3103.0: Monday, November 13, 2000 - 3:30 PM

Abstract #10678

Homeless supplement to the diagnostic interview schedule: Test-retest and discrepancy analysis

Karin M. Eyrich, MSW1, Carol S. North, MD, MPE2, David E. Pollio, PhD1, and Linda B. Cottler, PhD2. (1) George Warren Brown School of Social Work, Washington University, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, (314)935-7582, kme1@gwbmail.wustl.edu, (2) School of Medicine, Washington University, Department of Psychiatry, Renard Building, Room 2210, St. Louis, MO 63108, (314)747-2013, northc@psychiatry.wustl.edu

Studying homelessness presents major methodologic challenges for research. Fundamental differences in conceptualization and measurement of homelessness have prevented comparison of results across studies. This report describes work to establish instrument reliability that is critical to systematic comparison of data in research on homelessness. The Homeless Supplement to the Diagnostic Interview Schedule (DIS/HS) was developed for a previous NIAAA-funded epidemiologic study of homelessness (Smith, North, & Spitznagel, 1992, 1993). Although feasibility testing was conducted on the DIS/HS, affirmation of test-retest reliability awaited subsequent study, recently completed during a NIDA-funded project. This presentation will: 1) describe the DIS/HS and 2) present test-retest reliability and discrepancy results. DIS/HS test-retest interviews (N=42) were conducted three weeks apart at a homeless drop-in program. Subjects with discrepant answers on key categorical (any disagreement) and continuous (>10% disagreement) variables also completed discrepancy interviews (N=23). For categorical data, kappa statistics (simple for dichotomous and weighted for polychotomous variables) were calculated to establish reliability and McNemar's tests performed for identification of floor and ceiling effects. For continuous variables, inter-class correlation coefficients assessed reliability, with paired t-tests and Yule's Ys identifying floor and ceiling effects. Frequencies of discrepant responses are provided with respondents' accompanying explanations for the differences. Several questions in the instrument were refined to reduce discrepancies, and for two items the number of categories was reduced by collapsing value codes via factor analysis. The revised Homeless Supplement interview provides systematic data on course of homelessness (first onset, remissions, lifetime duration, precipitants), recent residential history, shelter use, and transience.

Learning Objectives: 1. Discuss measurement problems associated with homelessness research. 2. Describe the Homeless Supplement to the Diagnostic Interview Schedule. 3. Evaluate the strength and usefulness of the Homeless Supplement to the Diagnostic Interview Schedule

Keywords: Homelessness, Epidemiology

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA