A person-reported cumulative social risk measure does not show bias by income and education.

IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES
Salene M W Jones, Katherine J Briant, David R Doody, Ronaldo Iachan, Jason A Mendoza
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引用次数: 0

Abstract

Background: Social risk such as housing instability, trouble affording medical care and food insecurity are a downstream effect of social determinants of health (SDOHs) and are frequently associated with worse health. SDOHs include experiences of racism, sexism and other discrimination as well as differences in income and education. The collective effects of each social risk a person reports are called cumulative social risk. Cumulative social risk has traditionally been measured through counts or sum scores that treat each social risk as equivalent. We have proposed to use item response theory (IRT) as an alternative measure of person-reported cumulative social risk as IRT accounts for the severity in each risk and allows for more efficient screening with computerized adaptive testing.

Methods: We conducted a differential item functioning (DIF) analysis comparing IRT-based person-reported cumulative social risk scores by income and education in a population-based sample (n = 2122). Six social risk items were analyzed using the two-parameter logistic model and graded response model.

Results: Analyses showed no DIF on an IRT-based cumulative social risk score by education level for the six items examined. Statistically significant DIF was found on three items by income level but the ultimate effect on the scores was negligible.

Conclusions: Results suggest an IRT-based cumulative social risk score is not biased by education and income level and can be used for comparisons between groups. An IRT-based cumulative social risk score will be useful for combining datasets to examine policy factors affecting social risk and for more efficient screening of patients for social risk using computerized adaptive testing.

由个人报告的累积社会风险衡量标准不会因收入和教育程度而出现偏差。
背景:住房不稳定、难以负担医疗费用和粮食不安全等社会风险是健康的社会决定因素(SDOHs)的下游效应,通常与健康状况恶化有关。社会决定健康因素包括种族主义、性别歧视和其他歧视,以及收入和教育方面的差异。一个人报告的每个社会风险的集体影响被称为累积性社会风险。传统上,累积性社会风险是通过将每种社会风险视为等同的计数或总分来衡量的。我们建议使用项目反应理论(IRT)作为个人报告的累积社会风险的替代测量方法,因为 IRT 会考虑到每种风险的严重程度,并允许使用计算机适应性测试进行更有效的筛选:我们在一个以人口为基础的样本(n = 2122)中进行了一项差异项目功能(DIF)分析,比较了基于 IRT 的个人报告的累积社会风险得分(按收入和教育程度划分)。采用双参数逻辑模型和分级反应模型对六个社会风险项目进行了分析:分析表明,在基于 IRT 的累积社会风险得分上,所研究的六个项目的教育水平均无 DIF。收入水平对三个项目的 DIF 有统计学意义,但对分数的最终影响可以忽略不计:结果表明,基于 IRT 的累积社会风险评分不会因教育和收入水平而产生偏差,可用于组间比较。基于 IRT 的累积社会风险评分将有助于结合数据集来研究影响社会风险的政策因素,并有助于利用计算机自适应测试对患者进行更有效的社会风险筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Patient-Reported Outcomes
Journal of Patient-Reported Outcomes Health Professions-Health Information Management
CiteScore
3.80
自引率
7.40%
发文量
120
审稿时长
20 weeks
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