Assessing the AQOL-MHS: Longitudinal Change and Clinical Applicability

 描述(由申请人提供)：健康结果研究对于做出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)，有可能改善健康质量和公平，特别是对未得到充分服务的人群，并减少昂贵或无效治疗的做法。制定侧重于拉丁裔人口生活质量的成果衡量标准对公共卫生有重大影响，对于全面了解个人的身心健康状况至关重要。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)，这是一个新的西班牙语工具，专注于有心理健康问题的青少年(12-18岁)的生活质量。AQOL-MHS是由居住在岛上的波多黎各青少年用西班牙语开发的，并取得了令人振奋的成果。这一更新应用程序扩展了我们在三个重要领域的工作：它扩展了对AQOL-MHS纵向数据的分析，将注意力集中在测量的纵向效用上，并检查了其临床适用性的障碍。拟议的目标将：1)评估AQOL-MHS使用创新的变化心理测量模型检测生活质量随时间变化的能力，以及2)考虑对AQOL-MHS进行改进，以提高其对变化的敏感度。为了实现这些目标，我们将把心理测量学方法从日记研究和动态评估应用到生活质量研究领域，以便使用概化理论来衡量治疗过程和治疗后的变化。这将通过二级数据分析进行。然后，我们将使用这些结果来改进AQOL-MHS，使其对变化敏感，并在新的数据收集中测试它们，样本量增加到250名青少年参与者和四波数据。我们还将检查精神卫生提供者在使用AQOL-MHS的实践中遇到的障碍，采用混合方法设计(n=30)。这包括探索新的技术解决方案，以克服临床环境下AQOL-MHS管理方面的障碍。我们相信，AQOL-MHS将通过向提供者提供反馈以改善护理，帮助将研究整合到实践中，既可以作为进一步探索诊断和治疗的筛查工具，也可以作为评估治疗结果的精神健康生活质量评估工具。

 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.