Measuring disparities: bias in the Short Form-36v2 among Spanish-speaking medical patients.
Measuring disparities: bias in the Short Form-36v2 among Spanish-speaking medical patients.
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DOI：
10.1097/mlr.0b013e31820fb944
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发表时间：
2011-05
期刊：
影响因子：
3
通讯作者：
Baker DW
中科院分区：
文献类型：
--
作者：
Sudano JJ;Perzynski A;Love TE;Lewis SA;Murray PM;Huber GM;Ruo B;Baker DW
许多全国性调查发现，讲西班牙语的拉美裔与其他种族/族裔群体在自我报告的总体健康状况（SROH）方面存在显著差异。然而，由于文化和语言差异可能产生测量偏差，目前尚不清楚所观察到的SROH差异是否反映了健康状况的真实差异。
本研究采用横断面调查来研究SF - 36v2在四个种族/族裔和语言群体中的心理测量特性。多组潜变量模型用于测试越来越严格的测量等价性标准。
我们的样本（N = 1281）包括383名非拉美裔白人、368名非拉美裔黑人、206名用英语接受访谈的拉美裔以及324名从两个大城市地区的门诊医疗诊所招募的用西班牙语接受访谈的拉美裔。
我们发现四个群体之间存在弱因子不变性，但不存在强因子不变性。在要求所有群体的截距相等后，模型的整体拟合度明显变差（CFI变化>0.02，RMSEA变化>0.003）。进一步的比较确定，对讲西班牙语的拉美裔截距的等式约束是导致模型拟合度下降的原因。
与其他三个群体相比，讲西班牙语的拉美裔在SF - 36v2分数上的观测差异存在系统性偏差。缺乏强不变性表明，在比较讲西班牙语的拉美裔与其他群体的SF - 36v2平均分数时需要谨慎。然而，本研究的测量等价性测试支持对所有四个亚组的SF - 36v2回答进行相关性或多变量潜变量分析，因为这些分析仅需要弱因子不变性。
Many national surveys have found substantial differences in self-reported overall health (SROH) 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 SROH reflect true differences in health. This study uses a cross-sectional survey to investigate psychometric properties of the SF-36v2 for subjects across four racial/ethnic and language groups. Multi-group latent variable modeling was used to test increasingly stringent criteria for measurement equivalence. 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 two large urban areas. We found weak factorial invariance across the four groups. However, there was no strong factorial invariance. The overall fit of the model was substantially worse (change in CFI > .02, RMSEA change > .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. Observed differences between SF-36v2 scores for Spanish speaking Hispanics are systematically biased relative to the other three 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 four subgroups, since these analyses require only weak factorial invariance.