Standardized Cronbach Research Articles

Validation of the ukrainian version of Binge Eating Scale

The article presents the results of validation of the Ukrainian ver- sion of the Binge Eating Scale (BES), the psychometric properties of which have not yet been tested among the Ukrainian-speaking population. The BES is a questionnaire de- signed to identify and diagnose in- dividuals suffering from Binge-eating disorder (BED). The aim of the work was to check the psychometric properties of the Ukrainian version of BES, to es- tablish the factor structure, internal consistency and constructive validity in the sample of Ukrainian youth. A cross-sectional study of 87 par- ticipants was conducted: students from different higher education in- stitutions who could read and write in the Ukrainian language. To char- acterize the criterion of validity, the BES was compared with the data of the clinical criteria for BED on DSM- 5, which in this study is considered the gold standard for the diagnosis of BED. The Ukrainian version of BES dem- onstrated a standardized Cronbach’s alpha of 0.885, showing good internal consistency close to high (0.9). The split half size was 0.899, indi- cating a very high split half. The corre- lation between the halves of the test was 0.766720035, which indicates a fairly high reliability in terms of in- ternal consistency. Factor analysis showed a two- factor structure. This explained only 46.2 % of the variance. The ROC analysis found that the re- sulting area under the curve (AUC) was 0.811 (95 % CI: 0.713; 0.887), indicating good model quality. The results of our study confirm the psychometric reli- ability of the BES, high design and criterion validity. Thus, the Ukrainian version of BES has psychometric char- acteristics close to the original.

Reliability of the telephone-administered International Physical Activity Questionnaire in an Italian pilot sample


 Background: the International Physical Activity Questionnaire (IPAQ) is an instrument for crossnational monitoring of physical activity and inactivity. The aim of the study was the reliability evaluation of the Italian telephone-administered IPAQ version in Rome.
 Methods: the IPAQ short form (IPAQ-SF), consisting of 7 items, was administered. The responses, used to compute Metabolic Equivalent Task (MET in minutes per week), were processed to analyze the internal consistency. Standardized Cronbach’s alpha was used for reliability estimation.
 Results: a total of 133 adults (51 males and 82 females) participated in the study, with a mean age of 51 years (SD=19). The mean MET was 4 130, corresponding to good physical activity levels. The standardized Cronbach’s alpha on 6 items, concerning time spent on vigorous and moderate activity and walking, was 0.614.
 Conclusions: according to the findings from other countries, the Italian IPAQ-SF has acceptable measurement properties, as good as other established self-reports. The IPAQ-SF has a questionable reliability as previously reported, but the results of the present pilot study are promising and suggest that these instruments can be used to compare population estimates of physical activity.

Assessing the Psychometric Properties of the Chinese Version of Ten-Item Personality Inventory (TIPI) Among Medical College Students

ObjectiveThe Ten-Item Personality Inventory (TIPI) was designed as a brief instrument of the Big Five personality traits. This study aimed to explore the internal consistency and structural validity of the Chinese version of TIPI (TIPI-C) in medical college students.MethodsA cross-sectional study was conducted in 11 provinces of China. Spearman–Brown coefficient, standardized Cronbach’s α coefficient, and Cronbach’s α coefficient were applied to estimate the internal consistency. Spearman–Brown coefficient was applied to estimate split-half reliability. Principal components analysis (PCA) and confirmatory factor analysis (CFA) were used to identify the structural validity.ResultsA total of 2223 medical college students recruited from different regions of China were included. The Spearman–Brown coefficients of TIPI-C ranged from 0.129 to 0.786 and the Cronbach’s α coefficients ranged from 0.119 to 0.785. The split-half reliability of the Spearman–Brown coefficient was 0.508. The latent structure of Extraversion, Emotional Stability, and Conscientiousness complied with the intended structure, and the internal consistency coefficients of these three traits were supported. However, the internal consistency coefficients of Agreeableness and Openness were low and the structural validity was not supported.ConclusionTIPI-C primarily stands out as a feasible instrument for brief measurements of the Extraversion, Emotional Stability, and Conscientiousness domains. Further research is required to evaluate the concurrent validity and the test–retest reliability of TIPI-C in different populations and potentially modify the instrument to be more suitable for the Chinese population.

