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).
Rice et al. Norms and stigma regarding pregnancy decisions during an unintended pregnancy: Development and predictors of scales among young women in the U.S. South. PLoS One. 2017 Mar 22;12(3):e0174210.
2. What was the definition of the construct?
Rice et al. developed an instrument to measure individual-level perceptions of norms and stigma around pregnancy decisions, and to capture variations of this across socio-demographic groups. The construct was defined as interpersonal and intrapersonal manifestations of stigma.
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 first developed and pre-tested 97 survey items using a mixed methods approach of focus groups, expert input, and cognitive interviews. For reliability and validity testing, the authors performed factor analyses, reliability analyses, independent t-tests, and correlation analyses. They used multiple linear regression to identify demographic predictors of higher scale 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 provide evidence on the reliability of the measure by reporting on their process of assessing internal consistency. They provide factor loading data for each item and Cronbach’s alpha for each subscale.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
They actually do a good job showing measurement reliability. The instrument was developed and validated in a group of majority women aged 18-19 and 70% recruited from a university campus. The survey will need to be re-validated in any new population to which it is applied. Not doing a re-validation prior to applying to survey to another population may lead to several problems: 1) new population not interpreting the questions as intended due to language discordance, literacy level, or cultural discordance; 2) survey questions irrelevant to new population (i.e., in a country where abortion has been low-stigma and readily accessible for a long time); and 3) survey too long for a population that may not have time to invest or who may have different levels of prioritization or expectation for what role a survey should take in their lives
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)
Lopez et al. What's Your "Street Race"? Leveraging Multidimensional Measures of Race and Intersectionality for Examining Physical and Mental Health Status Among Latinxs. Sociol Race Ethn (Thousand Oaks). 2018 Jan;4(1):49-66.
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 studied the relationship between three dimensions of race and physical and mental health status. The three dimensions of race were 1) “street race,” or how other “Americans” perceive your race; 2) “ascribed race” or social race, which is the race under which others usually classify you in the US; and 3) self-perceived race, or how you usually classify your race.
3. What is the evidence for the validity and reliability of the measures?
For self-reported health status, the authors modified the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), which has been validated in other populations in relation to mortality. The authors used a version of the BRFSS that was validated in Latino populations in the United States by Vargas et al. The authors also changed two questions’ answers from a 5-level Likert scale to a binary answer of optimal health or poor health, and they reference other studies that have done so for the physical and mental health questions and have found it to be “a valid, reliable, and cognitively tested value-added measure.” The authors do not do their own analysis for validity and reliability in their paper.
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 referent category is people whose street-race, ascribed race, and/or self-perceived race is White. The comparison is those whose dimensions of race are non-White. This is a appropriate use of reference and comparison groups for this 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.
The outcome is measured as a binary of optimal health vs fair/poor health. The outcome means are presented as absolute measures. They are then adjusted for various factors and presented as the logit coefficient and odds ratio (relative measure) for each of the dimensions of race. It is helpful to have both absolute and relative measures reported. As described in the Harper & Lynch reading’s segment on gender disparity in stomach cancer mortality, relative and absolute disparities can give divergent interpretations of reality.