Secondary Analysis Of Survey Data Research Articles

Total, Between-, and Within-Item Attribute Person Fit Analysis Using Mokken Scaling Techniques: An Exploratory Nonparametric Approach to Person Fit

The purpose of this study was to consider how researchers can incorporate item attributes into nonparametric person fit analysis for the purpose of providing additional insight into person fit beyond what is available using typical total-scale person fit approaches. Inspired by parametric person fit statistics that consider patterns of residuals at the total-scale, between-item-attribute, and within-item-attribute levels, we proposed simple adaptations to standard Mokken Scale Analysis (MSA) person fit analysis techniques to reflect these three levels of person fit analysis. We demonstrated the technique using a secondary analysis of survey data related to learning motivation and considered how the results may be interpreted in an affective assessment context. We used a simple exploratory simulation study to consider the techniques under a wider range of conditions. Overall, the results suggested that it is possible to incorporate item attributes into MSA person fit analysis at the total-scale, between-item-attribute, and within-item attribute levels, and that each set of analyses provides a unique perspective on person fit.

Wealth-related inequalities in self-reported health status in the United States and 14 high-income countries.

To examine wealth-related inequalities in self-reported health status among older population in the United States and 14 European countries. We used secondary individual-level data from Health and Retirement Survey (HRS) and the Survey of Health, Ageing, and Retirement in Europe (SHARE) in 2011 and 2019. In this cross-sectional study, we used two waves from HRS (wave 10 and 14) and SHARE (wave 4 and 8) to compare wealth-related health inequality across countries, age groups, and birth cohorts. We estimated Wagstaff concentration indices to measure these inequalities across three age groups (50-59, 60-69, 70-79) and two birth cohorts (1942-1947, 1948-1953) in the US and 14 European countries. We performed secondary analysis of survey data. Focusing on older population, we found evidence of wealth-related inequalities in self-reported health status across several high-income countries, with the US demonstrating higher levels of inequality than its European counterparts. The magnitude of these inequalities with respect to wealth remained unchanged over the study period across all countries. Our findings also suggest that wealth-related health inequalities differ at different stages of workforce engagement, especially in the United States. This could be explained either by potential redistributive effects of retirement or by uneven survivor effect, as less wealthy may drop out of the observations at a greater rate partly due to their poorer health. Wealth-related inequalities in self-reported health status are strong and persistent across countries. Our results suggest that there is meaningful variation across high-income countries in health-wealth dynamics that merits further investigation to better understand whether certain health or welfare systems are more equitable. They also highlight the need to consider social policy and wealth redistribution mechanisms as strategies for improving population health among the less wealthy, in the United States and elsewhere.

Integration policies shape ethnic-racial majorities' threat reactions to increasing diversity.

Increasing ethnic and racial diversity often fuels feelings of threat among ethnic-racial majorities (e.g., self-identified white Americans and European nationals). We contend that these threat perceptions depend on the policy context. Across four studies, we test whether more inclusive immigrant integration policies attenuate ethnic-racial majorities' threat reactions. Studies 1 to 3 (n = 469, 733, and 1745, respectively) used experimental methods with white American participants in the United States. Study 4 (n = 499,075) used secondary analysis of survey data comparing attitudes of nationals in 30 European countries and measured the impact of actual changes in diversity and policies over 10 years. Our results show that integration policies shape threat reactions even in those situations when increasing diversity could be seen as the most threatening: when narratives highlight the majority's impending minority position or when diversity suddenly increases. When policies are more inclusive toward immigrants, ethnic-racial majority participants report less threat (or no threat) in response to increasing diversity.

U.S. beef producer perspectives on “sustainable beef” and implications for sustainability transitions

