Part 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).
Johnson, J. G., Harris, E. S., Spitzer, R. L., & Williams, J. B. (2002). The patient health questionnaire for adolescents. Journal of Adolescent Health, 30(3), 196-204.
(See attached)
2. What was the definition of the construct?
Patient Health Questionnaire for Adolescents (PHQ-A): a self-administered instrument that assesses anxiety, eating, mood, and substance use disorders among adolescent primary care patients.
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 demonstrated the diagnostic validity of the PHQ-A by agreement with an independent interview by a trained mental health professional (criterion validity), and by the association of PHQ-A diagnosis with guides of impaired functioning, distress and poor health (construct validity). Compared with the interview, the authors assessed for the sensitivity, specificity, diagnostic agreement and overall accuracy of the measure (PHQ-A).
I think they have a done a decent job at assessing for validity of the measure—I cannot think of an approach that may substantially affect their results.
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 did not assess for the reliability of the measure. Primary care physicians typically use the Primary Care Evaluation of Mental Disorders (PRIME-MD), which is a two-stage diagnostic system including a screening questionnaire and a clinical interview. More recently this tool includes the PHQ-9 (depression screener), and the authors indicate that it has shown to accurately and reliably diagnose mental disorders among primary care patients. The expanded version, PHQ-A, however, has not been assessed for reliability.
Test-retest reliability should be used to evaluate the reliability of the measure.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
Lack of measurement validity or reliability yields serious problems including, most importantly, misdiagnoses (e.g., false positives and false negatives). Misdiagnosis may come with unnecessary treatment or withholding necessary treatment and both should avoided.
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)
Morgan, P. L., Hillemeier, M. M., Farkas, G., & Maczuga, S. (2014). Racial/Ethnic Disparities in ADHD Diagnosis by Kindergarten Entry. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 55(8), 905–913. http://doi.org.ucsf.idm.oclc.org/10.1111/jcpp.12204
(See attached)
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 authors mainly measured whether and to what extend racial/ethnic disparities in Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis occur by kindergarten entry; they also looked at SES inequalities (a composite of father’s education, mother’s education, father’s occupation, mother’s occupation, and household income). The main outcome measure was risk of receiving an ADHD diagnosis. Secondary outcomes include ADHD medication use, socio-demographic characteristics, vocabulary knowledge, cognitive functioning, learning-related behaviors, home environment quality, parenting quality, parental/family history of mental illness, limited access to health insurance, and primary language.
3. What is the evidence for the validity and reliability of the measures?
They did not directly assess for the validity and reliability of the measures in their study, which they indicated as a potential limitation. However the authors indicated that the used measures were validated and found reliable in multiple studies (e.g., parent-reported ADHD screening, Bayley Short Form Research Edition [BSF-E] for cognitive functioning, Behavioral Rating Scale-Research Edition for learning-related behaviors).
4. What is the reference category used for the disparity measure (i.e., who is the comparison group)? Why does this reference category make sense (or not) for this research question?
The analytical sub-sample (N = 6,550) included children with and without an ADHD diagnosis at 60 months. For race/ethnicity, non-Hispanic Blacks were compared with the reference group, non-Hispanic Whites. The reference group seems relevant since it reflects their research question.
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.
They conducted a logistic regression that yielded Odds Ratios of ADHD diagnosis by 60-month assessment. They provided both—relative for SES, and absolute for race/ethnicity. I think it depends on the research question. Since this study explores both SES and race/ethnicity inequalities then using both absolute and relative is plausible given that SES has a natural ordering whereas race/ethnicity does not.