Interview Administration of PROMIS Depression and Anxiety Short Forms
Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence how patients report symptoms, leading to underestimates or overestimates of symptom severity. No prior studies have examined health literacy measure...
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Published in | Health literacy research and practice Vol. 3; no. 3; pp. e196 - e204 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
United States
SLACK INCORPORATED
01.07.2019
SLACK Incorporated |
Subjects | |
Online Access | Get full text |
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Summary: | Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence how patients report symptoms, leading to underestimates or overestimates of symptom severity. No prior studies have examined health literacy measurement bias.
The purpose of the current study was to determine whether PROMIS (Patient-Reported Outcomes Measurement Information System) anxiety and depression short forms, administered by interview, capture symptoms equally across health literacy groups. We examined the psychometric properties of PROMIS anxiety and depression short forms using differential item functioning (DIF) analysis by level of health literacy.
The sample analyzed included 888 adults, age 55 to 74 years, in Chicago, IL. Health literacy was measured using the Test of Functional Health Literacy in Adults. PROMIS short forms assessed anxiety and depression.
DIF was present in 3 of 8 depression items, and 3 of 7 anxiety items. All items flagged for DIF had lower item-slopes for people with limited health literacy.
Items with DIF were less strongly related to anxiety and depression, and thus less precise. Overall, impact of DIF on PROMIS scores was negligible, likely mitigated by interview administration. Although overall test impact of health literacy was minimal, DIF analyses flagged items that were potentially too complex for people with limited health literacy. Design and validation of patient-reported surveys should incorporate respondents with a range of health literacy and methods to identify and reduce measurement bias.
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This study suggests that people with limited health literacy may respond differently to questions about depression and anxiety than people with adequate health literacy. Therefore, it is important to be aware of differences in literacy ability when creating and using questionnaires. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Grant: This research was supported in part by a grant (5R01AG030611-02) from the National Institute on Aging (Health Literacy and Cognitive Function among Older Adults) and by a grant (1R01MD010440-01A1) from the National Institute on Minority Health and Health Disparities (Reducing Assessment Barriers for Patients with Low Literacy). Bayley J. Taple, MS, is a Doctoral Candidate, Department of Medical Social Sciences. James W. Griffith, PhD, is a Research Associate Professor, Department of Medical Social Sciences. Michael S. Wolf, PhD, MPH, is the Associate Vice Chair for Research, and a Professor, Department of General Internal Medicine and Geriatrics. All authors are affiliated with Northwestern University Feinberg School of Medicine. Disclosure: The authors have no relevant financial relationships to disclose. |
ISSN: | 2474-8307 2475-6024 2474-8307 |
DOI: | 10.3928/24748307-20190626-01 |