Subjective/Objective Health Measures by Race/Ethnicity

描述(由申请人提供)：目的：种族和民族群体在主观健康指标方面的差异有很好的记录。然而，主观评估也不同，因为混淆了与种族/族裔有关的变量以及其他系统偏见的潜在来源，例如语言和/或文化。因此，一些最广泛使用的主观衡量标准可能并不适用于美国所有的亚人群。本研究检验了SF-36(主观测量)的测量等价性和几个不同种族/民族之间的基于表现的身体功能指数(“黄金标准”)的测量等价性，解决了以下问题：1)这些人群的主观测量和体能测量是否存在结构等价性差异(测量不变性)；2)主观测量中是否有种族/民族的主观测量中存在差异项目功能(DIP)的迹象；3)在控制其他变量后，主观测量是否在每个组中平等地预测基于表现的测量(度量和标量等价)；以及4)观察到的差异是否因性别而异？方法：从克利夫兰和芝加哥的4个普通内科诊所和其他社区中心招募来自4个种族/民族(非西班牙裔白人、非西班牙裔非裔美国人、说英语的拉美裔美国人、说西班牙语的拉美裔美国人；N=1320)的约330名年龄在45-之间的受试者。SF-36是一项简短的人口统计学调查，将使用训练有素的临床研究助理对每个受试者进行11项身体任务(上肢和下肢力量、耐力、敏捷性/灵巧度、步态和爬楼梯)。将审查病历，并记录慢性病和药物。使用结构方程模型、验证性因素分析、多元回归技术和项目反应理论(IRT)的数据分析将被用来调查上述目标。意义：这项研究将首次验证身体机能和总体健康状况的主观衡量标准，使用包括讲英语和西班牙语的中年拉美裔美国人在内的基于表现的“黄金标准”，增加对我们增长最快的种族人口的健康状况衡量的知识。无论结果如何，结果将为指导进一步研究提供启发式价值，并将为评估当前调查的变化提供指导。

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.