Beef production systems are at the center of ongoing discussion and debate on food systems sustainability. There is a growing interest among beef producers, consumers, and other beef supply chain stakeholders in achieving greater sustainability within the industry, but the relationship of this interest to general sustainability issues such as climate change, biodiversity loss, food security, livelihood risks, and animal welfare concerns is unclear. Specifically, there is very little research documenting how beef producers define and view the concept of sustainability and how to achieve it. Producer perspectives are critical to identifying constraints to sustainability transitions or to help build agreement with other producers about the shared values such transitions may support. Through a secondary analysis of survey data of U.S. beef producers (n = 911) conducted in 2021 by the Trust in Food division of Farm Journal, a corporation that provides content, data, and business insights to the agricultural community (e.g., producers, processors/distributors, and retailers), we investigated what “sustainable beef” means to U.S. beef producers, highlighting the key components and constraints they perceive to achieving desirable sustainability outcomes. Leveraging the three-pillar model of sustainability as a framework for analysis, we identified key themes producers use to define “sustainable beef.” We found that producers collectively viewed sustainability as: (1) multidimensional and interconnected; (2) semi-closed and regenerative; (3) long-lasting; and (4) producer-centered, although an integrated perspective uniting these aspects was rare. We discuss how these perspectives may be the basis for sustainability efforts supported by producers and raise future research considerations toward a shared understanding of what sustainability is and what is needed for enduring sustainability solutions in the U.S. beef industry.

Factors Affecting Autistic Students’ School Motivation

Factors Affecting Autistic Students’ School Motivation

Validation of a short form of the practice environment scale of the nursing work index: The PES-5.

The Practice Environment Scale of the Nursing Work Index (PES-NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES-5. We conducted a cross-sectional, secondary analysis of survey data from nurses in 760 hospitals in six U.S. states in 2016 or 2019. One representative item per subscale was selected by highest item-to-subscale R2 from the original PES-NWI publication. Five psychometric properties of the PES-5 were evaluated. The reproduced structure of the full form was confirmed in the 2016 data by the highest R2 for the selected items. The unidimensional structure of the PES-5 was confirmed through confirmatory factor analysis. The correlation between the composite values of the 28-item and 5-item versions was 0.94. The Cronbach's alpha reliability of the PES-5 was >0.80. The intraclass correlation coefficient (ICC 1, k), which evaluates the stability of aggregated values when data are clustered, i.e., nurses are nested within hospitals, was >0.80 in both datasets, demonstrating satisfactory aggregate properties. Construct validity was supported by the selected items being ranked highly in their respective subscales by an expert panel. Criterion validity was supported by an analysis of variance of the PES-5 mean value across responses to a single-item work environment measure. Similar patterns of relationships with other key variables were identified by statistically significant odds ratios in regression models predicting patient mortality from the PES-5. The classification accuracy of the PES-5 was high, with 88% of hospitals classified identically by both versions. The PES-5 shows promise for measurement of nurses' work environments while maximizing response rate by reducing participant burden.

274 Examining Composite Measures of Social Determinants of Health and their Relationship to Mental Health Symptoms in Parents of Children Hospitalized in the United States

OBJECTIVES/GOALS: The primary aim of this study is to explore the relationship between neighborhood deprivation index as measured by the Social Vulnerability Index (primary predictor) and anxiety and depression in primary caregivers of hospitalized children, measured using the Hospital Anxiety and Depression Scale (primary outcome). METHODS/STUDY POPULATION: Design: This descriptive, comparative, non-intervention, cross-sectional substudy is is a secondary analysis of survey data collected from parents of hospitalized children staying at Ronald McDonald Houses. Regression models will examine the relationship between a parent’s social determinants of health and their anxiety and depression in the context of their child’s hospitalization. Setting/Study population: Parents/primary caregivers were recruited from the following sites: RMH of the Greater Philadelphia Region, RMH of San Diego, RMH of Greater Cincinnati, RMH of the Bluegrass (Lexington, KY), and RMH of Alabama. RESULTS/ANTICIPATED RESULTS: In the DAG below I hypothesize the associations between the variables and anxiety and depression based on what has been reported in the literature. The analysis is in progress. [blob:https://acts.slayte.com/50293cb7-4274-49bb-998d-7601dffd23cb] DISCUSSION/SIGNIFICANCE: Parents of hospitalized children experience a high burden of anxiety and depression. Pre-existing indicators of social determinants of health may contribute or compound parental anxiety and depression. A better understanding of this association can lead to improved screening and interventions to better support parents and their children.

Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data

ObjectiveThis study aims to examine temporal trends and the association between falls and self-rated oral health (SROH) status in community-dwelling older Korean adults.DesignSecondary analysis of a serial cross-sectional study.MethodsWe analysed...