Validation and minimally important difference of the Child-OIDP in a socioeconomically diverse sample of Indian adolescents

IntroductionWhile different measures have been validated and used to assess the oral health related quality of life (OHRQoL) of children and adolescents, no previous study has tested the psychometric performance of OHRQoL amongst the most marginalized adolescents, living in extremely deprived neighbourhoods like urban slums and resettlement areas in modern cities. Our study assessed the internal consistency reliability, construct validity and Minimally Important Difference (MID) of the Child-OIDP in a sample of adolescents aged 12–15 years reporting oral health problems that lived in three different types (including two extremely vulnerable) of neighbourhoods (urban slums, resettlement colonies, and middle and upper middle-class neighbourhoods) in the National Capital Territory of Delhi.MethodsWe conducted data analysis on a cross-sectional study, comprising of 840 adolescents. The Child-OIDP was used as a measure of OHRQoL. Internal consistency reliability was tested using the standardized Cronbach’s Alpha Coefficient. The Child-OIDP was also tested for content and construct validity (the latter through the median test), while a distribution-based approach was used to identify the MID.ResultsThe Indian Child-OIDP showed good internal consistency, as the Cronbach’s alpha coefficient was 0.77. Inter-item correlation coefficients among the items ranged from 0.13 to 0.50, with the mean inter-item correlation being 0.30. The corrected item-total correlations ranged from 0.30 (social contact) to 0.54 (speaking). For construct validity, the Child-OIDP extent was significantly associated with three subjective oral and general health variables in the expected direction. The calculated effect sizes for these differences indicated that they were moderate (0.50–0.79). We also calculated the standard error of measurement (SEM) of Child-OIDP extent as 0.75.ConclusionThis study demonstrated that the Indian Child-OIDP is a reliable and valid measure for the assessment of the oral health related quality of life among Indian adolescents especially from marginalised and socioeconomically vulnerable groups. This is an essential step towards assessing oral health and evaluating oral health promotion interventions in those populations and settings.

KNOWLEDGE, PERCEPTIONS, AND PREVENTIVE PRACTICES TOWARDS COVID-19 DURING THE EARLY STAGES OF THE OUTBREAK AMONG SAUDI PEOPLE: A CROSS-SECTIONAL STUDY

Introduction: Knowledge of and adherence to preventive measures concerning the transmission of coronavirus disease (2019) (COVID-19) remain the frontline strategies to control its spread. This cross-sectional study aims to determine the knowledge, perceptions, and preventive practices towards COVID-19 among the general Saudi population. Methods: A 40-item self-administered online questionnaire concerning knowledge and preventive practices towards COVID-19 was developed and validated. The questionnaire was highly reliable (standardized Cronbach’s alpha = 0.89). Results: A total of 2024 participants were included (60% men; age range: 18 to 73 years). Estimated median knowledge and preventive practices score were 63 (IQR = 59–67) and 63 (IQR = 54–68) respectively. The results reflected high levels of knowledge and preventive practices among the participants. The knowledge score and preventive practices score were significantly differed by educational level, work status, region, and purpose of leaving one’s house. Correlation analyses demonstrated a significant weak correlation between knowledge and preventive practices (r=0.056, p=0.012). Conclusion: This study indicates that majority of Saudi people having above average level of knowledge and preventive practices towards the COVID-19. Health education programs must be designed to target less educated residents and expatriates. The findings provide a baseline for the knowledge, perceptions, and preventive practices towards the COVID-19 pandemic among Saudi Arabian residents at the early stages of the outbreak.

