Psychometric evaluation of the hope, agency and opportunity (HAO): a brief measure of mental health recovery

Background: The development of safe and effective mental health services is a priority. This requires valid measures of personal recovery, yet these tools are not embedded in routine clinical practice. Brief “patient reported measures” are most likely to be acceptable to service-users and clinicians. The 4-item “Hope, Agency and Opportunity” (HAO) was co-produced to assess recovery outcomes and experience of mental health services.

Aim: To evaluate the psychometric properties of the HAO.

Method: A clinical sample from secondary healthcare services and a non-clinical sample were assessed at baseline and two weeks, on measures of personal recovery.

Results: Factor analysis indicated goodness of fit for the HAO with both clinical and non-clinical samples. The measure demonstrated acceptable internal consistency, moderate to strong construct validity and substantial test-retest reliability over two weeks.

Conclusions: The HAO demonstrates satisfactory psychometric properties. Co-production of the measure confers clinical credibility. The brevity of the tool means it can be incorporated into routine clinical practice to drive improvements in service quality.