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).
Walsh CA, MacMillan HL, Trocmé N, Jamieson E, Boyle MH. Measurement of victimization in adolescence: development and validation of the Childhood Experiences of Violence Questionnaire. Child Abuse Negl. 2008 Nov;32(11):1037-57. doi: 10.1016/j.chiabu.2008.05.003. Epub 2008 Nov 6.
PMID: 18992940
2.What was the definition of the construct?
The authors created and validated a short questionnaire (Childhood Experiences of Violence Questionnaire (CEVQ)) about childhood experiences of violence for use in adolescents, “The CEVQ is a brief (15-min), 18-item self-report measure of victimization (peer-on-peer violence, witnessing domestic violence, EA, physical punishment, PA and SA) for use among adolescents, ages 12–18 years; it also collects information about the perpetrator, severity, onset, duration, and disclosure of abuse.”
3.How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
The authors had 11 child welfare workers assess content validity of the questionnaire, and had 57 youth assess face validity through focus groups about questions. The authors assessed construct validity through comparing adolescent participant scores on the CEVQ questionnaire to their scores on a previous validated self-administered questionnaire on levels of emotional and behavioral problems as childhood violence exposures can be associated with emotional and behavioral problems during adolescence. The authors assessed criterion validity by comparing adolescent participant scores on the CEVQ questionnaires to social workers’, child and youth workers’, or a pediatrician’s, all who had worked with the participant previously, description of the participant’s violence experiences based on their clinical relationship with the patient and a reading of their record. I think it may have been helpful for the authors to have interviewed the adolescent participants as well as there can be large variability in how well a social worker or pediatrician knows their client. The “gold standard” in this case is not very good.
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 looked at test–retest reliability by givign the questionnaire to particpatns twice with a mean interval between test administration of 16.4 days. I would consider increasing the time between test administrations to 60-90 days.
5.Describe the implications of a lack of measurement validity or reliability for future research applications.
A lack of measurement validity or reliability would likely lead to difficulty in establishing relationships between childhood exposures to violence and long-term health outcomes, as well as problems estimating prevalence of violence, and trouble evaluating if programs designed to prevent violence are successful.
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)
Mennis J, Stahler GJ. Racial and Ethnic Disparities in Outpatient Substance Use Disorder Treatment Episode Completion for Different Substances. J Subst Abuse Treat. 2016 Apr;63:25-33. doi: 10.1016/j.jsat.2015.12.007. Epub 2015 Dec 29.
PMID: 26818489
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).
Construct: Racial disparities. Outcome: outpatient substance use treatment episode completion
3.What is the evidence for the validity and reliability of the measures?
In their study, the variable of race was coded as three mutually exclusive categories of white, African American and Hispanic, as determined from Treatment Episode Dataset. Any individual who identified as Hispanic was coded as Hispanic, regardless of other racial identification. It was unclear if racial identification in the Treatment Episode Dataset was self-reported or provider/staff determined. The validity/reliability of race as a variable is improved when self-reported as opposed to provider/staff determined. For the outcome, they excluded outpatient treatment discharges with “non-completion due to transfer to another program, incarceration, death, or for other reasons (“Other” or “Unknown”),” which they justified as valid given previous studies who had used this dataset had not found differences their study results when including and excluding these groups.
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 group was white individuals in outpatient substance use treatment programs, controlling for age, sex, high school completion and employment. They looked at the racial disparities among substances (alcohol, methamphetamine, cocaine, heroin, marijuana). This reference category is reasonable for this study, though it would have been helpful to see the racial break-up among substances.
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 an odds ratio (relative measure) and no absolute measure was provided. An absolute measure would be helpful to have in addition to the relative measure to help estimate the magnitude of impact in America (how many people are affected) caused by this disparity as I suspect it would be large given the prevalence of substance use problems in America.
Part 3:
- 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
Shabnam gave an interesting example of an article attempting to look at the impact of neighborhood factors and fetal diagnosis of critical congenital heart disease. The tool used to characterize neighborhood leaves out many factors associated with health disparities, and focuses mostly economic and education. I agree with Shabnam that the score should be utilized with caution and may underestimate disparities between neighborhoods.