CROSS-SECTIONAL SURVEY TO DEVELOP VALIDATED SCALES FOR ASSESSMENT OF JEERNA AAHARA LAKSHANAS

Digestion of food is the mainspring of nourishment of the body. Jatharagni (strength of digestion) plays a vital role in digestion. As digestion progresses, our body shows the signs that reflect the digestion stage known as Jeerna Aahara Lakshanas. This research aimed to develop and validate a scale for assessing Jeerna Aahara Lakshanas using standardized questionnaire development and validation methods. In the developmental phase, Jeerna Aahara Lakshanas were collected from the Samhitas of Ayurveda. The factors that influence digestion, like Ahara Vidhi Vidhana (Rules for food consumption) and Loulya (greediness for food), are also considered in developing the questionnaire. Keeping the information available in texts of Ayurveda Charaka Samhitha and Ashtanga Hridaya as primary information, Open-ended questions were formed under different domains and subdomains of Jeerna Ahara Lakshanas. The domains and questions were validated by 25 Ayurvedic academicians, practitioners. A set of closed-ended questions was developed based on a 5 and 7 Likert scale response. In the validation process, the closed-ended questions were distributed to 200 healthy volunteers of both genders aged 18-40 after screening health with an SF 12 questionnaire, with prior consent in each stage. The response was analyzed using SPSS 2.0 software, and an assessment of reliability was carried out by adopting the data reduction. The reliability was assessed using the standard Cronbach’s Alpha (CA) test. The questions which didn’t give the acceptable CA were redacted, and the questions with good and acceptable CA were retained. The final questionnaire was obtained with 51 questions after obtaining a CA of 0.826 in the 5th stage.

Translation, validation and psychometric properties of Effort-Reward Imbalance questionnaire among nurses in Vietnam

We translated the Effort-Reward imbalance questionnaire, an instrument for measuring work stress, into the Vietnamese language and investigated its psychometric properties among nurses in Vietnam. In a hospital-based cross-sectional study design, we sampled and interviewed 207 nurses working full-time (response rate 83%). We evaluated the internal consistency using standardized Cronbach's alpha coefficients and structural validity using confirmatory factor analysis. Discriminative validity was assessed by comparing the measured scores between age groups, gender, education levels, income groups, and job positions. In addition, we confirmed the criterion validity by investigating its association with self-reported health using simple and multiple logistic regression models. Most of the participants were female (73.3%), young (average 28.5 years old), and had education levels of college or higher (53.5%). We observed sufficient internal consistency in effort, reward, and over-commitment scales (Cronbach's alpha 0.80, 0.76, and 0.68, respectively). Confirmatory factor analysis of the three-factor hierarchical model showed an acceptable fit and fair construct validity with most moderate or stronger (>0.3) factor loading coefficients. Poor self-rated health was more likely in respondents in both Effort-Reward ratio's middle tertile (adjusted Odd-Ratio = 2.80, p-value = 0.031) and highest tertile (adjusted Odd-Ratio = 2.64, p-value = 0.05), adjusting for age, gender, and education levels. The Effort-reward imbalance scale has adequate reliability and validity for assessing work stress among nurses in Vietnam. Its significant association with poor self-rated health warrants further investigation. The validated instrument can help measure the effort-reward imbalance to manage better work-related emotional strains and mental health issues among nurses and ensure human resources' stability in healthcare in Vietnam.

Pain measurement in the older people: evaluation of the psychometric properties of the Geriatric Pain Measure (GPM-24) \u2013 Polish version

