American Journal of Public Health Research
ISSN (Print): 2327-669X ISSN (Online): 2327-6703 Website: http://www.sciepub.com/journal/ajphr Editor-in-chief: Apply for this position
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American Journal of Public Health Research. 2020, 8(6), 184-189
DOI: 10.12691/ajphr-8-6-1
Open AccessArticle

An IRT-constructed Brief Physical Functioning Scale and Its Association with Health Status

Peter D. Hart1,

1Health Promotion Research, Havre, MT 59501

Pub. Date: September 25, 2020

Cite this paper:
Peter D. Hart. An IRT-constructed Brief Physical Functioning Scale and Its Association with Health Status. American Journal of Public Health Research. 2020; 8(6):184-189. doi: 10.12691/ajphr-8-6-1

Abstract

Background: This study used item response theory (IRT) to create a brief PF scale (BPFS) and subsequently examined its relationship with several health characteristics. Methods: Data were used from N=1,716 adults 50+ years of age participating in a large health survey. A pool of 19 PF items were dichotomized to either 1 (any amount of difficulty) or 0 (no difficulty). A 2-parameter logistic (2PL) IRT model was used to evaluate item fit to the unidimensional PF construct. Criteria used to eliminate an item was 1) a small discrimination (slope) parameter, 2) a significant chi-square statistic for cell residuals, and 3) a large root mean square error of approximation (RMSEA). The IRT model was continually re-fitted until all remaining items met criteria. SAS PROC IRT and R ltm were used for scale construction. Results: The IRT analysis resulted in 8 well-fitting items with large item discrimination (as > 2.03), moderate item difficulty range (bs: -0.07 - 1.35), and adequate item fit (RMSEAs < .036). After full adjustment, each additional BPFS point significantly (ps < .05) increased stepwise the odds of reporting poor HRQOL (OR = 1.59), being depressed (OR = 1.46), having thoughts of suicide (OR = 1.35), not meeting PA guidelines (OR = 1.29), being BMI-obese (OR = 1.23), being WC-obese (OR = 1.13), experiencing poor sleep (OR = 1.29), and reporting sleepiness (OR = 1.16). Conclusion: Results from this study show that the IRT-constructed BPFS is an efficient and valid tool that can predict health status in older adults.

Keywords:
physical functioning Item response theory (IRT) psychometrics aging and health

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References:

[1]  Garber CE, Greaney ML, Riebe D, Nigg CR, Burbank PA, Clark PG. Physical and mental health-related correlates of physical function in community dwelling older adults: a cross sectional study. BMC geriatrics. 2010 Dec 1; 10(1): 6.
 
[2]  Moreira MN, Bilton TL, Dias RC, Ferriolli E, Perracini MR. What are the main physical functioning factors associated with falls among older people with different perceived fall risk?. Physiotherapy research international. 2017 Jul; 22(3): e1664.
 
[3]  Alghwiri AA. The correlation between depression, balance, and physical functioning post stroke. Journal of stroke and cerebrovascular diseases. 2016 Feb 1; 25(2): 475-9.
 
[4]  Andrasfay T. Changes in physical functioning as short-term predictors of mortality. The Journals of Gerontology: Series B. 2020 Feb 14; 75(3): 630-9.
 
[5]  Cooper R, Kuh D, Cooper C, Gale CR, Lawlor DA, Matthews F, Hardy R, FALCon and HALCyon Study Teams. Objective measures of physical capability and subsequent health: a systematic review. Age and ageing. 2011 Jan 1; 40(1): 14-23.
 
[6]  Chiarotto A, Ostelo RW, Boers M, Terwee CB. A systematic review highlights the need to investigate the content validity of patient-reported outcome measures for physical functioning in patients with low back pain. Journal of Clinical Epidemiology. 2018 Mar 1; 95: 73-93.
 
[7]  Myagmarjav S, Burnette D, Goeddeke Jr F. Comparison of the 18-item and 6-item Lubben Social Network Scales with community-dwelling older adults in Mongolia. PloS one. 2019 Apr 18; 14(4): e0215523.
 
[8]  DeVellis RF. Classical test theory. Medical care. 2006 Nov 1: S50-9.
 
