Quality of Life Differences In an African American and Caucasian Sample of Chronic Illness Patients: Assessment of Differential Item Functioning

Scott M. Debb; David L. Blitz; Seunh W. Choi

Scott M. Debb
David L. Blitz
Seunh W. Choi

Abstract

The value of a health care intervention is judged by its impact on the quantity and quality of life (QOL) of an individual (Cella & Bonomi, 1996). When analyzing QOL data, results from the general population are often as- sumed to be equally representative of various subpopulations; however, establishing measurement invariance across different populations (e.g., racial and ethnic groups) is crucial for score interpretability. In this study, ordinal logistic regression (following Zumbo, 1999) was used to examine differential item functioning (DIF) in an African American and Caucasian sample of 898 cancer and chronic illness patients that had been administered a QOL questionnaire for use with chronic illness sufferers. Results indicated that significant differences in response patterns were present between the two groups. This has which have clinical implications pertaining to psychological assessment, conceptualization and intervention.

References

Agresti, A. (1990). Categorical data analysis. New York: Wiley.

Ashing-Giwa, K., Padilla, G., Tejero, J., Kraemer, J., Wright, K., Coscarelli, A., et al. (2004). Understand- ing the breast cancer experience of women: A qualitative study of African American, Asian American, Latina, and Caucasian cancer survivors. Psycho-Oncology, 13, 408-428.

Barofsky, I., & Sugarbarker, P.H. (Eds.). (1990). Quality of Life Assessments in Clinical Trials. New York: Raven.

Bloor, L.E., Sandler, R.S., Martin, C., Uchino, B.N., & Kinney, A.Y. (2006). Associations between emotional support and health-related quality of life among a population-based sample of blacks and Caucasians. Journal of Social and Clinical Psychology, 25, 96-116.

Bynum, M.S., Burton, E., & Best, C. (2007). Racism experiences and psychological functioning in African American college freshmen: Is racial socialization a buffer? Cultural Diversity & Ethnic Minority Psychology, 13, 64-71.

Cella, D., & Bonomi, A. (1996). The Functional Assessment of Cancer Therapy (FACT) and Functional Assessment of HIV Infection (FAHI) quality of life measurement system. In B. Spilker (Ed.). Quality of Life and Pharmaco economics in Clinical Trials. Philadelphia: Lippincott-Raven.

Cella, D.F., Lloyd, S.R., & Wright, B. (1996). Cross-Cultural Instrument Equating: Current Research and Future Directions. Quality of Life and Pharmacoeconomics in Clinical Trials, 73, 707-715.

Cella, D.F., McCain, N.L., Peterman, A.H., Mo, F., & Wolen, D. (1998). Development and validation of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Quality of Life Research, 5, 450-463.

Cella, D.F., Tulsky, D.S., Gray, G., Sarafian, B., Linn, E., Bonomi, A., et al. (1993). The Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570-579.

Center On Outcomes, Research and Education (CORE). (1997). Manual of the Functional Assessment Of Chronic Illness Therapy (FACIT) Measurement System (Version 4). Evanston, IL: David Cella.

Chang, H.H., Mazzeo, J., Roussos, L. (1995). Detecting DIF for polytomously scored items: An adaptation of the SIBTEST procedure. Journal of Educational Measurement, 33(3), 333-353.

Dana, R.H. (1993). Multicultural Assessment Perspectives for Professional Psychology. Needham Heights, MA: Simon & Shuster.

Day, S.X. (2004). Theory and Design in Counseling and Psycho- therapy. Boston: Houghton Miffllin.

Delfino, R.J., Ferrini, R.L., Taylor, T.H., Howe, S., & Anton-Culver, M. (1998). Demographic differences in prostate cancer incidence and stage: An examination of population diversity in California. American Journal of Preventive Medicine, 14, 96-102.

Eton, D., Lepore, S., & Helgeson, V. (2001). Early quality of life in patients with localized prostate carcinoma. Cancer, 92, 1451-1459.

Fave, A.D. (2006). The impact of subjective experience on the quality of life: A central issue for health professionals. In M. Csikszentmihalyi & I.S. Csikszent mihalyi (Eds.). A life worth living: Contributions to positive psychology. New York: Oxford University Press.

Fayers, P.M., & Hays, R.D. (2005). Assessing quality of life in clinical trials: Methods and Practice. Oxford: Oxford University Press.

French, A.W., & Miller, T.R. (1996). Logistic regression and its use in detecting differential item functioning in polytomous items. Journal of Educational Measurement, 33, 315-332.

