Part 1:
1. Choose a paper describing the development or validation of a measure of relevance in health disparities research (please give the full citation and/or upload the paper if that's possible).
https://www-ncbi-nlm-nih-gov.ucsf.idm.oclc.org/pubmed/30142483
Int J Nurs Stud. 2018 Dec;88:1-8.
2. What was the definition of the construct?
The construct was a diabetes health literacy scale. The construct goal was to evaluate the “abilities and skills to assess, understand, appraise, communicate, and use health information” as it relates to diabetes.
3. How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
They provided evidence that the measure was valid by testing the instrument on a panel of five experts on health literacy and diabetes educators. While this is valid, I think it would be better to have the content validity assessed by a group of patients with very good diabetes control who providers have deemed to understand the diabetes.
4. How did the authors provide evidence on the reliability of the measure? Could you think of additional approaches to evaluating the reliability of the measure?
The authors used test-retest reliability, as separated by 1 week, and internal consistency as measures of reliability. They used Cronbach’s alpha testing to check the internal consistency.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
If a measure does not have validity it is not assessing the thing it is trying to assess. As such, we have no idea that the outcome we are trying to assess is in fact being looked at. This means that we have no idea what the instrument is looking at. As for reliability, if it does not have reliability then we do not know what to do with the instrument results because it varies very differently depending on when it is taken. As for this measure, I think that it has great future applications. It could be used before an education intervention to help target education and maximize diabetes management.
Part 2:
1. Find a paper describing a health disparity (please give the full citation or, even better, upload the paper so everyone else can look at it too)
https://www.ncbi.nlm.nih.gov/pubmed/30734279
2. Summarize the construct and measurement of the dimension of disparity (e.g., racial inequalities?, SES inequalities?) and the outcome measured (e.g., self-rated health).
The dimension of the disparity is differences in gender and racial/ethnic groups as it relates to the outcome of specialty behavioral health utilization/expenditures.
3. What is the evidence for the validity and reliability of the measures?
The authors used data from a managed health care plan (Optum “carve in” plan). The measures are theoretically reliable because they used data collected for insurance purposed within a managed plan, however, they authors do not explicity comment on the validity and reliabililty.
4. What is the reference category used for the disparity measure (ie, who is the comparison group)? Why does this reference category make sense (or not) for this research question?
In this study they assessed the validity and reliability by using behavioral health utilization and behavioral health expenditures in matched socioeconomic controls. This does make sense, however, I think that it should also be matched by diagnosis because different diagnostic groups will have different expenditures.
5. How is the disparity quantified or measured? Is this an absolute or relative measure or are both provided? Describe which type of measure you would prefer for this research area, or, if both, why.
The disparity was measured as annual behavioral health specialty expenditure. They used linear regression modeling to assess the disparity. I think that expenditure is a good way to look at this, however, another way to assess this would be by looking at number of study visits. I prefer this because some patients may require an expensive drug by the severity of their disease which will increase expenditure without increasing visits.
Part 3:
1. Read someone else's response to part 1 above (identifying a construct) and comment, specifically noting whether you can see any additional implications of measurement quality for future research or whether you agree with those noted by your classmate.
I agree with Ashley Younger’s assessment in the person centered maternity care. I agree with her comments about the difference between rural vs urban environments being a concern, however, I think that the measure is promising and could be applicable elsewhere.