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).
Roblin DW1. Validation of a neighborhood SES index in a managed care organization.
Med Care. 2013 Jan;51(1):e1-8. doi: 10.1097/MLR.0b013e3182349b97.
2. What was the definition of the construct?
Neighborhood SES index was based on 7 measures: (1) Percent of households with income below the poverty level, (2) Percent of households receiving public assistance, (3) Percent of households with annual income below $30,000, (4) Percent of working age adult males not in the labor force, (5) Percent of adults 25 and older with a high school education or less, (6) Log of median household income, and (7) Log of median value of single family homes. The value of each variable assigned to a geocoded managed care organization (MCO) enrollee was based on the US census tract or block group of the enrollee’s residence. A principal components analysis was performed on the study population and a factor score was assigned to each enrollee.
3. How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
The author examined concordance between the proposed index with self-reported SES (level of formal education and household income) across several surveys of MCO adults. Additional approaches could be to examine concordance with alternative aspects of SES, such as wealth.
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 author compared the composite factor score distribution from all adult enrollees within their population with three surveys of MCO adults. Reliability could also be evaluated by examining the concordance of the same measure across alternate populations to see if similar levels of concordance are maintained.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
If a measurement lacks validity or reliability it cannot be implemented in future research applications with any great confidence. The results of a future analysis will always be questioned on the basis of the lack of validity/reliability.
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)
Rauscher GH, Allgood KL, Whitman S, Conant E. Disparities in Screening Mammography Services by Race/Ethnicity and Health Insurance. J Womens Health (Larchmt). 2012 Feb; 21(2): 154–160.
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 dimensions of the disparity were race and health care access (whether or not participants had private insurance). Rates of screening mammography was the outcome measured.
3. What is the evidence for the validity and reliability of the measures?
The authors note how they estimated the number of mammograms performed in different race groups and different insurance status based on the midpoint of the categories reported by each facility but do not provide specific evidence for evaluating the accuracy of this estimate. The authors also note that they were able to include every major mammography center within the city of Chicago in their analysis (40 of the 48 facilities providing screening mammograms), although they do not provide an estimate of the screened population or the characteristics of the population they are missing in the eight facilities not included. However, they do note the number of mammography machines at each of these facilities (a single machine at each of these eight).
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?
The reference category was non-Hispanic white women and women with private insurance. These reference categories make sense as we expect them to represent the maximal use of screening mammography.
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 is quantified as both an estimated absolute and relative measure. I would prefer both as the relative gives you a direct sense of the magnitude of the potential disparity and the absolute gives you a better sense of the generalizability of the result.
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 Bushra’s comments regarding an analysis of social determinants of mental health, in that the authors could also have checked for DMS correlation with other negative health outcomes. Although, the provided measures of validity and reliability appear reasonably sufficient.