Not everyone is the same: How Demographic, Contextual, and Instructional Factors Contribute to Mathematics Identity in Various Student Populations

Research suggests a positive mathematics identity is associated with increased achievement and engagement in mathematics. However, previous large scale research on mathematics identity has examined students as a homogeneous group, ignoring differences that may exist due gender, race, or ability level. Additionally, research examining conceptual instruction has focused on the effect it has on achievement, but not on the way it improves identity. This study addresses these two gaps by examining the contribution conceptual instruction makes to the mathematics identity of students and how that contribution differs when considering race, gender, and achievement. This secondary analysis of survey data from the High School Longitudinal Study of 2009 uses multiple regression to investigate the relationship between conceptual instruction and mathematics identity in a sample of over 23,000 ninth graders. I divided the sample by achievement level to look for different relationships between samples of low and high achieving students across the United States. Findings show that conceptual instruction positively contributes to student mathematics identity and reveals race to be a significant moderator in this relationship

Locality is the strongest predictor of expert performance in image-based differentiation of bacterial and fungal corneal ulcers from India.

This study sought to identify the sources of differential performance and misclassification error among local (Indian) and external (non-Indian) corneal specialists in identifying bacterial and fungal keratitis based on corneal photography. This study is a secondary analysis of survey data assessing the ability of corneal specialists to identify acute bacterial versus fungal keratitis by using corneal photography. One-hundred images of 100 eyes from 100 patients with acute bacterial or fungal keratitis in South India were previously presented to an international cohort of cornea specialists for interpretation over the span of April to July 2021. Each expert provided a predicted probability that the ulcer was either bacterial or fungal. Using these data, we performed multivariable linear regression to identify factors predictive of expert performance, accounting for primary practice location and surrogate measures to infer local fungal ulcer prevalence, including locality, latitude, and dew point. In addition, Brier score decomposition was used to determine experts' reliability ("calibration") and resolution ("boldness") and were compared between local (Indian) and external (non-Indian) experts. Sixty-six experts from 16 countries participated. Indian practice location was the only independently significant predictor of performance in multivariable linear regression. Resolution among Indian experts was significantly better (0.08) than among non-Indian experts (0.01; P < 0.001), indicating greater confidence in their predictions. There was no significant difference in reliability between the two groups ( P = 0.40). Local cornea experts outperformed their international counterparts independent of regional variability in tropical risk factors for fungal keratitis. This may be explained by regional characteristics of infectious ulcers with which local corneal specialists are familiar.

Breast Cancer Risk Perceptions Among Underserved, Hispanic Women: Implications for Risk-Based Approaches to Screening.

Understanding factors that shape breast cancer risk perceptions is essential for implementing risk-based approaches to breast cancer detection and prevention. This study aimed to assess multilevel factors, including prior screening behavior, shaping underserved, Hispanic women's perceived risk for breast cancer. Secondary analysis of survey data from Hispanic women (N = 1325, 92% Spanish speaking, 64% < 50) enrolled in a large randomized controlled trial. Analyses were performed in two cohorts to account for the role of age on screening guideline recommendations (< 50 and 50 +). For each cohort, we examined differences in three common measures of perceived risk of breast cancer (percent lifetime, ordinal lifetime, comparative) by participant factors with chi-square or Kruskal-Wallis tests, as appropriate. Multivariate analyses examined the association between mammography history with percent perceived lifetime risk (outcome > 10 vs ≤ 10%). Overall, 75% reported a lifetime risk between 0 and 10%, 96% rated their ordinal risk as "not high," and 50% rated their comparative risk as "much lower." Women < 50 with a family history of breast cancer reported significantly higher levels of perceived risk across all three measures. Among women 50 + , those reporting lower levels of perceived risk were significantly more likely to be Spanish speaking. No significant association was observed between mammography history and percent lifetime risk of breast cancer. Factors shaping breast cancer risk perceptions differ by age. Prior screening may play less of role in constructing risk perceptions. Research is needed to develop culturally and linguistically appropriate strategies to improve implementation of risk-based screening.

Use of Behavioral Health Treatment Among Parenting Women With Opioid Use Disorder in the United States

ObjectiveTo examine use of mental health treatment, substance use disorder treatment, and perceived barriers to treatment by whether a major depressive episode occurred during the past year among parenting women with opioid use disorder. DesignSecondary analysis of survey data from the National Survey on Drug Use and Health, 2015–2019. SettingUnited States. ParticipantsWomen aged 18 to 44 years with opioid use disorder and at least one child in the household. MethodsWe computed descriptive statistics for demographic characteristics, treatment by major depressive episode status, and barriers to treatment by major depressive episode status. We conducted multinomial logistic regression to examine associations among demographic characteristics, major depressive episode status, and type of treatment. ResultsOf the 36% of respondents in our weighted sample (N ≈ 254,300) who experienced major depressive episode, 35% received substance use disorder and mental health treatment, and 27% did not receive any form of treatment. We found that identification as a person of color was significantly associated with a lower relative risk of receiving any type of treatment. Frequently reported barriers to treatment included affordability, access, and stigma. ConclusionRespondents with opioid use disorder and co-occurring major depressive episode did not obtain necessary treatment. Barriers to treatment, including affordability, access to treatment, and stigma, need to be addressed, particularly among women of color.

