Elizabeth W. Jackson

Psychometric properties of the Centers for Disease Control and Prevention Health-Related Quality of Life (CDC HRQOL) items in adults with arthritis

BackgroundMeasuring health-related quality of life (HRQOL) is important in arthritis and the SF-36v2 is the current state-of-the-art. It is only emerging how well the Centers for Disease Control and Prevention (CDC) HRQOL measures HRQOL for people with arthritis. This studys purpose is to assess the psychometric properties of the 9-item CDC HRQOL (4-item Healthy Days Core Module and 5-item Healthy Days Symptoms Module) in an arthritis sample using the SF-36v2 as a comparison.MethodsIn Fall 2002, a cross-sectional study acquired survey data including the CDC HRQOL and SF-36v2 from 2 North Carolina populations of adult patients reporting osteoarthritis, rheumatoid arthritis, and fibromyalgia; 2182 (52%) responded. The first item of both the CDC HRQOL and the SF-36v2 was general health (GEN). All 8 other CDC HRQOL items ask for the number of days in the past 30 days that respondents experienced various aspects of HRQOL. Exploratory principal components analyses (PCA) were conducted on each sample and the combined samples of the CDC HRQOL. The multitrait-multimethod matrix (MTMM) was used to compute correlations between each trait (physical health and mental health) and between each method of measurement (CDC HRQOL and SF36v2). The relative contribution of the CDC HRQOL in predicting the physical component summary (PCS) and the mental component summary (MCS) was determined by regressing the CDC HRQOL items on the PCS and MCS scales.ResultsAll 9 CDC HRQOL items loaded primarily onto 1 factor (explaining 57% of the item variance) representing a reasonable solution for capturing overall HRQOL. After rotation a 2 factor interpretation for the 9 items was clear, with 4 items capturing physical health (physical, activity, pain, and energy days) and 3 items capturing mental health (mental, depression, and anxiety days). All of the loadings for these two factors were greater than 0.70. The CDC HRQOL physical health factor correlated with PCS (r = -.78, p < 0.0001) and the mental health factor correlated with MCS (r = -.71, p < 0.0001). The relative contribution of the CDC HRQOL in predicting PCS was 73% (R2 = .73) when GEN was included in the CDC HRQOL score and 65% (R2 = .65) when GEN was removed. The relative contribution of the CDC HRQOL in predicting MCS was 56% (R2 = .56) when GEN was included and removed.ConclusionThe CDC HRQOL appears to have strong psychometric properties in individuals with arthritis in both community-based and subspecialty clinical settings. The 9 item CDC HRQOL is a reasonable measure for overall HRQOL and the two subscales, representing physical and mental health, are reasonable when the goal is to examine those aspects.

Consumer Perceptions of Integrated Trauma-Informed Services among Women with Co-Occurring Disorders

As part of a national, multi-site treatment outcome study, an instrument was designed to assess consumers’ perceptions of key services integrating trauma, mental health, and substance abuse issues, the Consumer Perceptions of Care (CPC). This study evaluates the psychometric properties of this instrument and analyzes consumers’ perceptions of the services they received. The results suggest that the measure has four factors: services integration, choice in services, trauma-informed assessment, and respect for cultural identity. These factors demonstrated adequate reliability, and the overall results suggested that the measure is a reliable, sensitive, and valid reflection of consumers’ perceptions of their services and their providers for diverse racial and ethnic groups. Women in the intervention programs perceived their services as more highly integrated for trauma, mental health, and substance use than women in the services as usual or comparison programs, supporting its utility as a measure of programs designed to provide integrated services.

Reliability of Self-Reported Health Service Use: Evidence from the Women with Co-occurring Disorders, and Violence Study

In behavioral health services research, self-reporting provides comprehensive information on service use, but may have limited reliability because of recall bias and misclassification. This study examines test–retest reliability of self-reported health service use, factors affecting reliability, and the impact of inconsistent reporting on the robustness of cost estimates using the test–retest data from the Women, Co-occurring Disorders, and Violence Study (n = 186). Reliability varies widely across service types: moderate to substantial (k = 0.65–0.94) for any use; slight to substantial (ICC = 0.12–0.93) for quantity of use; and none to moderate (k = −0.06–0.79) for service content, but is not affected by psychiatric symptom severity. Cost estimates do not differ according to the use of test or retest data. Findings suggest that self-reporting provides reliable data on service quantity and is adequate for economic evaluations. However, self-reporting of treatment content in highly specified service categories (e.g., individual counseling during residential treatment) may not be reliable.

Toward the abandonment of female genital cutting: advancing research, communication and collaboration.

Local regional and international efforts to end to female genital cutting (FGC) have increased dramatically in recent years. This traditional practice most frequently found in parts of East and West Africa as well as the Nile Valley countries of Egypt and Sudan is variously associated with cultural norms of femininity chastity and religious observance. Efforts to end the practice have met with limited and scattered success and have been constrained by a lack of coordination among the many actors attempting to contribute to the end of this practice. In particular we continue to know very little about the complex social institutions that support this practice the magnitude of the health and psychosexual consequences associated with it or effective means of eliminating it. This gap in practical understanding of factors associated with FGC and effective interventions represents a serious constraint to the promotion of reproductive health in regions of Africa where FGC is widely practiced. It is this information gap that the papers presented in this themed symposium address. (excerpt)