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Health and Work Performance Questionnaire

World Health Organization Health and Work Performance Questionnaire

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Purpose

The HPQ is a self-report instrument that is designed to estimate the workplace costs of health problems in areas of reduced job performance, sickness related absences, and work-related injuries and helps evaluate effects of investments in employee health care.

Link to Instrument

Instrument Details

Acronym HPQ

Area of Assessment

Occupational Performance

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

CDE Status

Not a CDE as of 12/11/2022

Key Descriptions

  • Evaluates three workplace productivity enhancement intervention areas to add rationale to healthcare purchasing decisions shown in three subscales:
    ? Absenteeism (31 items)
    ? Work performance (16 items)
    ? Job-related accidents (8 items)
  • Identifies:
    ? Health problems of the employees
    ? How the health problems impact work performance, absences, accidents, and disability
    ? The monetary value of the impacts on these areas
    ? Identify the available interventions to reduce these impacts and their effectiveness
    ? The return-on-investment (ROI) of these interventions

  • 0-100 score scale with two scoring methods, relative & absolute
    ? Relative scoring: ratio between the employee’s perception of how they perform at work compared to others
    ? Absolute scoring: a percentage rating obtained from the employee’s perception of how they have performed in the last 28 days/four weeks
  • Additional versions of the scale include a short form and a form designed for clinical trials

Number of Items

55

Equipment Required

  • Paper & Pencil

Time to Administer

10 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Instrument Reviewers

Megan Baumunk, MS, CRC, LPC-IT and Lindsay Clark, PhD (University of Wisconsin - Madison vocational rehabilitation)

Kevin Fearn, MS, Shirley Ryan 嫩B研究院

 

ICF Domain

Body Function
Activity
Participation

Measurement Domain

General Health
Activities of Daily Living

Non-Specific Patient Population

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Test/Retest Reliability

Non-Specific: (Kessler et al., 2004; n = 551)

  • Excellent test-retest reliability of HPQ Presenteeism Scale (ICC = 0.89)

 

Internal Consistency

Non-Specific: (Kessler et al., 2003; n = 2,350)

  • Excellent: Cronbach’s alpha for customer service representatives (n=505) was 0.81
  • Adequate: Cronbach’s alpha for reservation agents (n=441) was 0.74

Criterion Validity (Predictive/Concurrent)

 

Predictive validity:

Non-Specific: (Kessler et al., 2004; n = 551)

  • Trichotomized HPQ presenteeism scale significantly predicted supervisor ratings of high and low performance
    • With workers with HPQ scores in the high performance category defined with an OR of 1.0, workers with HPQ medium and low scores had ORs of 2.2 and 5.0 respectively in predicting supervisor ratings of high performance.
    • With workers with HPQ scores in the high performance category defined with an OR of 1.0, workers with HPQ medium and low scores had ORs of 2.1 and 3.9 respectively in predicting supervisor ratings of low performance.

Construct Validity

Convergent validity:

Non-Specific: (Kessler et al., 2003; n = 2,350)

  • Excellent convergent validity between HPQ self-reports about absenteeism and payroll work absence records among reservation agents (n = 441) and railroad engineers (n = 850) (r=0.61-0.87)

Responsiveness

Non-Specific: (Kessler et al., 2004; n = 551)

  • Reliability of HPQ change score was 0.73 and the stability of true presenteeism was 0.59 over a two-month time period
    • The formula for computing the reliability of the HPQ change score implies that the reliability of the score increases as the time interval increases. Over longer time intervals, the stability of true presenteeism would decrease and the reliability of the HPQ change score would increase proportionally.

Arthritis

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Standard Error of Measurement (SEM)

 Arthritis: (AlHeresh et al., 2017; n = 287; mean age = 50.4; SEM calculated from SD/square root of sample size, i.e. SD/16.94).

  • SEM for absolute score: 1.08
  • SEM for relative score: 0.0177

Minimal Detectable Change (MDC)

 Arthritis: (AlHeresh et al., 2017; MDC calculated from 1.96 x SEM x square root of 2)

  • MDC for absolute score: 2.98
  • MDC for relative score: 0.0489

Normative Data

Arthritis: ( AlHeresh et al., 2017; n = 287; mean age = 50.4)

  • HPQ absolute score: Mean = 74.1 (18.3), range 0 - 100
  • HPQ relative score: Mean = 1.0 (0.3), range 0.25 - 2.0

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Arthritis: (Wang et al., 2003; n = 2,350)

  • 17.8 (SE = 6.2) annual excess absenteeism and presenteeism days combined (p < 0.05)
    • When the annual excess absenteeism and presenteeism days are expressed as a rate per 100 overall workers in the workforce, arthritis is associated with the largest aggregate effects for three of the four occupations: reservation agents (226.4 [79.2]), executives (167.6 [58.7]), and railroad engineers (328.0 [114.8]). Arthritis was second-highest for customer service representatives (217.5 [76.1]). 