[9]  van der Linden WJ, Hambleton RK, editors. Handbook of modern item response theory. Springer Science & Business Media; 2013 Mar 9.
 
[10]  Krok-Schoen JL, Price AA, Luo M, Kelly OJ, Taylor CA. Low dietary protein intakes and associated dietary patterns and functional limitations in an aging population: A NHANES analysis. The journal of nutrition, health & aging. 2019 Apr 1; 23(4): 338-47.
 
[11]  Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey: Plan and Operations, 1999-2010: Atlanta (GA): Centers for Disease Control and Prevention; 2013 [August 10, 2020] Available from: https://wwwn.cdc.gov/nchs/nhanes/analyticguidelines.aspx#plan- and-operations.
 
[12]  Centers for Disease Control and Prevention National Center for Health Statistics. NHANES 2005-2006 Anthropometry and Physical Activity Monitor Procedures Manual; 2005.
 
[13]  De Ayala RJ. The theory and practice of item response theory. Guilford Publications; 2013 Oct 15.
 
[14]  Tabachnick, B.G., Fidell, L.S. and Ullman, J.B., 2007. Using multivariate statistics. (Vol. 5, pp. 481-498). Boston, MA: Pearson.
 
[15]  Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate data analysis. Upper Saddle River, NJ: Prentice hall; 2012 Mar 23.
 
[16]  Stokes ME, Davis CS, Koch GG. Categorical data analysis using SAS. SAS institute; 2012 Jul 31.
 
[17]  Lewis, T.H., 2016. Complex survey data analysis with SAS. CRC Press.
 
[18]  Rizopoulos D. ltm: An R package for latent variable modeling and item response theory analyses. Journal of statistical software. 2006 Nov 17; 17(5): 1-25.
 
[19]  An X, Yung YF. Item response theory: What it is and how you can use the IRT procedure to apply it. SAS Institute Inc. SAS364-2014. 2014; 10(4).
 
[20]  Monforte-Royo C, González-de Paz L, Tomás-Sábado J, Rosenfeld B, Strupp J, Voltz R, Balaguer A. Development of a short form of the Spanish schedule of attitudes toward hastened death in a palliative care population. Quality of Life Research. 2017 Jan 1; 26(1): 235-9.
 
[21]  DeWitt EM, Stucky BD, Thissen D, Irwin DE, Langer M, Varni JW, Lai JS, Yeatts KB, DeWalt DA. Construction of the eight-item patient-reported outcomes measurement information system pediatric physical function scales: built using item response theory. Journal of clinical epidemiology. 2011 Jul 1; 64(7): 794-804.
 
[22]  Chiesi F, Morsanyi K, Donati MA, Primi C. Applying Item Response Theory to Develop a Shortened Version of the Need for Cognition Scale. Advances in Cognitive Psychology. 2018; 14(3): 75.
 
[23]  Keshavarzi S, Ahmadi SM, Lankarani KB. The impact of depression and malnutrition on health-related quality of life among the elderly Iranians. Global journal of health science. 2015 May; 7(3): 161.
 
[24]  Richter D, Eikelmann B, Berger K. Use of the SF-36 in the evaluation of a drug detoxification program. Quality of Life Research. 2004 Jun 1; 13(5): 907-14.
 
[25]  Pinto Pereira SM, De Stavola BL, Rogers NT, Hardy R, Cooper R, Power C. Adult obesity and mid-life physical functioning in two British birth cohorts: investigating the mediating role of physical inactivity. International journal of epidemiology. 2020 Jun 1; 49(3): 845-56.
 
[26]  Alami YZ, Ghanim BT, Sa’ed HZ. Epworth sleepiness scale in medical residents: quality of sleep and its relationship to quality of life. Journal of Occupational Medicine and Toxicology. 2018 Dec; 13(1): 21.
 
[27]  Bashkireva AS, Bogdanova DY, Bilyk AY, Shishko AV, Kachan EY, Arutyunov VA. Quality of life and physical activity among elderly and old people. Advances in Gerontology= Uspekhi Gerontologii. 2018 Jan 1; 31(5): 743-50.