BackgroundChronic pain in older people is of particular importance not only with regard to negative subjective experience but also as an indicator of the quality of medical care. Brief scales to assess pain may help health professionals with early recognition and treatment to avoid patient suffering. However, these scales should be adapted to the cultural context to provide valid assessments. The aim of this study was to evaluate the psychometric properties of the Polish translation of the Geriatric Pain Measure – 24 (GPM-24) in older people.MethodsThe study was conducted among 181 people aged 65 and over with chronic (noncancer) pain of varying intensity lasting more than 6 months. Construct validity was assessed using the principal component analysis (PCA) method with oblimin rotation. Criterion validity was evaluated by correlating the scores of the GPM-24 with the scores of the McGill-Melzack questionnaire (MPQ). The reliability of the GPM-24 was estimated in terms of internal consistency using Cronbach’s alpha coefficients.ResultsThe PCA revealed a 6- component structure of the set of items that constituted the GPM-24. Most of these components were defined by items included in the same subscale, similar to the result obtained by the original scale’s authors. There were significant correlations between the GPM-24 and some dimensions of MPQ: affective (rho = 0.25, p = 0.001), present pain intensity (rho = 0.44, p < 0.001), pain rating index total (rho = 0.31, p < 0.001), and number of words chosen (rho = 0.26, p < 0.001). The value of the standardized Cronbach’s alpha equalled 0.89 and thus confirmed the high reliability of the GPM-24.ConclusionsThe Geriatric Pain Measure − 24 is a reliable and valid tool that is recommended for the monitoring and multidimensional assessment of chronic pain in older people in daily practice as well as in clinical trials.Trial registrationStatutory research “Chronic pain in people over 65 years of age” K/ZDS/005733, conducted in 2015–2018.

Psychometric Validation of the Cardiff Wound Impact Schedule Questionnaire in a Spanish Population with Diabetic Foot Ulcer

Diabetic foot ulcers (DFU) negatively affect the quality of life (QoL) of people with diabetes. The Cardiff Wound Impact Schedule (CWIS) questionnaire has been designed to measure the QoL of people with chronic foot wounds. However, no studies have been specifically designed to validate this instrument in a Spanish population. In this prospective study, a total of 141 subjects with DFU were recruited. DFU was determined by performing physical examinations. Medical records were exhaustively reviewed to collect clinical variables. The CWIS was transculturally adapted by a group of experts and a group of patients with DFU. The SF-36 and EQ-5D generic instruments were used as reference tools. The questionnaires were administered at 7 days and 4, 12, and 26 weeks after the baseline assessment by personal interview with each of the study subjects. The psychometric properties of the instrument were assessed using statistical methods. The content validity had an average of 3.63 (90.7% of the maximum score of 4). The internal consistency of the CWIS subscales had a standardized Cronbach’s alpha range from 0.715 to 0.797. The reproducibility was moderate with an intraclass correlation coefficient (ICC) range from 0.606 to 0.868. Significant correlations between CWIS domains and SF-36 and EQ-5D subscales were observed, demonstrating a good criterion validity of the CWIS questionnaire (p < 0.001). However, the construct validity of the CWIS was not validated with a comparative fit index (CFI) of 0.69, a root mean square error of approximation (RMSEA) of 0.09, and a standardized root mean square residual (SRMR) of 0.10. The sensitivity to changes over time was optimal in the three domains (i.e., social life, well-being, and physical symptoms) (p < 0.001). In conclusion, the Spanish version of the CWIS shows acceptable psychometric properties to assess the QoL of subjects with DFU, except for its construct validity.

Working in "smart" mode during the Covid-19 pandemic. Validation of a questionnaire in the healthcare sector.

The present tool is adequate to investigate attitudes towards Smart Working among healthcare workers. During the most difficult phases of the Covid-19 he-alth emergency, when access to the usual work location was not allowed due to the constraints related to the pandemic, Smart Working enabled business continuity in the face of the ongoing health emergency. Mo-dern technology serves a new way of working, allowing workers to effectively manage their professional and personal spheres in a world that increasingly requires them to optimize their time. The main objective of this research is to validate a Smart Working questionnaire administered to healthcare workers. The questionnaire, reported in Annex I, consisting of 30 questions and submitted electronically through Google Forms, was administered in Italian to healthcare personnel of the Teaching hospi-tal Umberto I and Sapienza University of Rome between September and October 2020. The questionnaire analyzed the characteristics of the sample and investigated the perception and attitude of healthcare personnel towards seven different aspects of Smart Working. A descriptive analysis of the sample examined and an internal consistency analysis was performed through the use of the SPSS (Statistical Package for Social Science) program version 25.0. Cronbach's alpha statistical indicator, which measures reprodu-cibility over time, reliability, and homogeneity of questions, was used for the analysis. A total number of 53 health care providers answered the online questionnaire. The majority of the respondents were female (60.4%); 73.6% of respondents reported having a college degree or a higher educational level. The analysis showed an overall standardized Cronbach's Alpha of 0.709, which corresponds to a good reliability. In the items analysis, the alpha value ranged from a minimum of 0.652 to a maximum of 0.756.

