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Measuring disparities: bias in the Short Form-36v2 among Spanish-speaking medical patients.

Abstract：

BACKGROUND:Many national surveys have found substantial differences in self-reported overall health between Spanish-speaking Hispanics and other racial/ethnic groups. However, because cultural and language differences may create measurement bias, it is unclear whether observed differences in self-reported overall health reflect true differences in health. OBJECTIVES:This study uses a cross-sectional survey to investigate psychometric properties of the Short Form-36v2 for subjects across 4 racial/ethnic and language groups. Multigroup latent variable modeling was used to test increasingly stringent criteria for measurement equivalence. SUBJECTS:Our sample (N=1281) included 383 non-Hispanic whites, 368 non-Hispanic blacks, 206 Hispanics interviewed in English, and 324 Hispanics interviewed in Spanish recruited from outpatient medical clinics in 2 large urban areas. RESULTS:We found weak factorial invariance across the 4 groups. However, there was no evidence for strong factorial invariance. The overall fit of the model was substantially worse (change in Comparative Fit Index >0.02, root mean square error of approximation change >0.003) after requiring equal intercepts across all groups. Further comparisons established that the equality constraints on the intercepts for Spanish-speaking Hispanics were responsible for the decrement to model fit. CONCLUSIONS:Observed differences between SF-36v2 scores for Spanish-speaking Hispanics are systematically biased relative to the other 3 groups. The lack of strong invariance suggests the need for caution when comparing SF-36v2 mean scores of Spanish-speaking Hispanics with those of other groups. However, measurement equivalence testing for this study supports correlational or multivariate latent variable analyses of SF-36v2 responses across all the 4 subgroups, as these analyses require only weak factorial invariance.

journal_name

Med Care

journal_title

Medical care

authors

Sudano JJ,Perzynski A,Love TE,Lewis SA,Murray PM,Huber GM,Ruo B,Baker DW

doi

10.1097/MLR.0b013e31820fb944

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

480-8

issue

eissn

0025-7079

issn

1537-1948

journal_volume

pub_type

杂志文章

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Measuring disparities: bias in the Short Form-36v2 among Spanish-speaking medical patients.