Annual Excess Absenteeism and Presenteeism Days from Chronic Conditions Per 100 Workers in Four Occupations: 

Chronic Condition

Reservation Agents

No. (SE)

Customer Service Reps

No. (SE)

Executives

No. (SE)

Railroad Engineers

No. (SE)

 

Arthritis

226.4 (79.2)

217.5 (76.1)

167.6 (58.7)

328.0 (114.8)

Asthma

110.6 (49.2)

201.8 (89.9)

77.6 (34.6)

106.7 (47.5)

COPD

128.6 (51.1)

60.0 (33.9)

17.1 (6.9)

85.7 (34.1)

Depression

181.3 (89.3)

219.1 (107.9)

58.9 (29.0)

133.0 (65.5)

Content Validity

Convergent validity:

 

Arthritis: (AlHeresh et al., 2017)

  • Results suggest differences in construct validity depending on the scoring method used (higher correlations when using HPQ absolute vs relative score, although correlations still weaker than expected)

Convergent validity between Health Performance Questionnaire (HPQ) and other measures by HPQ scoring method:

Measure

HPQ Absolute

HPQ Relative

Work Limitations Questionnaire (WLQ)

-0.41

Adequate

-0.25

Poor

Health Assessment Questionnaire (HAQ)

-0.15

Poor

-0.14

Poor

Job Type

0.05

Poor

0.07

Poor

Pain Score

-0.11

Poor

-0.14

Poor

Self-Efficacy

0.29

Poor

0.05

Poor

 

Pulmonary Diseases

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Criterion Validity (Predictive/Concurrent)

 

Predictive validity:

Asthma: (Wang et al., 2003; n = 2,350)

  • 19.4 (SE = 8.6) annual excess absenteeism and presenteeism days combined (p < 0.05)
    • When the annual excess absenteeism and presenteeism days are expressed as a rate per 100 overall workers in the workforce, asthma is associated with the second-largest aggregate effects for executives (77.6 [34.6]), the third-highest effects for customer service agents (201.8 [89.9]) and railroad engineers (106.7 [47.5]), and the lowest effect for reservation agents (110.6 [49.2]).

COPD/Emphysema: (Wang et al., 2003; n = 2,350)

  • 42.9 (SE = 17.0) annual excess absenteeism and presenteeism days combined (p < 0.05)
    • When the annual excess absenteeism and presenteeism days are expressed as a rate per 100 overall workers in the workforce, COPD/Emphysema is associated with the smallest aggregate effects for three of the four occupations: executives (17.1 [6.9]), customer service representatives (60.0 [33.9]) and railroad engineers (85.7 [34.1]). COPD/Emphysema was third-highest for reservation agents (128.6 [51.1]).

Mental Health

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Criterion Validity (Predictive/Concurrent)

 Predictive validity:

Depression: (Wang et al., 2003; n = 2,350)

  • 15.1 (SE = 7.4) annual excess absenteeism and presenteeism days combined (p < 0.05)
    • When the annual excess absenteeism and presenteeism days are expressed as a rate per 100 overall workers in the workforce, depression is associated with the largest aggregate effects for customer service agents (219.1 [107.9]), the second-highest for reservation agents (181.3 [89.3]) and railroad engineers (133.0 [65.5]), and the second-lowest effect for executives (58.9 [29.0]).
 

Bibliography

AlHeresh, R., LaValley, M. P., Coster, W., & Keysor, J. J. (2017). Construct validity and scoring methods of the World Health Organization-Health and Work performance questionnaire among workers with arthritis and rheumatological conditions. Journal of occupational and environmental medicine, 59(6), e112–e118.

Kessler, R. C. (2002). The Harvard health and work performance initiative: Background information. Harvard Medical School. Retrieved Oct 23, 2022 from  

Kessler, R. C., Ames, M., Hymel, P. A., Loeppke, R., McKenas, D. K., Richling, D. E., Stang, P. E., & Ustun, T. B. (2004). Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. Journal of occupational and environmental medicine46(6 Suppl), S23–S37. https://doi.org/10.1097/01.jom.0000126683.75201.c5

Kessler, R. C., Barber, C., Beck, A., Berglund, P., Cleary, P. D., McKenas, D., Pronk, N., Simon, G., Stang, P., Ustun, T. B., & Wang, P. (2003). The World Health Organization Health and Work Performance Questionnaire (HPQ). Journal of occupational and environmental medicine45(2), 156–174.

Harvard Medical School. (2005). World Health Organization Health & Work Performance Questionnaire. Retrieved Oct 23, 2022 from

Wang, P. S., Beck, A., Berglund, P., Leutzinger, J. A., Pronk, N., Richling, D., Schenk, T. W., Simon, G., Stang, P., Ustun, T. B., & Kessler, R. C. (2003). Chronic Medical Conditions and Work Performance in the Health and Work Performance Questionnaire Calibration Surveys. Journal of Occupational and Environmental Medicine, 45(12), 1303–1311. http://www.jstor.org/stable/44996932