Development and calibration data for the Healthcare Access Item Bank: a new computer adaptive test for persons with type 2 diabetes mellitus

Carlozzi, Noelle E.; Kallen, Michael A.; Troost, Jonathan P.; Bragg, Alexa; Martin-Howard, Jessica; Cruz, Barbara De La; Miner, Jennifer A.; Moldovan, Ioana; Jack, Brian; Mitchell, Suzanne

doi:10.1007/s11136-022-03278-w

Cited by 4 publications

(2 citation statements)

References 95 publications

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“…The results of the known-group analysis indicate that the Chinese version of the PAHCQ can distinguish the ability of patients in different groups of age, gender, material status, education level, per capita monthly income, and CCI levels to perceive the accessibility of the health system, which plays an important role in expanding the application scope of this questionnaire in different population groups. Moreover, the study of the English version of the PAHCQ in the American population also mentioned the scalability of the questionnaire in different populations (28). The perception of healthcare accessibility plays a crucial role as an essential aspect of the social determinants of health.…”

Section: Discussionmentioning

confidence: 99%

Reliability and Validity of the Chinese Version of the Perceived Access to Health Care Questionnaire

Wang,

Tankumpuan,

Utriyaprasit

et al. 2023

J Nurs Midwifery Sci

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Background: The Perceived Access to Health Care Questionnaire (PAHCQ) is the latest specific tool used to evaluate patients' accessibility to the health system. Objectives: This study aimed to translate and verify the item analysis, test-retest reliability, content validity, construct validity, and known-group analysis of the PAHCQ in a Chinese population. Methods: This study developed and validated the Chinese version of the PAHCQ. The translation of the PAHCQ was based on the back translation of Brislin. This study used simple random sampling to include a sample of 591 subjects in Jiangsu, China. Item analysis was used to verify the questionnaire's expert consistency and cultural adaptation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the effectiveness of the structure. Internal consistency was determined using Cronbach's α, and item validity and test-retest reliability were analyzed. Results: The CFA results indicated that the modified PAHCQ is reasonable. The Cronbach alpha value of the PAHCQ was 0.96. The correlation coefficients for the six domains in test-retest reliability were between 0.67 and 0.91. Comparison of the total PAHCQ scores among participants in different groups of age, gender, maternal status, education level, per capita monthly income, and CCI levels showed statistically significant differences (P < 0.05). Conclusions: The Chinese version of the PAHCQ is a feasible, effective, and reliable tool that can be used to evaluate Chinese patients' perception of health system accessibility.

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Section: Discussionmentioning

confidence: 99%

Reliability and Validity of the Chinese Version of the Perceived Access to Health Care Questionnaire

Wang,

Tankumpuan,

Utriyaprasit

et al. 2023

J Nurs Midwifery Sci

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“…12 Specifically, this new measure was developed as part of a larger study focused on developing and validating measures that capture important social determinants of behavior. [27][28][29] We tested this measure in people with T2DM, although we would expect this measure to have broad applicability across a number of diverse clinical populations This report describes the development of this new PRO, the Re-Engineered Discharge for Diabetes Computer Adaptive Test (REDD-CAT) Housing Security measure, and provides preliminary score reliability and validity data.…”

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confidence: 99%

Development of a New Measure of Housing Security: The REDD-CAT Housing Security Measure

et al. 2023

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Background Housing security is a key social determinant of behavior related to health outcomes. Objective The purpose of this study was to develop a new patient-reported outcome measure that evaluates aspects of housing security for use in the Re-Engineered Discharge for Diabetes-Computer Adaptive Test (REDD-CAT) measurement system. Design Qualitative data, literature reviews, and cross-sectional survey study. Participants A total of 225 people with T2DM provided responses to the items in this item pool. Main Measures A new item pool that evaluates important aspects of housing security was developed using stakeholder data from focus groups of persons with T2DM. Key Results For the Housing Affordability scale, factor analysis (both exploratory and confirmatory) supported the retention of six items. Of these items, none exhibited sparse cells or problems with monotonicity; no items were deleted due to low item-adjusted total score correlations. For the six affordability items, a constrained graded response model indicated no items exhibited misfit; thus, all were retained. No items indicated differential item functioning (examined for age, sex, education, race, and socioeconomic status). Thus, the final Affordability item bank comprised six items. A Housing Safety index (three items) and a Home Features index (eight items) were also developed. Reliability (i.e., internal consistency and test–retest reliability) and validity (i.e., convergent, discriminant, and known-groups) of the new measures were also supported. Conclusions The REDD-CAT Housing Security Measure provides a reliable and valid assessment of housing affordability, safety, and home features in people with type 2 diabetes mellitus. Future work is needed to establish the clinical utility of this measure in other clinical populations.

