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).
Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33-42.
2. What was the definition of the construct?
Functional health care literacy, defined as a patient’s ability to read and understand things normally encountered within the realm of the health care system.
3. How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
The measure was based on the Test of Functional Health Literacy in Adults (TOFHLA) which had been previously validated. The original TOFHLA was 22 minutes long, so the purpose of this study was to develop a shorter form that would be easier to implement. To establish validity, results were correlated with the Rapid Estimate of Adult Literacy in Medicine (REALM) instrument. The authors found a correlation of 0.8 between the S-TOFLA and the REALM scores.
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 examined internal consistency to assess the reliability of the measure. They reported Cronbach’s alpha values of 0.68 and 0.97.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
The purpose of this study was to develop a more concise measurement of functional healthcare literacy. If this measure was not valid or reliable, this would result in a compromised assessment of health care literacy and may jeopardize future work at creating more concise measures.
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)
Jesse MT, Abouljoud M, Goldstein ED, et al. Racial disparities in patient selection for liver transplantation: An ongoing challenge. Clinical transplantation. 2019;33(11):e13714
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 construct was racial inequality in access to liver transplantation, and the outcome was the result of the liver transplant evaluation.
3. What is the evidence for the validity and reliability of the measures?
None.
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 is white patients. White patients make up the majority of those referred for liver transplantation, so I think this reference category makes sense for this type of assessment.
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 measured in odds of liver transplant listing, which is a relative measure compared with all other racial groups. The process of access to liver transplantation consists of multiple steps (identification of liver disease, referral to transplant center, transplant evaluation, transplant listing, transplant) and racial inequalities are typically measured in transplant listing or transplant events because there are large national databases that track patients throughout those phases. There is not, however, a comprehensive assessment of the disparities that occur prior to listing, so I think the outcome of transplant evaluation outlined in this paper is important and novel.