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Table 1 Characteristics of the empowerment measurement adopted in the review

From: Assessment tools measuring health-related empowerment in psychosocially vulnerable populations: a systematic review

Author (year) Country Study aim Participants characteristics Measure Item development No. of scale items Methods of administration Domains of empowerment Response scale EFA and/ or CFA
Anderson, Funnell [30] USA To evaluate the effectiveness of a problem-based empowerment patient education program targeting urban African Americans with type 2 diabetes N = 239
Mean age = 61
Mean years since diagnosis = 8.5
Currently Married = 31%
Completed
high school = 73%
Without insurance = 73%
Diabetes Empowerment Scale Short-Form (DESSF) NR 8 Self-administered 8 domains:
1) assessing the need for change
2) developing a plan 3) overcoming barriers 4) asking for support 5) supporting oneself 6) coping with emotion 7) motivating oneself; 8) making diabetes care choices appropriate for one’s priorities and circumstances
4-Point Likert Scale NR
Bhatta and Liabsuetrakul [31] Nepal To assess effectiveness of an empowerment intervention to HIV infected people receiving prevention and antiretroviral therapy N = 132
Mean age (intervention group) = 36.3 Mean age (control group) = 35.8 The majority had a low family income, was married and had children
Empowerment Scale NR 28 Self-administered 5 domains:
1)self-efficacy/self-esteem
2)power-powerlessness 3) community activism and autonomy 4) optimism and control over the future 5) righteous anger
5-Point Likert Scale NR
Blanchard, Mohan [15] India To assess effectiveness of empowerment program for HIV prevention among female sex workers N = 1750
Mean age = 32, majority were unable to read or write
Empowerment survey Adapted from previous surveys NR interviewer-administered 3 domains:
1) power with: a sense of individual self-esteem and confidence
2) power within: collective identity and solidarity
3) power over: reflects access to social entitlements
4-Point Likert Scale EFA
Borghei, Taghipour [32] Iran To development and validation of a new tool to measure Iranian pregnant women’s empowerment N = 161
Mean age = 25.8
A great majority of pregnant mothers (92.5%) were primigravidae and most of them (87.0%) lived independently with their husbands
Self-Structured Pregnancy Empowerment Questionnaire Literature review, panel consultation and pilot testing 32 Self-administered 3 domains:
1) educational empowerment
2) autonomy
3)socio-political empowerment
4-Point Likert Scale EFA
Cheung, Mok [33] Hongkong, China To examines the relationship between personal empowerment and life satisfaction among self-help group members N = 719
31 to 40 years old (27.1%)
41 to 50 years old (30.2%)
51 to 60 years old (16.1%)
Above 61 year old (19.4%)
majority had a rather low education level
Personal empowerment
Scale
NR 20 Self-administered 3 domains:
1) intrapersonal empowerment
2) interpersonal empowerment 3) extrapersonal empowerment
6-Point Likert Scale NR
Contreras-Yáñez, Ruiz-Medrano [20] Mexico To adapt the Spanish version of the Health Empowerment Scale (S-HES) in RA patients from Latin American N = 270
Patients were primarily middle-aged females, married, had basic education and medium-low socioeconomic status
RA Empowerment Scale for Hispanic patients (RAEH) Literature review, panel consultation and pilot testing 8 Self-administered 8 domains:
1) satisfaction and dissatisfaction related to health
2) identification and achievement of personally meaningful goals
3) application of a systematic problem-solving process
4) coping with the emotional aspects of living with health
5) stress management
6) appropriate social support
7) self-motivation
8) making cost/benefit decisions about making behavior changes
5-Point Likert Scale EFA
Corrigan [34] USA To assess relationship between participation in consumer operated services and measures of recovery and empowerment in people with psychiatric disability N = 1824
1094 were women (60%) Mean ± SD = 41.8 ± 10.4 1356 (74%) was European American
Empowerment Scale NR 28 Self-administered 5 domains:
1)self-efficacy/self-esteem
2)power-powerlessness 3) community activism and autonomy 4) optimism and control over the future 5) righteous anger
4-Point Likert Scale NR
Dempsey and Dunst [35] USA, and Australia To investigate how help-giving practices operate to produce variations in family empowerment N = 141
Most respondents were mothers;
Majority of Children of Australian respondents were more likely to be over 3 years of age