Business and Economics Students’ Self-Reports on Academic Reading in English as L2: A Factor Analysis

Abstract Adequate reading behaviour is vital for text comprehension across fields. In today’s professional environment, a well-developed reading skill is also expected in English as a second language (EL2), which happens already in college, although transition to college-level reading may be difficult even in the first language. It is therefore useful to analyse students’ use of reading strategies to facilitate their academic progress. This study investigates the reading behaviour of junior students of business/economics when reading academic texts in EL2. We conducted an exploratory factor analysis (N=134) of a 45-item questionnaire about students’ awareness of reading strategies and their reading confidence (i.e. self-perceived competence in text retelling). The majority of the items were based on self-reports found in the literature (Kolić-Vehovec, Bajšanski, 2001; Mokhtari, Reichard, 2002; Taraban, Kerr, Rynearson, 2004) and several items were added to the questionnaire (e.g. questions related to note taking). Five factors were interpretable: four factors related to Metacognitive Awareness of Reading Strategies (Repeated Reading, Monitoring/Regulation, Note Taking and Elaboration) and the fifth factor covering self-perceived competence in text retelling (Reading Confidence). Internal consistency of the factors indicated by standardized Cronbach’s alphas were 0.83 (Repeated Reading), 0.80 (Monitoring and Regulation), 0.77 (Note Taking), 0.63 (Elaboration) and 0.75 (Reading Confidence). Three strategies positively correlated with each other (Repeated Reading, Monitoring/Regulation and Elaboration), while negative correlation was found between Note Taking and Reading Confidence. The results provide valuable information on the patterns in student reading as a baseline for further analysis of L2 text comprehension in college.

Reliability and repeatability of a smartphone-based 6-min walk test as a patient-centred outcome measure.

The 6-min-walk test (6MWT) is a validated proxy for frailty and a predictor of clinical outcomes, yet is not widely used due to implementation challenges. This comparative effectiveness study assesses the reliability and repeatability of a home-based 6MWT compared to in-clinic 6MWTs in patients with cardiovascular disease. One hundred and ten (110) patients scheduled for cardiac or vascular surgery were enrolled during a study period from June 2018 to December 2019 at the Palo Alto VA Hospital. Subjects were provided with an Apple iPhone 7 and Apple Watch Series 3 loaded with the VascTrac research study application and performed a supervised in-clinic 6MWT during enrolment, at 2 weeks, 1, 3, and 6 months post-operatively. Subjects also received notifications to perform at-home smartphone-based 6MWTs once a week for a duration of 6 months. Test-retest reliability of in-clinic measurements and at-home measurements was assessed with an industry standard Cronbach's alpha reliability test. Test-retest reliability for in-clinic ground truth 6MWT steps vs. in-clinic iPhone 6MWT steps was 0·99, showing high reliability between the two tested measurements. When comparing for in-clinic ground truth 6MWT steps vs. neighbouring at-home iPhone 6MWT steps, reliability was 0·74. Running the test-reliability test on both measurements shows that an iPhone 6MWT test is reliable compared to an in-clinic ground truth measurement in patients with cardiovascular disease.

Validity and precision of the International Physical Activity Questionnaire for climacteric women using computational intelligence techniques.

