LJ, Hilker K. The Perceived Medical Condition Self-Management Scale applied to persons with HIV/AIDS. J Health Psychol. 2010 Jul 23. [Epub ahead of print] PubMed PMID: 20656769.

5.8.11 Social Support

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Medical Outcomes Study Social Support Survey (MOS- SS)¹	Specific to chronic disease Descriptive	Self-reported questionnaire 19 items 5 domains	Reliability: High internal consistency reliability (Cronbach’s alpha ≥ 0.90) among people living with HIV. Validity: Convergent and discriminant construct validity demonstrated among people living with HIV.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Medical Outcomes Study Social Support Survey (MOS- SS)¹

Specific to chronic disease

Descriptive

Self-reported questionnaire

19 items

5 domains

Reliability: High internal consistency reliability (Cronbach’s alpha ≥ 0.90) among people living with HIV.

Validity: Convergent and discriminant construct validity demonstrated among people living with HIV.

¹ Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705-14. PubMed PMID: 2035047.

5.8.12 Stigma

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
HIV Stigma Scale¹	HIV-specific Descriptive	Self-reported questionnaire 40 items 4 domains	Reliability: Good internal consistency reliability (Cronbach’s alpha ≥ 0.90 for subscales and 0.96 for the summary scale) among people living with HIV. Validity: Construct validity in a sample of people living with HIV.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

HIV Stigma Scale¹

HIV-specific

Descriptive

Self-reported questionnaire

40 items

4 domains

Reliability: Good internal consistency reliability (Cronbach’s alpha ≥ 0.90 for subscales and 0.96 for the summary scale) among people living with HIV.

Validity: Construct validity in a sample of people living with HIV.

¹ Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001 Dec;24(6):518-29. PubMed PMID: 11746080.

5.8.13 Stress

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
HIV Stress Scale¹	HIV-specific Descriptive	Self-reported questionnaire 29 items 3 domains	Validity: Convergent construct validity among men living with HIV.

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

HIV Stress Scale¹

HIV-specific

Descriptive

Self-reported questionnaire

29 items

3 domains

Validity: Convergent construct validity among men living with HIV.

¹ Pakenham KI, Rinaldis M. Development of the HIV/AIDS Stress Scale. Psychology & Health, 2002;17(2):203-219.

5.8.14 Trauma

Measure (Authors, Year)	Generic vs Specific, Purpose	Administration, Number of Items, Number of Domains	Measurement Properties
Trauma Screening Questionnaire (TSQ)¹	Generic Descriptive	Self-reported questionnaire 10 items 2 domains	Reliability: Strong internal consistency, test-retest reliability a study of trauma patients.² Validity: Convergent- and discriminant validity in a study of trauma patients.² Clinical recommendation: This measure focuses on client reaction to event(s) versus day-to-day symptomology
Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5)³	Generic Descriptive	Self-reported questionnaire 20 items	Reliability: Strong internal consistency, test-retest reliability in two studies involving trauma exposed college students.⁴ Validity: Convergent- and discriminant validity in two studies involving trauma exposed college students.⁴ Clinical recommendation: The PCL-5 can be used/applied broadly so as to review/check trauma symptoms

Measure (Authors, Year)

Generic vs Specific, Purpose

Administration, Number of Items, Number of Domains

Measurement Properties

Trauma Screening Questionnaire (TSQ)¹

Generic

Descriptive

Self-reported questionnaire

10 items

2 domains

Reliability: Strong internal consistency, test-retest reliability a study of trauma patients.²

Validity: Convergent- and discriminant validity in a study of trauma patients.²

Clinical recommendation: This measure focuses on client reaction to event(s) versus day-to-day symptomology

Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5)³

Generic

Descriptive

Self-reported questionnaire

20 items

Reliability: Strong internal consistency, test-retest reliability in two studies involving trauma exposed college students.⁴

Validity: Convergent- and discriminant validity in two studies involving trauma exposed college students.⁴

Clinical recommendation: The PCL-5 can be used/applied broadly so as to review/check trauma symptoms

¹ U.S. Department of Veteran’s Affairs. Trauma Screening Questionnaire (TSQ).

² Mouthaan J, Sijbrandij M, Reitsma JB, Gersons BP, Olff M. Comparing screening instruments to predict posttraumatic stress disorder. PLoS One. 2014 May 9;9(5):e97183. doi: 10.1371/journal.pone.0097183. PMID: 24816642; PMCID: PMC4016271.

³ U.S. Department of Veteran’s Affairs. PTSD Checklist for DSM-5 (PCL-5)

⁴ Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation. J Trauma Stress. 2015 Dec;28(6):489-98. doi: 10.1002/jts.22059. Epub 2015 Nov 25. PMID: 26606250.