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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Format | Journal Article |
Language | English |
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01.07.2019
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Abstract | 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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AbstractList | 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. BACKGROUNDHealth 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.OBJECTIVEThe 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.METHODSThe 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.KEY RESULTSDIF 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.CONCLUSIONSItems 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. [HLRP: Health Literacy Research and Practice. 2019;3(3):e196-e204.].PLAIN LANGUAGE SUMMARYThis 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. BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. KEY RESULTS: 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. CONCLUSIONS: 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. Background: 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. Objective: 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. Methods: 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. Key Results: 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. Conclusions: 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. [ HLRP: Health Literacy Research and Practice . 2019;3(3):e196–e204.] Plain Language Summary: 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. Background: 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. Objective: 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. Methods: 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. Key Results: 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. Conclusions: 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. [HLRP: Health Literacy Research and Practice. 2019;3(3):e196–e204.] Plain Language Summary: 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. |
Author | Taple, Bayley J Griffith, James W Wolf, Michael S |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31511845$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Copyright | This work is published under https://creativecommons.org/licenses/by/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 Taple, Griffith, Wolf 2019 Taple, Griffith, Wolf |
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Notes | 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. |
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Snippet | Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence how patients... Background: Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence... Background: Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence... BACKGROUNDHealth literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence... BACKGROUND: Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence... |
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StartPage | e196 |
SubjectTerms | Anxiety Bias Cognitive ability depression Educational attainment Health education Health literacy Information systems Internal medicine measurement bias Medicine Memory Mental depression numeracy Older people Original Research Patients Quantitative psychology Social sciences Studies |
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Title | Interview Administration of PROMIS Depression and Anxiety Short Forms |
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