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Advancing health disparities research: can we afford to ignore measurement issues?
Med Care. 2003 Nov; 41(11):1207-20.MC

Abstract

BACKGROUND

Research on racial and ethnic health disparities in the United States requires that self-report measures, developed primarily in mainstream samples, are appropriate when applied in diverse groups. To compare groups, mean scores must reflect true scores and have minimal bias, assumptions that have not been tested for many self-report measures used in this research.

OBJECTIVE

To identify conceptual and psychometric issues that need to be addressed to assure the quality of self-report measures being used in health disparities research.

METHODS

We present 2 broad conceptual frameworks for health disparities research and describe the main research questions and measurement issues for 4 key concepts hypothesized as potential mechanisms of health disparities: socioeconomic status, discrimination, acculturation, and quality of care. This article is based on a small conference convened by 6 Resource Centers for Minority Aging Research (RCMAR) measurement cores. We integrate written materials prepared for the conference by quantitative and qualitative measurement specialists and cross-cultural researchers, conference discussions, and current literature.

RESULTS

Problems in the quality of the conceptualizations and measures were found for all 4 concepts, and little is known about the extent to which measures of these concepts can be interpreted similarly across diverse groups. Many problems also apply to other concepts relevant to health disparities. We propose an agenda for accomplishing this challenging measurement research.

CONCLUSIONS

The current national commitment to reduce health disparities may be compromised without more research on measurement quality. Integrated, systematic efforts are needed to move this work forward, including collaborative efforts and special initiatives.

Authors+Show Affiliations

Center for Aging in Diverse Communities and Medical Effectiveness Research Center, University of California San Francisco, San Francisco, California 94143, USA. anitast@itsa.ucsf.eduNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14583684

Citation

Stewart, Anita L., and Anna M. Nápoles-Springer. "Advancing Health Disparities Research: Can We Afford to Ignore Measurement Issues?" Medical Care, vol. 41, no. 11, 2003, pp. 1207-20.
Stewart AL, Nápoles-Springer AM. Advancing health disparities research: can we afford to ignore measurement issues? Med Care. 2003;41(11):1207-20.
Stewart, A. L., & Nápoles-Springer, A. M. (2003). Advancing health disparities research: can we afford to ignore measurement issues? Medical Care, 41(11), 1207-20.
Stewart AL, Nápoles-Springer AM. Advancing Health Disparities Research: Can We Afford to Ignore Measurement Issues. Med Care. 2003;41(11):1207-20. PubMed PMID: 14583684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advancing health disparities research: can we afford to ignore measurement issues? AU - Stewart,Anita L, AU - Nápoles-Springer,Anna M, PY - 2003/10/30/pubmed PY - 2003/12/3/medline PY - 2003/10/30/entrez SP - 1207 EP - 20 JF - Medical care JO - Med Care VL - 41 IS - 11 N2 - BACKGROUND: Research on racial and ethnic health disparities in the United States requires that self-report measures, developed primarily in mainstream samples, are appropriate when applied in diverse groups. To compare groups, mean scores must reflect true scores and have minimal bias, assumptions that have not been tested for many self-report measures used in this research. OBJECTIVE: To identify conceptual and psychometric issues that need to be addressed to assure the quality of self-report measures being used in health disparities research. METHODS: We present 2 broad conceptual frameworks for health disparities research and describe the main research questions and measurement issues for 4 key concepts hypothesized as potential mechanisms of health disparities: socioeconomic status, discrimination, acculturation, and quality of care. This article is based on a small conference convened by 6 Resource Centers for Minority Aging Research (RCMAR) measurement cores. We integrate written materials prepared for the conference by quantitative and qualitative measurement specialists and cross-cultural researchers, conference discussions, and current literature. RESULTS: Problems in the quality of the conceptualizations and measures were found for all 4 concepts, and little is known about the extent to which measures of these concepts can be interpreted similarly across diverse groups. Many problems also apply to other concepts relevant to health disparities. We propose an agenda for accomplishing this challenging measurement research. CONCLUSIONS: The current national commitment to reduce health disparities may be compromised without more research on measurement quality. Integrated, systematic efforts are needed to move this work forward, including collaborative efforts and special initiatives. SN - 0025-7079 UR - https://www.unboundmedicine.com/medline/citation/14583684/Advancing_health_disparities_research:_can_we_afford_to_ignore_measurement_issues L2 - https://doi.org/10.1097/01.MLR.0000093420.27745.48 DB - PRIME DP - Unbound Medicine ER -