Health and Comorbidities in Minority Ethnic Adults Living with Visual Impairment in the UK

Visual impairment has been associated with mental and physical comorbidities in older adults. Research into comorbidities within minority ethnic communities (MEC) with visual impairment is yet to be explored, despite the increase in numbers. A secondary analysis of survey data collected by UK-based sight loss charities provides the first insight into comorbid conditions in a matched control sample of 77 MEC and 77 White adults aged 18–85 years. Participants were matched based on age, gender, UK region, and urban/rural setting. Group differences were explored, and subgroup analysis was also carried out for the two largest subgroups within the MEC group: Asian (n = 46) and Black (n = 22). Response frequencies (n) and proportions (%) were calculated for all variables including eye conditions, vision difficulties, comorbid conditions, and exercise. The sample was predominantly young, and few significant differences were found. Sub-group analysis showed that Asian participants were more likely to report not doing any exercise, having bad health, and comorbidities including high blood pressure, dexterity, hearing and communication difficulties, and a recent emotional/psychological/mental health condition. Black participants, however, were more likely to report comorbidity, in particular physical conditions and mobility difficulties.

"I've been doing this for years": the COVID-19 pandemic and family caregiver isolation and loneliness.

Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregivers are often considered a population at risk of experiencing increased stress, isolation, and loneliness. During the COVID-19 pandemic in the US, social isolation and decrease in social activities were a top concern among older adults and their family caregivers. Using secondary analysis of survey data as part of a multi-site implementation trial of a caregiver skills training program, we describe differences in caregiver experiences of loneliness before and during the COVID-19 pandemic. Health and wellbeing surveys of family caregivers were collected on 422 family caregivers of veterans before and during COVID-19. Logistic regression modeling examined whether the loneliness differed between caregiver groups pre vs during COVID-19, using the UCLA 3-item loneliness measure. Rapid directed qualitative content analysis of open-ended survey questions was used to explore the context of how survey responses were affected by the COVID-19 pandemic. There were no significant differences in loneliness between caregivers pre vs during COVID-19. In open-ended responses regarding effects of COVID-19, caregivers described experiencing loneliness and social isolation; why they were unaffected by the pandemic; and how caregiving equipped them with coping strategies to manage negative pandemic-related effects. Loneliness did not differ significantly between pre vs during COVID-19 caregivers. Future research could assess what specific characteristics are associated with caregivers who have resiliency, and identify caregivers who are more susceptible to experiencing loneliness. Understanding caregiver loneliness could assist other healthcare systems in developing and implementing caregiver support interventions.

The association between abortion training and obstetrics and gynecology resident competence and intention to provide abortion care before Dobbs

ObjectiveTo assess the role of abortion training in fourth-year obstetrics and gynecology (OBGYN) residents’ abortion care competence and practice intentions before the Dobbs decision. Study designThis is a planned secondary analysis of survey data of fourth-year U.S. OBGYN residents. Abortion training was defined as ‘routine’ if automatically included in schedules, ‘‘optional’’ if not scheduled but available, and ‘‘not available’’. Self-assessed competence was defined as feeling prepared to independently provide care. Participants were asked about their competence and post-residency intentions to provide specific aspects of pregnancy loss and induced abortion care. ResultsOf 1241 fourth-year residents, 885 (71%) completed the questions of interest. For each skill, more residents with routine training reported competence compared to those with less comprehensive training. More residents with routine training reported intentions to include abortion care in practice (422, 79%) compared to residents with optional (171, 66%) or no training (51, 55%), p < 0.001). Residents with routine training were nearly six times more likely to intend to provide medication abortion post-residency compared to residents without training; more residents in all groups reported intentions to provide care for pregnancy loss compared to abortion. ConclusionsPre-Dobbs, residents with routine abortion training had greater self-assessed competence in abortion care than those with optional or no training and were more likely to intend to provide this after residency. Given the evolving impacts of the 2022 reversal of Roe v Wade, residency training programs must work to ensure routine access to legally permissible abortion training as routine training is associated with intention to provide fundamental, reproductive healthcare. ImplicationsRoutine training in abortion care during OBGYN residency is associated with higher competence and intention to provide post-residency – availability of this training Is severely compromised in restricted states post-Dobbs.