This study aimed to evaluate the validity and precision of the International Physical Activity Questionnaire (IPAQ) for climacteric women using computational intelligence techniques. The instrument was applied to 873 women aged between 40 and 65 years. Considering the proposal to regroup the set of data related to the level of physical activity of climacteric women using the IPAQ, we used 2 algorithms: Kohonen and k-means, and, to evaluate the validity of these clusters, 3 indexes were used: Silhouette, PBM and Dunn. The questionnaire was tested for validity (factor analysis) and precision (Cronbach's alpha). The Random Forests technique was used to assess the importance of the variables that make up the IPAQ. To classify these variables, we used 3 algorithms: Suport Vector Machine, Artificial Neural Network and Decision Tree. The results of the tests to evaluate the clusters suggested that what is recommended for IPAQ, when applied to climacteric women, is to categorize the results into two groups. The factor analysis resulted in three factors, with factor 1 being composed of variables 3 to 6; factor 2 for variables 7 and 8; and factor 3 for variables 1 and 2. Regarding the reliability estimate, the results of the standardized Cronbach's alpha test showed values between 0.63 to 0.85, being considered acceptable for the construction of the construct. In the test of importance of the variables that make up the instrument, the results showed that variables 1 and 8 presented a lesser degree of importance and by the analysis of Accuracy, Recall, Precision and area under the ROC curve, there was no variation when the results were analyzed with all IPAQ variables but variables 1 and 8. Through this analysis, we concluded that the IPAQ, short version, has adequate measurement properties for the investigated population.

The Most Common Group Work Techniques Used Among the Jordanian EFL Teachers when Teaching English as a Foreign Language

The present study aims at investigating the Jordanian EFL teachers' attitudes toward the most common group work activities used among them to develop their students' linguistic competence. Moreover, it tries to shed the light on the teachers' common techniques in planning for the group work in their classrooms. Besides, it aims at finding if the teachers' attitudes toward using the group work as a technique vary according to gender. To conduct the study, a questionnaire was prepared in advance to measure the teachers' attitudes and the most working techniques that help in developing the students' language. It was distributed among 40 Jordanian EFL secondary teachers at Ajloun and Irbid directorates of education in Jordan. To analyze the participants' responses in the questionnaire, different statistical analyses were used such as Means and Standard Deviations and Cronbach's Alpha. The results pointed out that the Jordanian EFL secondary school teachers had a positive attitude towards using the group work to develop their students' English language, as it helps them in developing their students' linguistic competence. Moreover, the results pointed out that the overall degree of the group work activities that are used the most by the Jordanian EFL teachers is medium. Furthermore, the analysis showed that there are not any statistical differences in the teachers' attitudes towards using group work that could be attributed to gender.

Rating of road infrastructure and public transport in Radom according to respondents' sex and age

The article presents the results of surveys on public transport and road infrastructure of Radom. There were 855 questionnaires obtained. The 19 questions of the survey were used. The survey, in addition to questions about age and gender, contained questions with specific answer options with single or multiple choice and questions in which the respondent rated the various elements of the transport system. From 8 questions, a 5-point Liekert scale was created as a basis for evaluating public transportation and road infrastructure. The reliability of the scale was assessed using the standardized Cronbach's coefficient. The analysis was done in selected groups of respondents with respect to age of respondents, gender of respondents and with respect to both characteristics simultaneously. Using the chi-square test of independence, the dependence of the scores on the age and gender of the respondents was examined. To compare the significance of differences in ratings between the separate groups of respondents, the test of significance of averages was used. The results of the survey indicate that although the overall rating is positive, due to the high percentage of negative ratings, it is necessary to take measures to improve, among other things: safety at bus stops and public transportation vehicles, availability and distribution of parking spaces. The results of the survey were compared with the results of previous surveys. Compared to the 2014 survey, a significant improvement was found in the condition of road infrastructure and the condition and distribution of bike lanes.

