VALIDATION DATA

The internal consistency analyses produced alpha coefficients of .79, .79, and .89 for factors 1, 2, and 3, respectively. The alpha of the overall scale was .83

The ICCs for the three factors were .62 (95% CI: .37–.78), .70 (95% CI: .49–.83), .60 (95% CI: .35–.77), and .70 (95% CI: .48–.83) for all the items.

The multidimensional nature of the concept of individual empowerment was confirmed by three factors that explain more than 68% of the total variance.

In another validation study, after discussion during the virtual NGT in phase 1, participants selected the HCEQ as their preferred measure of patient empowerment or self-advocacy, pointing to its ability to ‘provide much more valuable information’ as compared to other surveys, lending support to its face validity. Overall, on their initial ratings of the HCEQ and its items, more than half of participants reported that they thought the HCEQ was moderately to extremely useful. When examining ratings across the three subscales, participants indicated that one HCEQ subscale (‘Degree of Control’) was not as easy to answer.

The model (n = 9226) indicated good overall fit to the data with regard to most model fit indices, RMSEA =0.075 (90% CI =0.070-0.080), CFI =0.987, TLI =0.978 and SRMR =0.026. Chi-square for the model was significant (χ2(13) =685.229, P < .001), which is not unexpected since chi-square is sensitive to large samples (ie over 200). 

 Using ML estimation with the Satorra-Bentler adjustment, the model for Feelings (n = 9226) indicated good overall fit to the data, RMSEA = 0.067 (90% CI =0.062-0.072), CFI = 0.985, TLI = 0.979 and SRMR = 0.026, again with the exception of the chi-square, χ2 (13) =571.809, P < .001. The same was true for Importance (n = 9226), showing good overall fit to the data, RMSEA =0.059 (90% CI =0.054-0.064), CFI =0.984, TLI = 0.974 and SRMR =0.028, with the exception of the chi-square, χ2 (13) =438.883, P < .001.