FAMILY CAREGIVER COMFORT WITH TELEHEALTH TECHNOLOGIES: DIFFERENCES BY RACE/ETHNICITY IN A CROSS SECTIONAL SURVEY

Abstract Telehealth has seen widespread use since the onset of the COVID-19 pandemic, and 82% patients required assistance in accessing their telehealth appointments. This assistance commonly comes from a family caregiver who may or may not be comfortable using the technologies associated with telehealth. The objective of our study was to analyze a demographically representative survey of US family caregivers to understand the level of comfort using telehealth technologies among family caregivers through a secondary analysis of survey data collected during the COVID-19 pandemic in 2020. Level of caregiver comfort using computers, smartphones, and tablets was determined through three Likert-style questions. Proportional odds logistic regression was used to understand the associations between demographic variables and level of caregiver comfort using each technology, when adjusting for covariates. A total of 340 caregivers were included in the analysis. Compared to Non-Hispanic White caregivers, Asian caregivers had a higher odds (OR 3.14; 95%CI 1.36, 8.02; p=0.01) of expressing comfort using computers; Black caregivers (OR 0.46; 95%CI 0.21, 0.98; p=0.04) and Hispanic caregivers (OR 0.36; 95%CI 0.17, 0.79 p=0.01) expressed lower odds of comfort using smartphones; and Asian caregivers had a higher odds (OR 4.64; 95%CI 2.05, 11.69; p=0.001) of expressing comfort using tablets. : There are identified disparities in level of technological comfort using computers, smartphones, and tablets by different racial and ethnic groups. Health systems should consider early stakeholder involvement in the design of telehealth technologies and culturally responsive training materials on telehealth technology use to reduce disparities in comfort using telehealth technologies.

I don’t know my child’s asthma risk: evidence against satisficing as an explanation for ‘don’t know’ responses

Several studies suggest that ‘don’t know’ (DK) responses to risk perception items may represent meaningful expressions of uncertainty about disease risk. However, researchers are often discouraged from including a DK response option in survey items due to concerns about respondents overusing it to minimize cognitive effort—a phenomenon often referred to as satisficing. Our objective was to investigate whether patterns of DK responses to risk perception survey items were consistent with satisficing behavior. We conducted a secondary analysis of survey data from 814 parents and guardians (hereafter caregivers) of children with asthma. Caregivers answered 18 items assessing their perceived risk of their child experiencing two types of poor asthma outcomes: asthma exacerbation, and low asthma control. We examined differences in the frequency and distribution of DK responses across all 18 items and by type of risk perception item (i.e. 2 vs. 5 response options, absolute vs. comparative risk). We found that 32% (n = 548) of respondents marked DK at least once. Of the 266 caregivers who provided any DK response, most did so for only 1 or 2 items (51.9%, n = 138), and only 6% (n = 15) answered DK to more than half of the items. Using random coefficient Poisson models, we found more DK responding for dichotomous absolute (30.1%) than ordinal absolute items (5.3%), b = 1.72, p<.001. We also found fewer DK responses to the ordinal absolute items than the comparative items (8.2%), b=-0.49, p<.001. Using Chi-square tests, we found that inattentive responding was not associated with responding DK. Our findings suggest that satisficing is unlikely to completely explain DK responding to perceived risk survey items. Researchers who exclude DK response options from risk perception survey items may obtain an incomplete understanding of their study sample’s beliefs about risk.

