ICECAP-A: Developing a Measure of an Adult’s Capabilities Hareth Al-Janabi, PhD Joanna Coast, PhD	PDF File
Health Economics Unit, University of Birmingham, UK Keywords: capability approach; ICECAP; in-depth interviews; item development; thematic analysis

Abstract

The capability approach defines wellbeing in terms of an individual’s ability to ‘be’ and ‘do’ the things that are important in life. A key question in operationalising the capability approach is: “what capabilities underpin an individual’s wellbeing?” Our research aims to address this question through using in-depth and semi-structured interviews to indentify: (i) the attributes of wellbeing for individuals in the UK, and (ii) how these attributes can be expressed in a concise capability instrument that can be used to measure patient outcomes for economic evaluations. 

The ICECAP-A (ICEpop CAPability measure for Adults) project follows on from work previously conducted to develop a

measure of quality of life for older people (ICECAP-O).1 Details of the latter project and the ongoing work can be found at: www.icecap.bham.ac.uk . Qualitative work with older people about what was valuable to them in their lives, revealed that people talked about what they were able to do (their ‘capability’), rather than necessarily what they actually did (their ‘functioning’).2 This led the resulting measure for older people to be conceptually linked with work by (Nobel Prize winner) Amartya Sen on capability, a paradigm that has mostly been associated with development studies, but that also offers promise for evaluating interventions in developed countries. The qualitative work with older people resulted in a measure of capability (ICECAP-O) covering five attributes of wellbeing (associated wording of the measure in parentheses): attachment (love and friendship); security (thinking about the future without concern); role (doing things that make you feel valued); enjoyment (enjoyment and pleasure) and control (being independent). Notably, an individual’s health was incorporated as an influence over their capabilities (e.g. mobility problems could restrict the capability to be independent) rather than health being a capability in its own right. In the ICECAP-O, each attribute (capability) can take one of four levels, roughly corresponding to ‘none’, ‘a little’, ‘a lot’ and ‘all’. With five attributes, each with four levels, the ICECAP-O descriptive system defines 1024 wellbeing states (capability sets).