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Four New Patient-Reported Outcome Measures Examining Health-Seeking Behavior in Persons With Type 2 Diabetes Mellitus (REDD-CAT): Instrument Development Study

Mitchell,

Kallen,

Troost

et al. 2024

JMIR Diabetes

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Background The management of type 2 diabetes mellitus (T2DM) includes mastery of complex care activities, self-management skills, and routine health care encounters to optimize glucose control and achieve good health. Given the lifelong course of T2DM, patients are faced with navigating complex medical and disease-specific information. This health-seeking behavior is a driver of health disparities and is associated with hospitalization and readmission. Given that health-seeking behavior is a potentially intervenable social determinant of health, a better understanding of how people navigate these complex systems is warranted. Objective To address this need, we aimed to develop new patient-reported outcome (PRO) measures that evaluate health-seeking behavior in persons with T2DM. These new PROs were designed to be included in the Re-Engineered Discharge for Diabetes-Computer Adaptive Test (REDD-CAT) measurement system, which includes several other PROs that capture the importance of social determinants of health. Methods Overall, 225 participants with T2DM completed 56 self-report items that examined health-seeking behaviors. Classical Test Theory and Item Response Theory were used for measurement development. Exploratory factor analysis (EFA; criterion ratio of eigenvalue 1 to eigenvalue 2 being >4; variance for eigenvalue 1 ≥40%) and confirmatory factor analysis (CFA; criterion 1-factor CFA loading <.50; 1-factor CFA residual correlation >.20; comparative fit index ≥0.90; Tucker-Lewis index ≥0.90; root mean square error of approximation <0.15) were used to determine unidimensional sets of items. Items with sparse responses, low-adjusted total score correlations, nonmonotonicity, low factor loading, and high residual correlations of high error modification indices were candidates for exclusion. A constrained graded response model was used to examine item misfit, and differential item functioning was examined to identify item bias. Cronbach α was used to examine internal consistency reliability for the new PROs (criterion ≥0.70), and floor and ceiling effects were examined (criterion ≤20%). Results Four unidimensional sets of items were supported by EFA (all EFA eigenvalue ratios >4; variance for eigenvalue 1=41.4%-67.3%) and CFA (fit statistics all exceeded criterion values). This included (1) “Health-Seeking Behavior: PCP-Specific” (6 items); (2) “Health-Seeking Behavior: General Beliefs” (13 items); (3) “Health-Seeking Behavior: Family or Friends-Specific” (5 items); and (4) “Health-Seeking Behavior: Internet-Specific” (4 items). All items were devoid of differential item functioning for age, sex, education, or socioeconomic status factors. “Health-Seeking Behavior: General Beliefs” was developed to include both a computer adaptive test and a 6-item short form version; all other PROs were developed as static short forms. The psychometric reliability of these new PROs was supported; internal consistency ranged from acceptable to excellent (Cronbach α=.78-.91), and measures were free of significant floor or ceiling effects (floor effects range: 0%-8.9%; ceiling effects range: 0%-8.4%). Conclusions The new REDD-CAT Health-Seeking Behavior PROs provide reliable assessments of health-seeking behaviors among those with T2DM.

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Development and calibration data for the Healthcare Access Item Bank: a new computer adaptive test for persons with type 2 diabetes mellitus

Cited by 4 publications

References 95 publications

Reliability and Validity of the Chinese Version of the Perceived Access to Health Care Questionnaire

Reliability and Validity of the Chinese Version of the Perceived Access to Health Care Questionnaire

Development of a New Measure of Housing Security: The REDD-CAT Housing Security Measure

Four New Patient-Reported Outcome Measures Examining Health-Seeking Behavior in Persons With Type 2 Diabetes Mellitus (REDD-CAT): Instrument Development Study

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