Family Empowerment Scale (FES) NR 34 Self-administered 2 domains:
1) level of empowerment (individual, service and community)
2) expression of empowerment (attitude, knowledge and behaviour)
NR EFA
Diamond-Smith, Treleaven [36] India To explore whether measures of women’s empowerment are associated with their experiences of mistreatment at their last childbirth N = 759
young women aged 16–30 living in slum
areas;
All women had given birth in the last 5 years
Gender Equitable Men scale NR 24 Self-administered 4 domains:
1)violence
2) sexual relationships
3) reproductive health and disease prevention
4) domestic chores and daily life
3-Point Likert Scale NR
Farber and Maharaj [37] USA To evaluate effectiveness of a group-based education curriculum empowerment program on high-risk African American families with children with developmental delays N = 39
32 participants (82%) aged 30–49
Participants had on average about three children listed
as living at home and under 18 years of age
Shortened Family Empowerment Scale (FES) NR 16 Self-administered 2 domains:
1) level of empowerment (individual, service and community)
2) expression of empowerment (attitude, knowledge and behaviour)
5-Point Likert Scale NR
Godoy, Patel [38] Bolivia To explore nutritional status and spousal empowerment among native Amazonians N = 440
Of the 231 households, 209 households were headed jointly by a wife and by a husband, and 22 were headed by a single adult
Individual
empowerment survey
Literature review 10 Self-administered;
Cross-checking
2 domains:
1)Decider
2) tie breaker
5-Point Likert Scale NR
Hansson and Björkman [39] Sweden To assess reliability and validity of the Swedish version of an empowerment scale in people with a mental illness N = 92
Mean age = 47
Approximately 60% of the subjects had a schizophrenia diagnosis and a further 20% other psychosis diagnoses
Making Decisions scale Adaption from the original empowerment scale (ES) 28 Self-administered 5 domains:
1)self-efficacy/self-esteem
2)power-powerlessness 3) community activism and autonomy 4) optimism and control over the future 5) righteous anger
4-Point Likert Scale EFA
Haswell, Kavanagh [17] Australia To validate psychometric properties of the Growth and Empowerment Measure (GEM) in Indigenous Australians N = 184
Mean age = 39.9
163 Aboriginal (88.6%), 13 Torres Strait Islander (7.1%) or both (4.3%)
Growth and Empowerment Measure (GEM) Literature review, panel consultation and pilot testing 14-item and 12 Scenarios Self-administered 2 domains:
1) Emotional Empowerment Scale (EES) (Self-Capacity; Inner Peace)
2) 12S (Healing and Enabling Growth, Connection and Purpose)
EES:5-Point Likert Scale
12S: 7-Point Likert Scale
EFA
Homko, Sivan [40] USA To examine the effect of self-monitoring blood glucose on feelings of self-efficacy in women with gestational diabetics N = 58
Maternal mean age (mean ± SD)
SMBG group: =30.3 ± 5.4
PM group: 29.0 ± 6.4
Diabetes Empowerment scale NR 23 Self-administered 5 domains:
1) setting goals
2) solving problems
3) obtaining support 4) motivating oneself 5) making decisions
5-Point Likert Scale NR
Jersky, Titmuss [13] Australia To evaluate effectiveness an urban art-based community health program on improving health service access and wellbeing of young Aboriginal parents N = 92
88 females, 4 males
Growth and Empowerment Measure (GEM) NR 14-item and 10 Scenarios Self-administered 2 domains:
1) Emotional Empowerment Scale (EES) (Self-Capacity; Inner Peace)
2) 10S (Healing and Enabling Growth, Connection and Purpose)
EES:5-Point Likert Scale
12S: 7-Point Likert Scale
NR
Kaczinski, Rosenheck [41] USA To assess psychometric property of empowerment and confidence among veterans with psychiatric disabilities N = 296
Mean age = 48.5; Majority participants
male (95%) and white (66%)
Empowerment Scale NR 28 Self-administered 5 domains:
1)self-efficacy/self-esteem
2)power-powerlessness 3) community activism and autonomy 4) optimism and control over the future 5) righteous anger
4-Point Likert Scale NR
Kameda and Shimada [42] Japan To develop an empowerment scale for pregnant women N = 171
Mean age (Mean ± SD) = 29.1 ± 4.4;
gestational age = 27.8 ± 9.8
Empowerment Scale for pregnant women Literature review, panel consultation and pilot testing 27 Self-administered 5 domains:
1)self-efficacy
2) future image
3)self-esteem
4) support and assurance from others
5) joy of an addition to the family
4-Point Likert Scale EFA
Klima, Vonderheid [43] USA To develop a Pregnancy-related Empowerment Scale and adapted in Spanish-speaking population N = 365
