Assessing the Validity and Reliability of Three Indicators Self-Reported on the Pregnancy Risk Assessment Monitoring System Survey
Assessing the Validity and Reliability of Three Indicators Self-Reported on the Pregnancy Risk Assessment Monitoring System Survey
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DOI：
10.1177/003335491312800612
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发表时间：
2013-11-01
影响因子：
3.3
通讯作者：
Morrow, Brian
中科院分区：
文献类型：
--
作者：
Ahluwalia, Indu B.;Helms, Kristen;Morrow, Brian
目标.我们调查了来自妊娠风险评估监测系统（PRAMS）调查的三个自我报告指标的信度和效度。我们使用了来自12个州的2008年PRAMS（n= 15，646）数据，这些州实施了2003年修订的美国活产证明。我们使用出生证明数据作为以下参考：产前参与妇女、婴儿和儿童特别补充营养计划（WIC）;医疗补助支付分娩费用;母乳喂养开始。这些指标在几个人口分组中进行了检查。所有三项措施的可靠性都很高：WIC参与为0.81，医疗补助支付分娩为0.67，母乳喂养开始为0.72。PRAMS指标的有效性也很高：WIC参与（敏感性= 90.8%，特异性= 90.6%），医疗补助支付分娩（敏感性= 82.4%，特异性= 85.6%）;和母乳喂养开始（敏感性= 94.3%，特异性= 76.0%）。除了非西班牙裔黑人妇女的医疗补助支付分娩外，PRAMS的患病率估计值高于出生证明的每个指标。大多数亚组内的Kappa值保持在中等范围内（0.40-0.80）。敏感性和特异性值较低的西班牙裔妇女谁回答了西班牙语的PRAMS调查和母乳喂养开始的妇女谁交付非常低的出生体重和非常早产儿。评估措施的PRAMS数据的有效性和可靠性很高。我们的研究结果支持使用PRAMS数据进行流行病学监测，研究和规划。
Objectives. We investigated the reliability and validity of three self-reported indicators from the Pregnancy Risk Assessment Monitoring System (PRAMS) survey.Methods. We used 2008 PRAMS (n=15,646) data from 12 states that had implemented the 2003 revised U.S. Certificate of Live Birth. We estimated reliability by kappa coefficient and validity by sensitivity and specificity using the birth certificate data as the reference for the following: prenatal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); Medicaid payment for delivery; and breastfeeding initiation. These indicators were examined across several demographic subgroups.Results. The reliability was high for all three measures: 0.81 for WIC participation, 0.67 for Medicaid payment of delivery, and 0.72 for breastfeeding initiation. The validity of PRAMS indicators was also high: WIC participation (sensitivity = 90.8%, specificity = 90.6%), Medicaid payment for delivery (sensitivity = 82.4%, specificity = 85.6%);and breastfeeding initiation (sensitivity = 94.3%, specificity = 76.0%). The prevalence estimates were higher on PRAMS than the birth certificate for each of the indicators except Medicaid-paid delivery among non-Hispanic black women. Kappa values within most subgroups remained in the moderate range (0.40-0.80). Sensitivity and specificity values were lower for Hispanic women who responded to the PRAMS survey in Spanish and for breastfeeding initiation among women who delivered very low birthweight and very preterm infants.Conclusion. The validity and reliability of the PRAMS data for measures assessed were high. Our findings support the use of PRAMS data for epidemiological surveillance, research, and planning.