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Mitchell SE, Kallen MA, Troost JP, De La Cruz BA, Bragg A, Martin-Howard J, Moldovan I, Miner JA, Jack BW, Carlozzi NE
Four New Patient-Reported Outcome Measures Examining Health-Seeking Behavior in Persons With Type 2 Diabetes Mellitus (REDD-CAT): Instrument Development Study
Development of four new patient-reported outcome measures examining health-seeking behavior in persons with type 2 diabetes mellitus
Suzanne E. Mitchell;
Michael A. Kallen;
Jonathan P. Troost;
Barbara A. De La Cruz;
Alexa Bragg;
Jessica Martin-Howard;
Ioana Moldovan;
Jennifer A. Miner;
Brian W. Jack;
Noelle E. Carlozzi
ABSTRACT
Background:
Health-seeking behavior is related to hospitalization and readmission risk for people living with type 2 diabetes mellitus (T2DM) and is an important social determinant of health. The purpose of this project was to develop new patient-reported outcome (PRO) measures that evaluate health-seeking behavior in persons with T2DM for use in the Re-Engineered Discharge for Diabetes-Computer Adaptive Test (REDD-CAT) measurement system.
Objective:
The purpose of this project was to develop new patient-reported outcome (PRO) measures that evaluate health-seeking behavior in persons with T2DM for use in the Re-Engineered Discharge for Diabetes-Computer Adaptive Test (REDD-CAT) measurement system.
Methods:
Two-hundred and twenty-five participants with T2DM completed 56 self-report items that examined health-seeking behaviors. Classical test theory and item response theory-based analyses were used to inform the development of new PROs.
Results:
Exploratory and confirmatory factor analyses supported four different unidimensional sets of items, each of which yielded a distinct PRO: 1) Health-Seeking Behavior: Primary Care Provider-Specific (six items); 2) Health-Seeking Behavior: General Beliefs (13 items); 3) Health-Seeking Behavior: Family/Friends-specific (five items); 4) Health-Seeking Behavior: Internet-specific (four items). The final item banks/measures did not have items exhibiting misfit to the constrained graded response model, nor did they exhibit differential item functioning for age, sex, education, or socioeconomic status factors. Health-Seeking Behavior: General Beliefs was developed to include both a computer adaptive test and a six-item short form version; all other PROs were developed as static short-forms. The psychometric reliability of these new PROs was supported; internal consistency ranged from acceptable to excellent, and measures were free of significant floor or ceiling effects.
Conclusions:
The new REDD-CAT Health-Seeking Behavior PROs provide reliable assessments of healthcare-seeking behaviors among those with T2DM. Clinical Trial: N/A
Citation
Please cite as:
Mitchell SE, Kallen MA, Troost JP, De La Cruz BA, Bragg A, Martin-Howard J, Moldovan I, Miner JA, Jack BW, Carlozzi NE
Four New Patient-Reported Outcome Measures Examining Health-Seeking Behavior in Persons With Type 2 Diabetes Mellitus (REDD-CAT): Instrument Development Study