Metrics of Phenotypic Aging From the Energetics Perspective

Identifying the most critical metrics of aging is an ongoing challenge due to a lack of comprehensive measurements and heterogeneity of the aging process. Using the Baltimore Longitudinal Study of Aging, we developed a conceptual framework to identify metrics of aging that capture the hierarchical and temporal relationships between functional aging, phenotypic aging, and biological aging based on four hypothesized domains: energy regulation, body composition, homeostatic mechanisms, and neurodegeneration. Focusing on the energetics domain, we examined trajectories of eight phenotypes using more than 10 years of longitudinal data. The standardized Cronbach’s alpha for these variables was 0.80, providing construct validity of our concept. We further implemented item response theory to integrate these phenotypes into a summarized energy score. Linear mixed models were used to assess the cross-sectional and longitudinal associations between the summarized energy score and physical functioning as measured by gait speed and time to walk 400m as quickly as possible (number of participants ~ 811, number of observations ~ 1700). After adjusting for age, sex, weight, and height, a higher summarized energy score was independently associated with faster baseline gait speed (0.13 m/s, p<0.001 ) and faster 400m time (-35.3 seconds, p<0.001), and longitudinally associated with slower gait speed decline (0.08 m/s/decade, p<0.001) and slower 400m time increase (-37.8 secs/decade, p<0.001). This work demonstrates the utility of our energetics domain-based summarized score. Moving forward, it will be important to clarify relationships between this summarized score and other functional metrics and assess its generalizability to the other cohorts.

Performance of a short, self-report adherence scale in a probability sample of persons using HIV antiretroviral therapy in the United States.

Excellent adherence to HIV antiretroviral therapy (ART) remains a cornerstone of HIV care. A three-item adherence self-report scale was recently developed and validated, but the scale has not been previously tested in a nationally representative sample. We administered the adherence scale to participants in the Centers for Disease Control and Prevention's Medical Monitoring Project, which is a probability sample of US adults with diagnosed HIV. We combined sociodemographic and clinical participant data from three consecutive cycles of the Medical Monitoring Project (6/2015-5/2018). We used medical record reviews to determine most recent viral load, and whether viral loads were suppressed at all measurement points in the past 12 months. We describe the relationship between adherence scale score and two measures of viral load suppression (most recent and sustained), and estimate linear regression models using sampling weights to determine independent predictors of ART adherence scores. Of those using ART, the median adherence score was 93 (100 = perfect adherence), and the standardized Cronbach's alpha was 0.83. For both measures of viral load suppression, the relationship with the adherence score was generally linear; there was no 'cutoff' point indicating good vs. poor adherence. In the multivariable model, younger age, nonwhite race, poverty, homelessness, depression, binge-drinking, and both non-IDU and IDU were independently associated with lower adherence. The adherence measure had good psychometric qualities and a linear relationship with viral load, supporting its use in both clinical care and research. Adherence interventions should focus on persons with the highest risk of poor adherence.

Validation of the care providers version of the Rainbow Model of Integrated Care-measurement tool in Chinese primary care systems

BackgroundThe original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the RMIC-MT and evaluate its psychometric properties by a pilot study in Chinese primary care systems.MethodsThe translation and adaptation process were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 1610 community care professionals in all 79 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method and promax rotation was used to assess the construct validity. Cronbach’s alpha was utilized to ascertain the internal consistency reliability. Lastly, confirmation factor analysis was used to evaluate the exploratory factor analysis model fit.ResultsDuring the translation and adaptation process, all 48 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Six factors (person- & community-centeredness, care integration, professional integration, organizational integration, cultural competence and technical competence) with 45 items were determined by exploratory factor analysis, accounting for 61.46% of the total variance. A standard Cronbach’s alpha of 0.940 and significant correlation among all items in the scale (> 0.4) showed good internal consistency reliability of the tool. And, the model passed the majority of goodness-to-fit test by confirmation factor analysis.ConclusionsThe results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT provider version. Its application in China will promote the development of people-centered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes.

Adaptation and Validation of the Diabetic Foot Ulcer Scale-Short Form in Spanish Subjects.

