Development and Validation of the Consumer Health Activation Index.
Development and Validation of the Consumer Health Activation Index.
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DOI：
10.1177/0272989x17753392
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Martin D
中科院分区：
文献类型：
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作者：
Wolf MS;Smith SG;Pandit AU;Condon DM;Curtis LM;Griffith J;O'Conor R;Rush S;Bailey SC;Kaplan G;Haufle V;Martin D
虽然人们对患者参与越来越感兴趣，但很少有公开可用的措施适合健康素养有限的患者。我们试图开发一种消费者健康激活指数(CHAI)，供不同患者使用。利用专家意见、系统的文献综述、焦点小组和对患者的认知访谈来创建和修改潜在的条目集。然后，在项目反应理论的指导下，对301名说英语的社区成年人进行了心理测量测试。这包括不同的项目功能分析，以评估不同参与者健康素养水平的项目表现。为了确定结构效度，将CHAI分数与测量相似人格结构的量表进行了比较。CHAI与身心健康之间的关联建立了预测效度。另一项针对9478名成年人的研究被用来证实柴胡与健康结局之间的关系。探索性因素分析显示，10个项目的单因素解决方案。CHAI具有良好的内部一致性(α=0.81)和中等的重测信度(ICC=0.53)。其阅读年级水平为6年级。与相似结构(多维健康控制源；r=0.38，p<；0.001；尽职尽责，r=0.41，p<；0.001)有中等到高度的相关性。预测效度是通过与功能性健康状况测量(抑郁，r=−0.28p<；0.001；焦虑，r=−0.22，p<；0.001；和身体功能，r=0.22，p<；0.001)的关联来证明的。在验证样本中，CHAI与自我报告的身心健康显著相关(r分别为0.31和0.32，P<；0.001)。CHAI似乎是一种有效、可靠和易于管理的工具，可用于评估成年人的健康激活情况，包括那些健康素养有限的人。未来的研究应该在实际使用中测试该工具，并探索进一步的应用。
While there has been increasing interest in patient engagement, few measures are publicly available and suitable for patients with limited health literacy. We sought to develop a Consumer Health Activation Index (CHAI) for use among diverse patients. Expert opinion, a systematic literature review, focus groups and cognitive interviews with patients were utilized to create and revise a potential set of items. Psychometric testing guided by item response theory was then conducted among 301 English-speaking, community-dwelling adults. This included differential item functioning analyses to evaluate item performance across participant health literacy levels. To determine construct validity, CHAI scores were compared to scales measuring similar personality constructs. Associations between the CHAI, physical and mental health established predictive validity. A second study among 9,478 adults was used to confirm CHAI associations with health outcomes. Exploratory factor analyses revealed a single factor solution with a 10-item scale. The CHAI showed good internal consistency (alpha=0.81) and moderate test-retest reliability (ICC=0.53). Its reading grade level was found to be at the 6th grade. Moderate to strong correlations were found with similar constructs (Multidimensional Health Locus of Control; r=0.38, p<0.001; Conscientiousness, r=0.41, p<0.001). Predictive validity was demonstrated through associations with functional health status measures (depression, r=−0.28, p<0.001; anxiety, r=−0.22, p<0.001; and physical functioning, r=0.22, p<0.001). In the validation sample, the CHAI was significantly associated with self-reported physical and mental health (r=0.31 and r0.32 respectively, both p<0.001). The CHAI appears to be a valid, reliable, and easily administered tool that can be used to assess health activation among adults, including those with limited health literacy. Future studies should test the tool in actual use and explore further applications.