Wenjing Huang

The Psychometric Performance of the PROMIS Smoking Assessment Toolkit: Comparisons of Real-Data Computer Adaptive Tests, Short Forms, and Mode of Administration

INTRODUCTION The PROMIS Smoking Initiative has developed six item banks for assessment related to cigarette smoking among adult smokers (Nicotine Dependence, Coping Expectancies, Emotional and Sensory Expectancies, Health Expectancies, Psychosocial Expectancies, and Social Motivations). This article evaluates the psychometric performance of the banks when administered via short form (SF), computer adaptive test (CAT), and by mode of administration (computer vs. paper-and-pencil). METHODS Data are from two sources: an internet sample (N = 491) of daily and nondaily smokers who completed both SFs and CATs via the web and a community sample (N = 369) that completed either paper-and-pencil or computer administration of the SFs at two time points. First a CAT version of the PROMIS Smoking Assessment Toolkit was evaluated by comparing item administration rates and scores to the SF administration. Next, we considered the effect of computer versus paper-and-pencil administration on scoring and test-retest reliability. RESULTS Across the domains approximately 5.4 to 10.3 items were administered on average for the CAT. SF and CAT item response theory-scores were correlated from 0.82 to 0.92 across the domains. Cronbachs alpha for the four- to eight-item SFs among daily smokers ranged from .80 to .91 and .82 to .91 for paper-and-pencil and computer administrations, respectively. Test-retest reliability of the SFs ranged from 0.79 to 0.89 across mode of administration. CONCLUSIONS Results indicate that the SF and CAT and computer and paper-and-pencil administrations provide highly comparable scores for daily and nondaily smokers, but preference for SF or CAT administration may vary by smoking domain.

Additional validity evidence for the PROMIS Smoking Assessment Toolkit

INTRODUCTION The Patient Reported Outcomes Measurement Information System (PROMIS®) Smoking Initiative has developed six item banks for assessing smoking behaviors and biopsychosocial correlates of smoking among daily and nondaily adult cigarette smokers. This paper presents new validity evidence for the item banks including correlations of the item banks to the existing legacy measures of smoking (Fagerström Test of Nicotine Dependence (FTND), Questionnaire of Smoking Urges (QSU), and the Wisconsin Inventory of Smoking Dependence Motives (WISDM)). METHODS Using data from a follow-up sample (N=491) and a community sample (N=369) of adult daily and nondaily smokers, we replicated the findings from Edelen et al. (2014a) and examined the correlations of legacy smoking measures with the new item bank scores. RESULTS Preliminary validity findings were largely replicated with the new data. Correlations among the banks are moderate and bank score associations with measures of smoking behavior, quitting history, and other PROMIS measures follow expected patterns (e.g., nicotine dependence is most strongly associated with smoking quantity and time to first cigarette of the day; health and psychosocial expectancies are most related to quitting recency and interest). Correlations of bank scores with legacy measures are moderate to strong. The PROMIS nicotine dependence scores were most strongly associated with the legacy instruments. CONCLUSIONS These analyses provide strong evidence for the validity of the PROMIS Smoking item banks in two independent samples.

Evaluating the PROMIS-29 v2.0 for use among older adults with multiple chronic conditions

PurposeThe Patient-Reported Outcomes Measurement Information System 29-item profile (PROMIS-29 v2.0), which measures health-related quality of life (HRQoL), has had limited evaluation among older adults (age 65+) with multiple chronic conditions. Our purpose was to establish convergent validity for PROMIS-29 in this population.MethodsWe collected the PROMIS-29 v2.0 and the Veterans RAND 36 (VR-36) for 1359 primary care patients aged 65 + with at least 2 of 13 chronic conditions, oversampling those aged 80+. We conducted multiple analyses to examine score differences across subgroups, differential item functioning (DIF), and comparisons of PROMIS-29 v2.0 and VR-36 scores.ResultsThe mean age was 80.7, and all patients had at least 2 of 13 chronic conditions. Older age, female sex, Hispanic ethnicity, and more chronic conditions were associated with worse physical health scores (PHS) and mental health scores (MHS) on the PROMIS-29 v2.0—findings which are in the expected direction. None of the 700 pairs of items met criteria for DIF. PHS and MHS were highly intercorrelated (r = 0.74, p < 0.001 for this and all other findings). PHS was more highly correlated with the VR-36 Physical Component Score (PCS) than the Mental Component Score (MCS) (r = 0.85 and 0.32, respectively), while MHS was highly correlated with both (r = 0.70 and 0.64, respectively).ConclusionsPROMIS-29 v2.0 demonstrates expected bivariate relationships with key person-level characteristics and does not show DIF. PROMIS-29 v2.0 scores are highly correlated with VR-36 scores. These results provide support for the validity of PROMIS-29 v2.0 as a measure of HRQoL among older adults with multiple chronic conditions.