Abstract 155: The Relationship Between Positive Psychology Factors and Quality of Life in Long-Term Cardiac Arrest Survivors

Introduction: There is a need to identify factors that can improve quality of life (QoL) post-CA. Long-term CA survivors (i.e., &gt; 1 year) have recommended utilizing positive psychology factors (i.e., psychological strengths that foster well-being) such as mindfulness, existential well-being, and resilient coping to manage survivorship challenges. We explored associations between these factors and QoL. Hypothesis: Higher levels of mindfulness, existential well-being, and resilient coping will be individually associated with better physical, psychological, and social QoL. Goal: Identify factors associated with improved QoL, that may become intervention targets. Methods: Secondary analysis of survey data of long-term CA survivors from the Sudden Cardiac Arrest Foundation. We examined demographic covariates (sex, months since arrest, age, income), self-reported daily memory problems, functional dependence (Lawton Independent Activities of Daily Living Scale), emotional distress (PTSD Checklist-5, Patient Health Questionnaire-4), and positive psychology factors (mindfulness [Cognitive and Affective Mindfulness Scale-Revised], existential well-being [Meaning in Life Questionnaire Presence of Meaning subscale], and resilient coping [Brief Resilient Coping Scale]). We used the WHOQOL-BREF to measure psychological, physical, and social QoL. We conducted 9 multiple regression models to test the individual relationship between each positive psychology factor and each QoL domain, adjusted for demographic covariates, functional dependence, daily memory problems, and emotional distress. Results: We included 129 long-term CA survivors (mean age: 52 years, 52% male, 98% white). In adjusted models, higher mindfulness and resilient coping were associated with better QoL in all domains (βs: 0.19 - 0.56, p &lt; 0.03, R 2 = 0.35 - 0.74); existential well-being was associated with better psychological and social QoL (βs: 0.27- 0.36, p = 0.001, R 2 = 0.4 - 0.72). Conclusion(s): Greater levels of positive psychology factors were associated with better QoL, even after accounting for emotional, cognitive, and functional sequelae. Future interventions should consider teaching these positive psychology factors to CA survivors.

Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe

BackgroundThere is a growing body of evidence for the role that communities can have in producing beneficial health outcomes. There is also an increasing recognition of the effectiveness and success of community-led interventions to promote public health efforts. This study investigated whether and how community-level measures facilitate a community-led intervention to achieve improved HIV outcomes.MethodsThis is a secondary analysis of survey data from a cluster randomised trial in 40 rural communities in Zimbabwe. The survey was conducted four months after the intervention was initiated. Communities were randomised 1:1 to either paid distribution arm, where HIV self-test (HIVST) kits were distributed by a paid distributor, or community-led whereby members of the community were responsible for organising and conducting the distribution of HIVST kits. We used mixed effects logistic regression to assess the effect of social cohesion, problem solving, and HIV awareness on HIV testing and prevention.ResultsWe found no association between community measures and the three HIV outcomes (self-testing, new HIV diagnosis and linkage to VMMC or confirmatory testing). However, the interaction analyses highlighted that in high social cohesion communities, the odds of new HIV diagnosis was greater in the community-led arm than paid distribution arm (OR 2.06 95% CI 1.03–4.19).ConclusionWe found some evidence that community-led interventions reached more undiagnosed people living with HIV in places with high social cohesion. Additional research should seek to understand whether the effect of social cohesion is persistent across other community interventions and outcomes.Trial registrationPACTR201607001701788.

Associations between psychological flexibility and daily functioning in endometriosis-related pain.

Processes of psychological flexibility (PF) are positively associated with health and wellbeing in several chronic pain disorders. However, these processes have not been investigated in endometriosis, a chronic pain disorder affecting 5-10 % of women worldwide. This study is a preliminary investigation of the associations between PF or psychological inflexibility (PI) and daily functioning in people with a primary diagnosis of endometriosis. This study is based on a secondary analysis of survey data from Swedish-speaking adult participants with chronic pain recruited online. The current study included only those reporting a diagnosis of endometriosis and significant long-term pain. All participants completed the Multidimensional Psychological Flexibility Inventory (MPFI), a measure of PF and PI, as well as other measures of PF, and measures of pain and daily functioning. Correlation and multiple regression analyses were performed to examine relations of PF and PI with measures of pain and daily functioning. In general, PF facet scores from the MPFI did not correlate with pain interference but did correlate with depression, with the exception of acceptance. The overall facets of PI appeared to perform better as correlates and in regression. Established measures of PF performed in correlation and regression analyses generally as has been observed in other chronic pain populations, with significant positive associations. In this preliminary analysis of PF and PI in participants with endometriosis-related pain, these processes appear relevant, especially in understanding depression, but results varied along with the measures used. Specifically, when employing the MPFI, the PI facets emerged as stronger correlates. The findings underscore the potential benefit of incorporating assessments of PF and PI as process variables in endometriosis-research, butalso that careful consideration should be given when selecting instruments.