Diabetic foot ulcer (DFU) is a chronic complication that negatively affects the quality of life (QoL) of diabetic patients. In Spain, there is no specifically designed and validated instrument to assess the QoL of patients with DFU. Our aim was to adapt the Diabetic Foot Ulcer Scale-Short Form (DFS-SF) questionnaire to a Spanish population and validate it. A prospective, observational design was used. The DFS-SF was administered by personal interview. The validated SF-36 and EQ-5D generic instruments were used as reference tools. The reliability, validity, and sensitivity to changes were assessed using standard statistical methods. A sample of 141 patients with DFU was recruited. The content validity was 3.46 on average (maximum score of 4). The internal consistency of the DFS-SF subscales showed a standardized Cronbach’s α range between 0.720 and 0.948. The DFS-SF domains showed excellent reproducibility measures (intraclass correlation coefficient from 0.77–0.92). The criterion validity was good with significant correlations between each DFS-SF subscale and its corresponding SF-36 and EQ-5D subscales (p < 0.001). However, the questionnaire structure was not validated (comparative fit index = 0.844, root mean square error of approximation = 0.095, and standardized root mean square residual = 0.093). The instrument showed high sensitivity to ulcer changes over time (p < 0.001). The adapted and validated Spanish version of the DFS-SF questionnaire has good psychometric properties and shows good sensitivity to ulcer changes, although the construct validity was not optimal. The adapted questionnaire will be a useful tool specifically to assess the QoL in subjects with diabetic foot ulcers in the clinical and research settings in Spain.

Validated Instruments of Quality of Life (QOL) in Patients With Acute Myeloid Leukemia (AML) and Other Cancers.

IntroductionAcute myeloid leukemia (AML) can negatively impact quality of life (QOL). Few QOL instruments are specific to and have been validated in AML. This review aims to identify QOL instruments that have been validated in patients with AML and other cancers and summarize their psychometric properties reported in published literature. A literature review search was performed using PubMed and OVID (Biosis, Embase, MEDLINE) databases through June 25, 2020. Search terms included: QOL, health-related QOL, patient-reported outcomes and validity, reliability, validated, tools, instruments, test-retest, and leukemia myeloid acute, leukemia, myeloid, acute, acute myeloid leukemia. Articles were included if they focused on cancer and reported psychometric properties that could be extracted. s and their references were reviewed for inclusion.ResultsTwelve evaluating ten instruments were included. Functional Assessment of Cancer Therapy Leukemia (FACT-Leu) showed internal consistency (IC) of α = 0.86 to >0.9, correlation with EQ-5D-3L of r > 0.50, correlation with European Organisation for Research and Treatment of Cancer (EORTC) QLQ-Leu of ρ = 0.29–0.63, test-retest reliability of κ = 0.861. FACT-F showed correlations with EORTC QLQ-C30 of r = 0.40–0.83. Hematological Malignancy Patient-Reported Outcome (HM-PRO) showed intraclass correlation coefficient (ICC) of 0.94–0.98. EORTC-8D and EQ-5D-3L showed ICC = 0.595, correlations with each other of ρ = 0.137–0.634 and with EORTC QLQ-C30 of r = 0.651–0.917. EORTC QLQ-C30 showed person separation reliability of 0.47 to 0.90 and patient-observer agreement of 0.85. Life Ingredient Profile (LIP) showed IC of α = 0.29–0.77 and test-retest reliability of κ = 0.42–1.0. QOL-E showed correlation with FACT-general of R = 0.71, internal validity of α = 0.7, and test-retest reliability of standardized Cronbach’s α = 0.7–0.92. EORTC QLQ-Leu showed IC of α = 0.6–0.79. The Acute Myeloid Leukemia–Quality of Life (AML-QOL) instrument showed IC of α = 0.72, correlations with EORTC QLQ-30 of magnitudes ρ = 0.59–0.72, and test-retest reliability of ICC = 0.52–0.91.ConclusionAlthough several QOL instruments have been validated, more research is needed to determine the most clinically useful instruments in patients with AML.