(166) Psychometric Assessment of the Optimal Screening for Prediction of Referral and Outcomes Yellow Flag (OSPRO-YF) Tool: Item Number and Factor Structure

Abstract

The Optimal Screening for Prediction of Referral and Outcomes Yellow Flag (OSPRO-YF) tool is a concise, multidimensional yellow flag assessment tool. It was developed to evaluate negative mood, fear-avoidance, and positive affect/coping; however, the ability of the OSRPO-YF items to appropriately evaluate these three factors has not been empirically validated. Therefore, the purpose of this secondary analysis was to compare factor structure for the 10- and 17-item OSPRO-YF versions. Two separate cohorts (n1=428; n2=440) with musculoskeletal pain (neck, low back, shoulder, or knee pain) completed both OSPRO-YF versions. An exploratory factor analysis (EFA) with principal axis factoring and oblique rotation identified the factor structure in the first cohort. Eigenvalues > 1 criterion determined the number of factors; factor composition was defined by loadings >0.4. A confirmatory factor analysis (CFA) using structural equation modeling then validated the identified factor structure in the second cohort. EFA yielded 2 factors (catastrophizing and negative mood) for the 10-item version and 4 factors (catastrophizing, positive coping, negative mood, and fear-avoidance) for the 17-item version. CFA indicated the 17-item factor structure demonstrated better model fit (RMSEA=0.056, p>0.05; NFI=0.9; TLI=0.9) compared to the 10-item factor structure (RMSEA=0.07, p