With a goal to “alleviate immediate and preventable suffering,” QALY seems to be a pretty terrible metric. You need to measure immediacy, preventability, and suffering, or at least the suffering due to just the immediate and preventable causes. I would suggest suffering needs construct definition before you consider an operationalization.
It would be smart to measure pre- and post-intervention. The good news is that if suffering is a subjective psychological state, you could do post-only and measure perceived change. If you’re worried about self-report, you could do observer-report (case worker), but since they’ll be doling out the funds that could be biased as well (and presumably they’ll be basing these decisions in part on self-reports of what is a “fire”).
The type of counterfactual analysis tailcalled suggests is likely what the family or case worker would be mentally approximating when responding to how big of a difference paying off the utility bill or a pizza night made to their suffering. Plus, n=1, so a qualitative assessment may be all you can really do—if they rate something a 7⁄7 on reducing their suffering and everything else came in at 1-2, sure, that hits you between the eyes, though you’d probably get that anyway from them saying “the most important thing, by a mile, was X, and this is why...”
With a goal to “alleviate immediate and preventable suffering,” QALY seems to be a pretty terrible metric. You need to measure immediacy, preventability, and suffering, or at least the suffering due to just the immediate and preventable causes. I would suggest suffering needs construct definition before you consider an operationalization.
It would be smart to measure pre- and post-intervention. The good news is that if suffering is a subjective psychological state, you could do post-only and measure perceived change. If you’re worried about self-report, you could do observer-report (case worker), but since they’ll be doling out the funds that could be biased as well (and presumably they’ll be basing these decisions in part on self-reports of what is a “fire”).
The type of counterfactual analysis tailcalled suggests is likely what the family or case worker would be mentally approximating when responding to how big of a difference paying off the utility bill or a pizza night made to their suffering. Plus, n=1, so a qualitative assessment may be all you can really do—if they rate something a 7⁄7 on reducing their suffering and everything else came in at 1-2, sure, that hits you between the eyes, though you’d probably get that anyway from them saying “the most important thing, by a mile, was X, and this is why...”