Document Detail

Measuring disparities: bias in the Short Form-36v2 among Spanish-speaking medical patients.
MedLine Citation:
PMID:  21430580     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Many national surveys have found substantial differences in self-reported overall health between Spanish-speaking Hispanics and other racial/ethnic groups. However, because cultural and language differences may create measurement bias, it is unclear whether observed differences in self-reported overall health reflect true differences in health.
OBJECTIVES: This study uses a cross-sectional survey to investigate psychometric properties of the Short Form-36v2 for subjects across 4 racial/ethnic and language groups. Multigroup latent variable modeling was used to test increasingly stringent criteria for measurement equivalence.
SUBJECTS: Our sample (N=1281) included 383 non-Hispanic whites, 368 non-Hispanic blacks, 206 Hispanics interviewed in English, and 324 Hispanics interviewed in Spanish recruited from outpatient medical clinics in 2 large urban areas.
RESULTS: We found weak factorial invariance across the 4 groups. However, there was no evidence for strong factorial invariance. The overall fit of the model was substantially worse (change in Comparative Fit Index >0.02, root mean square error of approximation change >0.003) after requiring equal intercepts across all groups. Further comparisons established that the equality constraints on the intercepts for Spanish-speaking Hispanics were responsible for the decrement to model fit.
CONCLUSIONS: Observed differences between SF-36v2 scores for Spanish-speaking Hispanics are systematically biased relative to the other 3 groups. The lack of strong invariance suggests the need for caution when comparing SF-36v2 mean scores of Spanish-speaking Hispanics with those of other groups. However, measurement equivalence testing for this study supports correlational or multivariate latent variable analyses of SF-36v2 responses across all the 4 subgroups, as these analyses require only weak factorial invariance.
Joseph J Sudano; Adam Perzynski; Thomas E Love; Steven A Lewis; Patrick M Murray; Gail M Huber; Bernice Ruo; David W Baker
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Medical care     Volume:  49     ISSN:  1537-1948     ISO Abbreviation:  Med Care     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-15     Completed Date:  2011-06-21     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  480-8     Citation Subset:  IM    
Center for Health Care Research and Policy Case Western Reserve University at The Metro Health System, 2500 Metro Health Drive R236A, Cleveland, OH, USA.
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MeSH Terms
Bias (Epidemiology)
Chicago / epidemiology
Cross-Sectional Studies
Educational Status
Factor Analysis, Statistical
Health Care Surveys / standards*,  statistics & numerical data
Healthcare Disparities / standards,  statistics & numerical data*
Hispanic Americans* / statistics & numerical data
Interviews as Topic
Middle Aged
Ohio / epidemiology
Questionnaires / standards
Socioeconomic Factors
Grant Support
R01 AG022459-01A2/AG/NIA NIH HHS; R01-AG022459/AG/NIA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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