This study investigated the sensitivity of common fit indices (i.e., RMSEA, CFI, TLI, SRMR-W, and SRMR-B) for detecting misspecified multilevel SEMs. The design factors for the Monte Carlo study were numbers of groups in between-group models (100, 150, and 300), group size (10, 20, 30, and 60), intra-class correlation (low, medium, and high), and the types of model misspecification (Simple and Complex). The simulation results showed that CFI, TLI, and RMSEA could only identify the misspecification in the within-group model. Additionally, CFI, TLI, and RMSEA were more sensitive to misspecification in pattern coefficients while SRMR-W was more sensitive to misspecification in factor covariance. Moreover, TLI outperformed both CFI and RMSEA in terms of the hit rates of detecting the within-group misspecification in factor covariance. On the other hand, SRMR-B was the only fit index sensitive to misspecification in the between-group model and more sensitive to misspecification in factor covariance than misspecification in pattern coefficients. Finally, we found that the influence of ICC on the performance of targeted fit indices was trivial.

BackgroundApproximately 21% of the US population speaks a language other than English at home; many of these individuals cannot effectively communicate in English. Hispanic and Chinese Americans, in particular, are the two largest minority groups having low health literacy in the United States. Fortunately, machine-generated translations represent a novel tool that non-English speakers can use to receive and relay health education information when human interpreters are not available.ObjectiveThe purpose of this study was to evaluate the accuracy of the Google Translate website when translating health information from English to Spanish and English to Chinese.MethodsThe pamphlet, “You are the heart of your family…take care of it,” is a health education sheet for diabetes patients that outlines six tips for behavior change. Two professional translators translated the original English sentences into Spanish and Chinese. We recruited 6 certified translators (3 Spanish and 3 Chinese) to conduct blinded evaluations of the following versions: (1) sentences translated by Google Translate, and (2) sentences translated by a professional human translator. Evaluators rated the sentences on four scales: fluency, adequacy, meaning, and severity. We performed descriptive analysis to examine differences between these two versions.ResultsCronbach's alpha values exhibited high degrees of agreement on the rating outcome of both evaluator groups: .919 for the Spanish evaluators and .972 for the Chinese evaluators. The readability of the sentences in this study ranged from 2.8 to 9.0 (mean 5.4, SD 2.7). The correlation coefficients between the grade level and translation accuracy for all sentences translated by Google were negative (eg, rMeaning=-.660), which indicates that Google provided accurate translation for simple sentences. However, the likelihood of incorrect translation increased when the original English sentences required higher grade levels to comprehend. The Chinese human translator provided more accurate translation compared to Google. The Spanish human translator, on the other hand, did not provide a significantly better translation compared to Google.ConclusionGoogle produced a more accurate translation from English to Spanish than English to Chinese. Some sentences translated by Google from English to Chinese exhibit the potential to result in delayed patient care. We recommend continuous training and credential practice standards for professional medical translators to enhance patient safety as well as providing health education information in multiple languages.

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Several researchers have recommended that level-specific fit indices should be applied to detect the lack of model fit at any level in multilevel structural equation models. Although we concur with their view, we note that these studies did not sufficiently consider the impact of intraclass correlation (ICC) on the performance of level-specific fit indices. Our study proposed to fill this gap in the methodological literature. A Monte Carlo study was conducted to investigate the performance of (a) level-specific fit indices derived by a partially saturated model method (e.g., [Formula: see text] and [Formula: see text]) and (b) [Formula: see text] and [Formula: see text] in terms of their performance in multilevel structural equation models across varying ICCs. The design factors included intraclass correlation (ICC: ICC1 = 0.091 to ICC6 = 0.500), numbers of groups in between-level models (NG: 50, 100, 200, and 1,000), group size (GS: 30, 50, and 100), and type of misspecification (no misspecification, between-level misspecification, and within-level misspecification). Our simulation findings raise a concern regarding the performance of between-level-specific partial saturated fit indices in low ICC conditions: the performances of both [Formula: see text] and [Formula: see text] were more influenced by ICC compared with [Formula: see text] and . However, when traditional cutoff values (≤ 0.06; ≥ 0.95;≤ 0.08) were applied, [Formula: see text] and [Formula: see text] were still able to detect misspecified between-level models even when ICC was as low as 0.091 (ICC1). On the other hand, both [Formula: see text] and [Formula: see text] were not recommended under low ICC conditions.

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