Assessing the AQOL-MHS: Longitudinal Change and Clinical Applicability

 描述（由申请人提供）：健康结果研究对于制定有效的临床研究和实践决策至关重要。改善患者报告的结果，如生活质量（QOL），有可能提高健康质量和公平性，特别是对于服务不足的人群，以及减少昂贵或无效治疗的做法。制定一个结果的措施，侧重于拉丁美洲人口的生活质量具有重大的公共卫生影响，是至关重要的，以提供一个完整的个人的身心健康状况的图片。我们之前的工作产生了青少年生活质量心理健康量表（AQOL-MHS），这是一种新的西班牙语工具，专注于青少年（12-18岁）的生活质量与心理健康问题。AQOL-MHS是用西班牙语与生活在岛上的波多黎各青少年一起开发的，并产生了有希望的结果。这项更新申请扩展了我们在三个重要领域的工作：它扩展了AQOL-MHS纵向数据的分析，重点关注该措施的纵向效用，并检查其临床适用性的障碍。拟议的目标将：1）评估AQOL-MHS使用创新的心理测量变化模型检测生活质量随时间变化的能力，2）考虑对AQOL-MHS进行改进，以提高其对变化的敏感性。为了实现这些目标，我们将适应心理测量方法，从日记研究和门诊评估领域的生活质量研究，以衡量在治疗过程中的变化和治疗后使用概化理论。这将通过次要数据分析进行。然后，我们将使用这些结果来完善AQOL-MHS，使其对变化敏感，并在新的数据收集中进行测试，增加250名青少年参与者的样本量和四波数据。我们还将研究精神卫生服务提供者在实践中使用混合方法设计（n=30）利用AQOL-MHS所遇到的障碍。这包括探索新的技术解决方案，以克服在临床环境中管理AQOL-MHS的障碍。我们相信，AQOL-MHS将有助于通过向提供者提供反馈来将研究融入实践，以改善护理，并作为进一步探索诊断和治疗的筛选工具，以及作为心理健康QOL评估工具来评估治疗结果。

 DESCRIPTION (provided by applicant): Health outcomes research is essential for making effective clinical research and practice decisions. Improving patient-reported outcomes, such as Quality of Life (QOL), has the potential to improve health quality and equity, especially for underserved populations, as well as reduce the practice of costly or ineffective treatment. Developing an outcome measure that focuses on the quality of life of Latino populations has a substantial public health impact and is crucial to provide a complete picture of an individual's physical and mental health status. Our prior work yielded the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS), a new Spanish language instrument that focuses on the QOL of adolescents (12-18 years old) with mental health problems. The AQOL-MHS was developed in Spanish with Puerto Rican adolescents living on the island and has produced promising results. This renewal application extends our work in three significant areas: It expands the analyses of longitudinal data for the AQOL-MHS, focuses attention on the longitudinal utility of the measure, and examines barriers to its clinical applicability. The proposed aims will: 1) assess the ability of the AQOL- MHS to detect change in quality of life over time using innovative psychometric models of change and 2) consider refinements to the AQOL-MHS that improve its sensitivity to change. To achieve these aims we will adapt psychometric methodology from diary research and ambulatory assessment to the field of QOL research, in order to measure change over the course of treatment and post-treatment using Generalizability Theory. This will be conducted with secondary data analyses. We will then use these results to refine the AQOL-MHS to be sensitive to change and test them in new data collection with an increased sample size of 250 adolescent participants and four waves of data. We will also examine the barriers experienced by mental health providers in utilizing the AQOL-MHS in their practice using a mixed methods design (n=30). This includes exploring new technological solutions to overcome barriers regarding the administration of the AQOL- MHS in clinical settings. We believe that the AQOL-MHS will help integrate research into practice by providing feedback to the provider to improve care, and serve both as a screening tool for further exploration of diagnosis and treatment, as well as function as a mental health QOL assessment instrument to evaluate treatment outcomes.