142nd APHA Annual Meeting and Exposition

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301939
Measurement Invariance of the Pediatric Version of PROMIS Symptom Scales between American and Chinese Children with Cancer

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Changrong Yuan, PhD , School of Nursing, Second Military Medical University, Shanghai, China, Shanghai, China
Pamela Hinds , School of Medicine, Children’s National Medical Center, The George Washington University, Washington, Washington, DC
Yanyan Liu, PhD candidate , School of Nursing, Second Military Medical University, Shanghai, China, Shanghai, China
Jichuan Wang, PhD , School of Medicine, The George Washington University, Bowie, MD
This study assesses measurement invariance of the symptom scales (i.e., anxiety, depression fatigue, and pain) of the pediatric version of Patient Reported Outcomes Measurement Information System (PROMIS) between American and Chinese children with cancer. First, we used categorical confirmatory factor analysis (CCFA) to test the factorial structures of the four PROMIS symptom scales for the American and Chinese populations, respectively. Once we have confirmed that the symptom scales have similar factorial structure in both populations, multi-group CCFA models were used to test measurement invariance of the scales across the populations. The Top-down approach was applied for implementing measurement invariance assessment. Our results show that the four PROMIS symptom scales have adequate structural validity in both American and China populations of children with cancer. Though the full measurement invariance models have acceptable model fit indices, non-invariance was identified in a few factor loadings and item thresholds in the four PROMIS symptom scales across cultures. The non-invariant factor loadings indicate a lower reliability of these items in Chinese population compared to the American population. The non-invariant thresholds indicates that the Chinese patients were less likely to endorse the “Often” and “Always” categories of the corresponding items, holding the level of the latent construct constant. Further studies are needed to gauge the PROMIS items that show non-invariant factor loadings and/or item thresholds across cultures.

Learning Areas:

Biostatistics, economics
Diversity and culture
Public health or related nursing
Public health or related research

Learning Objectives:
Describe the pediatric version of PROMIS instrument. Discuss the basics of testing measurement invariance using multi-group categorical confirmatory factor analysis (CCFA) models. Compare the measurement parameters of the PROMIS symptom scales between American and Chinese children with cancer. Demonstrate how to test measurement invariance using CCFA in Mplus.

Keyword(s): Biostatistics, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: because I have been working in public health studies for over 20 years. I usually make two presentations in Applied Public Health Statistics Section (previously "Statistics Section") of the APHA annual meeting each year in many of the past years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.