Calibration of the Spanish PROMIS Smoking Item Banks

INTRODUCTION The Patient-Reported Outcomes Measurement Information System (PROMIS) Smoking Initiative has developed item banks for assessing six smoking behaviors and biopsychosocial correlates of smoking among adult cigarette smokers. The goal of this study is to evaluate the performance of the Spanish version of the PROMIS smoking item banks as compared to the original banks developed in English. METHODS The six PROMIS banks for daily smokers were translated into Spanish and administered to a sample of Spanish-speaking adult daily smokers in the United States (N = 302). We first evaluated the unidimensionality of each bank using confirmatory factor analysis. We then conducted a two-group item response theory calibration, including an item response theory-based Differential Item Functioning (DIF) analysis by language of administration (Spanish vs. English). Finally, we generated full bank and short form scores for the translated banks and evaluated their psychometric performance. RESULTS Unidimensionality of the Spanish smoking item banks was supported by confirmatory factor analysis results. Out of a total of 109 items that were evaluated for language DIF, seven items in three of the six banks were identified as having levels of DIF that exceeded an established criterion. The psychometric performance of the Spanish daily smoker banks is largely comparable to that of the English versions. CONCLUSIONS The Spanish PROMIS smoking item banks are highly similar, but not entirely equivalent, to the original English versions. The parameters from these two-group calibrations can be used to generate comparable bank scores across the two language versions. IMPLICATIONS In this study, we developed a Spanish version of the PROMIS smoking toolkit, which was originally designed and developed for English speakers. With the growing Spanish-speaking population, it is important to make the toolkit more accessible by translating the items and calibrating the Spanish version to be comparable with English-language scores. This study provided the translated item banks and short forms, comparable unbiased scores for Spanish speakers and evaluations of the psychometric properties of the new Spanish toolkit.

Adapting summary scores for the PROMIS-29 v2.0 for use among older adults with multiple chronic conditions

PurposeThe patient-reported outcomes measurement information system 29-item profile (PROMIS-29 v2.0) is a widely used health-related quality of life (HRQoL) measure. Summary scores for physical and mental HRQoL have recently been developed for the PROMIS-29 using a general population. Our purpose was to adapt these summary scores to a population of older adults with multiple chronic conditions.MethodsWe collected the PROMIS-29 v2.0 for 1359 primary care patients age 65+ with at least 2 of 13 chronic conditions. PROMIS-29 has 7 domains, plus a single-item pain intensity scale. We used exploratory factor analysis (EFA), followed by confirmatory factor analysis (CFA), to examine the number of factors that best captured these eight scores. We used previous results from a recent study by Hays et al. (Qual Life Res 27:1885–1891, 2018) to standardize scoring coefficients, normed to the general population.ResultsThe mean age was 80.7, and 67% of participants were age 80 or older. Our results indicated a 2-factor solution, with these factors representing physical and mental HRQoL, respectively. We call these factors the physical health score (PHS) and the mental health score (MHS). We normed these summary scores to the general US population. The mean MHS for our population of was 50.1, similar to the US population, while the mean PHS was 42.2, almost a full standard deviation below the US population.ConclusionsWe describe the adaptation of physical and mental health summary scores of the PROMIS-29 for use with a population of older adults with multiple chronic conditions.

A Psychometric Study of the Modified Bridges for Newborns Screening Tool

Welcome Baby, a program that First 5 Los Angeles (First 5 LA) sponsors, provides new mothers with supportive services intended to create enriching environments for their children. To identify mothers in need of these services, First 5 LA employs hospital liaisons who administer a maternal risk assessment tool, the Modified Bridges for Newborns screening tool, during postpartum interviews of mothers. First 5 LA uses risk assessment scores from the Modified Bridges to classify mothers as low, moderate, or high risk; high-risk mothers are eligible for additional supportive services that are not available to low- and moderate-risk mothers. This article describes RAND Corporation work evaluating the psychometric characteristics of the Modified Bridges.

Development and Maintenance of Standardized Cross Setting Patient Assessment Data for Post-Acute Care: Summary Report of Findings from Alpha 1 Pilot Testing

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to identify and/or develop standardized items to include in the post-acute care patient assessment instruments. RAND was tasked by CMS with developing and testing items to measure seven areas of health status for Medicare beneficiaries: (1) vision and hearing; (2) cognitive status; (3) depressed mood; (4) pain; (5) care preferences; (6) medication reconciliation; and (7) bladder and bowel continence. This article presents results of the first Alpha 1 feasibility test of a proposed set of items for measuring each of these health status areas. Conducted between August and October 2016, the test is one of two Alpha tests that will be completed by mid-2017 to assess the feasibility of proposed items. The results of these small-scale feasibility tests will inform a national Beta test designed to determine how well the measures perform when implemented in post-acute care settings. The Alpha 1 testing phase was successfully completed, in that all items were pilot tested among 133 patients. Items from all content areas were assessed on interrater reliability and feasibility; items from some content areas were assessed on other metrics. Items have now been revised, when necessary, based on the findings of the Alpha 1 test. Alpha 2 testing is under way with the updated, revised items.