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11. Measuring Activity Limitations Within the National Health and Aging Trends Study (NHATS).

Author

Marfeo, Elizabeth E, Ni, Pengsheng, Keeney, Tamra, and Jette, Alan

Subjects
*AGING, *STATISTICAL correlation, *GERIATRIC assessment, *EXPERIMENTAL design, *FACTOR analysis, *HEALTH status indicators, *LONGITUDINAL method, *MATHEMATICAL models, *RESEARCH methodology, *PSYCHOMETRICS, *HEALTH self-care, *STATISTICS, *THEORY, *DATA analysis, *ACTIVITIES of daily living, *BODY movement, *GERIATRIC rehabilitation, *PHYSICAL activity, *DESCRIPTIVE statistics, *OLD age
Abstract

Background and Objectives To better understand the disablement process among older adults, improved measures of activity limitations are needed. Traditional population-level measures lack the ability to distinguish precise gradations of activity limitation and are unable to detect degrees of differences over a wide range of ability levels. Therefore, we used contemporary measurement methods to improve upon current methodologies for characterizing activity limitations within the National Health and Aging Trends Study (NHATS). Research Design and Methods We used the NHATS Round 1 cohort to assess the feasibility of constructing an Activity Limitations scale using Rasch item response theory methods. Factor analysis was used to develop the scale from a set of existing items in the NHATS Mobility, Self-Care, and Household Activity domains. Psychometric properties of the scale were evaluated and the scale was used to examine change in activity limitations among the sample from 2011 to 2015. Results Results supported an 18-item scale (N = 7,609). Rasch infit and outfit statistics were within acceptable range for all items (Cronbach's alpha = 0.95; sample score reliability = 0.83). From 2011 to 2015, 5.88% older adults demonstrated increase in function, 15% showed decrease in function, and 78% of the sample showed no change (did not exceed ± MDC90). Discussion and Implications Findings demonstrate that a unidimensional, interval scale of activity limitations can be constructed using traditional survey measures nested within the NHATS. Results revealed concerns regarding ceiling effects within the current self-report items of activity limitations suggesting future work is needed to expand the range of ability currently represented in the NHATS Activity Limitation items. [ABSTRACT FROM AUTHOR]

Published
2020
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13. Improving measures of work-related physical functioning

Author

McDonough, Christine M., primary, Ni, Pengsheng, additional, Peterik, Kara, additional, Marfeo, Elizabeth E., additional, Marino, Molly E., additional, Meterko, Mark, additional, Rasch, Elizabeth K., additional, Brandt, Diane E., additional, Jette, Alan M., additional, and Chan, Leighton, additional

Published
2016
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15. Optimizing Psychometrics in Measuring Behavioral Health Functioning: Combining Agreement and Frequency Rating Scales

Author

Marfeo, Elizabeth E., Ni, Pengsheng, Chan, Leighton, Rasch, Elizabeth K., and Jette, Alan M.

Subjects
Adult, Male, Psychometrics, Reproducibility of Results, Work Capacity Evaluation, Middle Aged, Article, Social Security, United States, Disability Evaluation, Cross-Sectional Studies, Humans, Disabled Persons, Female
Abstract

The goal of this article was to investigate optimal functioning of using frequency vs. agreement rating scales in two subdomains of the newly developed Work Disability Functional Assessment Battery: the MoodEmotions and Behavioral Control scales.A psychometric study comparing rating scale performance embedded in a cross-sectional survey used for developing a new instrument to measure behavioral health functioning among adults applying for disability benefits in the United States was performed.Within the sample of 1,017 respondents, the range of response category endorsement was similar for both frequency and agreement item types for both scales. There were fewer missing values in the frequency items than the agreement items. Both frequency and agreement items showed acceptable reliability. The frequency items demonstrated optimal effectiveness around the mean ± 1-2 standard deviation score range; the agreement items performed better at the extreme score ranges.Findings suggest an optimal response format requires a mix of both agreement-based and frequency-based items. Frequency items perform better in the normal range of responses, capturing specific behaviors, reactions, or situations that may elicit a specific response. Agreement items do better for those whose scores are more extreme and capture subjective content related to general attitudes, behaviors, or feelings of work-related behavioral health functioning.

Published
2014

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