Mean age (mean ± SD) = 27.1 ± 6.40 36.1% were Black non-Hispanic, 42.6% were White non-Hispanic and 21.3% were Hispanic
Pregnancy-Related Empowerment Sscale (PRES) Literature review, panel consultation and pilot testing 16 Self-administered 4 domains:
1) provider connectedness
2) skilful decision-making
3) peer Connectedness
4) gaining voice
4-Point Likert Scale CFA
Koren, DeChillo [44] USA To measure empowerment in families with children having emotional disabilities N = 440
Mean age (mean ± SD) = 40 ± 6.6
Majority are female, white
Family Empowerment Scale (FES) Literature review, pilot testing 34 Self-administered 3 domains:
1)Family
2) service system
3)community/political
5-Point Likert Scale EFA
LoGiudice, Josif [45] Australia To describe demographic features and wellbeing of carers of Aboriginal Australians N = 124
Mean age (mean ± SD) =38.8 ± 15.0
majority (97.6%) identified as Aboriginal
Growth and Empowerment Measure (GEM) NR 14-item and
A 6 item short form (Core6)
Self-administered 2 domains:
1) Emotional Empowerment Scale (EES) (Self-Capacity; Inner Peace)
2) Core 6 (Healing and Enabling Growth, Connection and Purpose)
EES:5-Point Likert Scale
12S: 7-Point Likert Scale
NR
Patil, Klima [14] Africa To investigate how antenatal care affects aspects of women’s sense of control over their pregnancy N = 218
All participants aged 16 years old, and 20–24 weeks pregnant
Pregnancy-Related Empowerment Scale (PRES) NR 16 Self-administered 4 domains:
1) provider connectedness
2) skilful decision-making
3) peer Connectedness
4) gaining voice
4-Point Likert Scale NR
Nishita, Cardazone [46] USA To examine effectiveness of empowerment program: life coaching and pharmacist counseling for employed adults with diabetes N = 190
Mean age (mean ± SD) =48.46 ± 0.71
6% of whom were Asian and 35% of whom were Native Hawaiian or Pacific Islander
Diabetes Empowerment Scale Short-Form (DESSF) NR 8 Self-administered 8 domains:
1) assessing the need for change
2) developing a plan 3) overcoming barriers 4) asking for support 5) supporting oneself 6) coping with emotion 7) motivating oneself; 8) making diabetes care choices appropriate for one’s priorities and circumstances
4-Point Likert Scale NR
Yamada and Suzuki [47] Japan To assess the levels of empowerment in Japanese patients with chronic schizophrenia N = 72
Mean age (mean ± SD) =41.7 ± 10.7, men, n = 43; women, n = 29
Empowerment Scale-J   28 Self-administered 5 domains:
1)self-efficacy/self-esteem
2)power-powerlessness 3) community activism and autonomy 4) optimism and control over the future 5) righteous anger
4-Point Likert Scale NR
Castelein, van der Gaag [48] Netherlands To compare three instruments that are used to measure empowerment of people with psychotic disorders N = 50
Mean age (mean ± SD) =31.4 ± 13.0
mean duration of illness was 6.5 ± 6.3 years
The diagnostic criteria for 39 participants were diagnosed with schizophrenia and 11 had a related psychotic disorder
Empowerment Scale (ES);
the Personal Empowerment Scale (PES);
the Mental Health Confidence Scale (MHCS)
NR ES: 28
PES: 20
MHCS:
16
Self-administered ES 5 domains:
1)self-efficacy/self-esteem
2)power-powerlessness 3) community activism and autonomy 4) optimism and control over the future 5) righteous anger
PES 2 domains:
1)discretion
2) reduction in chance
MHCS 3 domains:
1)optimism
2) coping
3) advocacy
NR NR
Bovill, Bar-Zeev [49] Australia To pilot the Growth and Empowerment Measure (GEM) with a sample of pregnant Aboriginal women who smoke N = 15
Mean age = 27.2 ± 5.5
and the average duration of pregnancy in weeks was 19.2
Growth and Empowerment Measure (GEM) NR 14-item and
a 6 item short form (Core6)
Self-administered 2 domains:
1) Emotional Empowerment Scale (EES) (Self-Capacity; Inner Peace)
2) Core 6 (Healing and Enabling Growth, Connection and Purpose)
EES:5-Point Likert Scale
12S: 7-Point Likert Scale
NR
Berry, Crowe [50] Australia To examines the sensitivity to change of the new Growth and Empowerment Measure (GEM) for Indigenous Australians in Substance Abuse Treatment N = 103
included 57 Indigenous and 46 non-Indigenous males over 18 years of age
Growth and Empowerment Measure (GEM) NR 14-item and
A 6 item short form (Core6)
Self-administered 2domains:
1) Emotional Empowerment Scale (EES) (Self-Capacity; Inner Peace)
2) Core 6 (Healing and Enabling Growth, Connection and Purpose)
EES:5-Point Likert Scale
12S: 7-Point Likert Scale
NR
  1. EFA exploratory factor analysis, CFA confirmatory factor analysis, NR Not reported