The Health Education Impact Questionnaire (heiQ): an outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions

Patient Educ Couns. 2007 May;66(2):192-201. doi: 10.1016/j.pec.2006.12.002. Epub 2007 Feb 22.


Objective: This paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.

Methods: Item development for the heiQ was guided by a Program Logic Model, Concept Mapping, interviews with stakeholders and psychometric analyses. Construction (N=591) and confirmatory (N=598) samples were drawn from consumers of patient education programs and hospital outpatients. The properties of the heiQ were investigated using item response theory and structural equation modeling.

Results: Over 90 candidate items were generated, with 42 items selected for inclusion in the final scale. Eight independent dimensions were derived: Positive and Active Engagement in Life (five items, Cronbach's alpha (alpha)=0.86); Health Directed Behavior (four items, alpha=0.80); Skill and Technique Acquisition (five items, alpha=0.81); Constructive Attitudes and Approaches (five items, alpha=0.81); Self-Monitoring and Insight (seven items, alpha=0.70); Health Service Navigation (five items, alpha=0.82); Social Integration and Support (five items, alpha=0.86); and Emotional Wellbeing (six items, alpha=0.89).

Conclusion: The heiQ has high construct validity and is a reliable measure of a broad range of patient education program benefits.

Practice implications: The heiQ will provide valuable information to clinicians, researchers, policymakers and other stakeholders about the value of patient education programs in chronic disease management.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adaptation, Psychological
  • Attitude to Health
  • Australia
  • Chronic Disease* / prevention & control
  • Chronic Disease* / psychology
  • Disease Management
  • Factor Analysis, Statistical
  • Female
  • Health Behavior
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Models, Psychological
  • Motivation
  • Outcome Assessment, Health Care / methods*
  • Patient Education as Topic* / standards
  • Power, Psychological
  • Program Evaluation / methods*
  • Psychometrics
  • Quality of Life
  • Self Care / methods
  • Self Care / psychology*
  • Self Efficacy
  • Surveys and Questionnaires / standards*