Subjective/Objective Health Measures by Race/Ethnicity

按种族/民族划分的主观/客观健康指标

• 批准号: 7066646
• 负责人: JOSEPH J SUDANO
• 金额: $ 47.48万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7066646
• 关键词: African American; Hispanic Americans; balance; behavioral /social science research tag; bias; body composition; caucasian American; clinical research; culture; data collection methodology /evaluation; functional ability; gait; gender difference; health surveys; human middle age (35-64); human subject; language; muscle strength; oxygen consumption; quality of life; questionnaires; racial /ethnic difference; socioeconomics

DESCRIPTION (provided by applicant): Aims: Differences between racial and ethnic groups in subjective measures of health are well documented. However, subjective assessments also differ by confounding variables related to race/ethnicity as well as other potential sources of systematic bias, for example, language and/or culture. Hence, some of the most widely used subjective measures may not be valid across all sub-populations in the United States. This study examines measurement equivalence properties of the SF-36 (subjective measure) and a performance based measure (PBM) index of physical functioning ("gold standard") among several diverse racial/ethnic groups, addressing the following questions: 1) are there structural equivalence differences (measurement invariance) in the subjective measure and PBM across these populations; 2) are there indications of differential item functioning (DIP) within the subjective measure by racial/ethnic group; 3) does the subjective measure predict the performance-based measures equally across each group (metric and scalar equivalence), after controlling for other variables; and 4) do any observed differences vary according to gender? Methods: Approximately 330 subjects age 45-64 from each of the 4 racial/ethnic groups (non- Hispanic whites, non-Hispanic African-Americans, English-speaking Hispanics, Spanish-speaking Hispanics; N=1320) will be recruited from 4 general medicine clinics and other community centers in Cleveland and Chicago. The SF-36, a short demographic survey, and 11 physical tasks (upper and lower extremity strength, endurance, agility/dexterity, gait, and stair climbing) will be administered to each subject using trained clinical research assistants. Medical charts will be reviewed and chronic conditions and medications recorded. Data analysis using structural equation modeling, confirmatory factor analysis, multivariate regression techniques, and item response theory (IRT) will be used to investigate the above aims. Significance: This study will be the first to validate subjective measures of physical functioning and general health status using a performance-based "gold standard" including middle-age English and Spanish speaking Hispanics, adding to the knowledge of health status measurement of our fastest growing ethnic population. Regardless of outcome, results will provide heuristic value in directing further research, and will provide guidance in evaluating changes to current surveys.

描述（由申请人提供）：目的：种族和族裔群体在主观健康衡量方面的差异得到了充分的记录。然而，主观评估也因混淆与种族/民族有关的变量以及其他潜在的系统性偏见来源（例如语言和/或文化）而有所不同。因此，一些最广泛使用的主观测量可能并不适用于美国的所有亚群。本研究考察了不同种族/民族群体的SF-36（主观测量）和基于表现的身体功能测量（PBM）指数（“黄金标准”）的测量等效性，解决了以下问题：1)这些人群的主观测量和PBM是否存在结构性等效差异（测量不变性）；2)在不同种族/民族的主观测量中是否存在差异项目功能（DIP）的迹象；3)在控制了其他变量之后，主观测量是否在每个组中对基于绩效的测量进行了平等的预测（度量和标量等效）；4)观察到的差异是否因性别而异？方法：将从克利夫兰和芝加哥的4个全科诊所和其他社区中心招募大约330名年龄在45-64岁之间的受试者，分别来自4个种族/族裔群体（非西班牙裔白人、非西班牙裔非裔美国人、说英语的西班牙裔美国人、说西班牙语的西班牙裔美国人；N=1320）。SF-36是一项简短的人口统计调查，11项身体任务（上肢和下肢力量、耐力、敏捷性/灵巧性、步态和爬楼梯）将由训练有素的临床研究助理对每个受试者进行管理。将审查医疗图表，并记录慢性病和药物。使用结构方程模型、验证性因子分析、多元回归技术和项目反应理论（IRT）的数据分析将用于调查上述目标。意义：本研究将首次使用基于表现的“黄金标准”来验证身体功能和一般健康状况的主观测量，包括中年英语和讲西班牙语的西班牙裔，增加了对我们增长最快的种族人口健康状况测量的知识。无论结果如何，结果将为指导进一步的研究提供启发式价值，并将为评价当前调查的变化提供指导。