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).
J Obstet Gynecol Neonatal Nurs. 2014 Nov-Dec;43(6):710-8. doi: 10.1111/1552-6909.12511. Epub 2014 Oct 14.
Development and psychometric testing of the attitude toward potential pregnancy scale.
2.What was the definition of the construct?
The paper investigates a tool to measure pregnancy intentions using the Attitude Towards Potential Pregnancy Scale (APPS). The concept that they are trying to address is the complexity surrounding pregnancy intentions, because it is something that is often captured as a dichotomous response to a simple question, but is often more nuanced, with changes over time and situation with the same woman, and can be complicated by ambivalence.
3.How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
They created the APPS questionnaire by reviewing existing literature and using their clinical knowledge. They piloted the survey with 20 women and then interviewed these women to modify the survey. They then implemented the APPS in a larger group, and used logistic regression to compare the participant’s APPS score and the effectiveness of the contraceptive they were using. In something where there isn’t really a gold standard, this seems like a reasonable way to create a questionnaire and testing it’s internal validity, though given the individual variability in contraceptive preferences and some user-dependent measures of effectiveness, I’m not sure this would give you a true reflection of pregnancy intention. If it did, then I would argue you could just look at how effective someone’s contraception was, and extrapolate their pregnancy intention from that. I think the initial approach of using the APPS scale and then using more qualitative methods to assess how the APPS score correlates with the participant’s true desires might be more useful.
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?
They implemented the survey in a larger cohort of women and used Cronbach’s alpha to assess consistency. This also seems like a reasonable method, similar to what we read about.
5.Describe the implications of a lack of measurement validity or reliability for future research applications.
Reducing unintended pregnancy is an interesting area that has received a fair amount of public health attention- whether it’s for preventing the effects of Zika virus or making sure women who drink alcohol and are at risk of pregnancy are using birth control. Finding a way to reliably measure unintended (or undesired) pregnancies could lead to better informed and less biased research and programming, but moving forward with an invalid or unreliable measurement tool could lead to uninformed decisions and wasted time/resources.
Part 2:
1.Find a paper describing a health disparity (please give the full citation or upload the paper)
Kim, T. Y., et al. (2015). "Racial/Ethnic Differences in Unintended Pregnancy: Evidence From a National Sample of U.S. Women." Am J Prev Med.
2.Summarize the construct and measurement of the dimension of disparity (e.g., race, SES) and the outcome measured (e.g., self-rated health).
This paper examined racial/ethnic disparities in unintended pregnancy.
3.What is the evidence for the validity and reliability of the measures?
The paper doesn’t delve into how valid or reliable their measure of unintended pregnancy was. They used NSFG data, which uses self-report to describe pregnancy intentions. For their outcome purposes, they use pregnancies that were mistimed or unwanted as unintended.
4.What is the reference category used for the disparity measure? Why does this reference category make sense (or not) for this research question?
They used non-Hispanic white as their reference category, which makes sense as far as the racial/ethnic context in this country as well as prior disparities research.
5.How is the disparity quantified? 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 using unadjusted and adjusted odds ratios for the dichotomous outcome of unintended pregnancy. This is a relative measure, and no absolute measures are reported. Based on the Harper article, I think reporting both absolute and relative measures would be useful.