Gallagher, R.M. (2001). Clinical pain research: Challenges across cancer, cultures, and disciplines. Pain Medicine, 2, 1-2.

Gonzales,V.A., Martelli,M.F., & Baker,J.M.(2000). Psychological assessment of persons with chronic pain. Neuro Rehabilitation, 14, 69-83.

Green, C.R., Anderson, K.O., Baker, T.A., Campbell, L.C., Decker, S., Fillingim, R.B., et al. (2003). The unequal burden of pain: Confronting racial and ethnic disparities in pain. Pain Medicine, 4, 277-294.

Hahn, E., & Cella, D. (2003). Health outcomes assessment in vulnerable populations: Measurement challenges and recommendations. Archive of Physical Medical Rehabilitation, 84, 35-41.

Hoffman, R.M., Gilliland, J., Elay, W., Stephenson, R.A., Stanford, J.L., et al. (2001). Racial and ethnic differences in advanced-stage prostate cancer: The Prostate Cancer Outcomes Study. Journal of the National Cancer Institute, 93, 388-395.

Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65-70.

Hoshmand, L.T. (2001). Psychotherapy as an Instrument of Culture. In B.D. Slife, R.N. Williams, & S.H. Bar- low (Eds.). Critical Issues in Psychotherapy- Translating New Ideas Into Practice (pp. 99-113). Thousand Oaks, CA: Sage.

Kim, S.H., Cohen, A.S., Alagoz, C., & Kim, S. (2007). DIF detection and effect size measures for polytomously scored items. Journal of Educational Measurement, 44, 93-116.

Krupski, T.L, Fink, A., Kwan, L., Maliski, S., Connor, S.E., Clerkin, B., et al. (2005). Health-related quality of life in low income uninsured men with prostate cancer. Journal of Health Care for the Poor and Underserved, 16, 375-390.

Lent, L., Hahn, E., Eremenco, S., Webster, K., & Cella, D. (1999). Using Cross-Cultural Input to Adapt the Functional Assessment of Chronic Illness Therapy (FACIT) Scales. Acta Oncologica, 38, 695-702.

Loge, C., Trudeau, E., Marquis, P., Kahrilas, P., Stanghellini, V., Talley, J., et al. (2004). Cross-cultural development and validation of a patient self-administered questionnaire to assess quality of life in upper gastrointestinal disorder: The PAGI-QOL. Quality of Life Research, 13, 1751-1762.

Lubeck, D.P., Kim, H., Grossfeld, G., Ray, P., Penson, D.F., Flanders, S.C., et al. (2001). Health related quality of life differences between Black and Caucasian men with prostate cancer: Data from the cancer of the prostate strategic urological research endeavor. The Journal of Urology, 166, 2281-2285.

Maliski, S.L., Kwan, L., Orecklin, J.R., Saigal, C.S., & Litwin, M.S. (2005). Predictors of fatigue after treatment for prostate cancer. Urology, 65, 101-108.

Mantel, N. (1963). Chi-square tests with one degree of freedom: Extensions of the Mantel-Haenszel procedure. Journal of the American Statistical Association,58, 690-700.

Mantel, N., & Haenszel, W. (1959). Statistical aspects of the analysis of data from retrospective studies of disease. Journal of the National Cancer Institute, 22, 719-748.

McFadden, D. (1974). Conditional logit analysis of qualitative choice behavior. In P. Zarembka (Ed.). Frontiers in Econometrics (pp.105-142). New York: Academic Press.

Mettlin, C.J., Murphy, G.P., Cunningham, M.P., & Menck, H.R. (1997).The National Cancer Data Base report on race, age, and region variations in prostate cancer treatment. Cancer, 80, 1261-1266.

Meyers, E. (2007). Why hasn’t psychology studied that? Monitor on Psychology, 38, 36.

Miller, T.A., & Spray, J.A. (1993). Logistic discriminant function analysis for DIF identification of polytomously scored items. Journal of Educational Measurement, 30, 107-122.

Park, C.L. & Adler, N.E. (2003). Coping style as a predictor of health and well-being across the first year of medical school. Health Psychology, 22, 627-631.

Penedo, F.J., Dahn, J.R., Shen, B., Schneiderman, N., & Antoni, M.H. (2006). Ethnicity and determinants of quality of life after prostate cancer treatment. Urology, 67, 1022-1027.

Roberts, C.M. (2001). Meeting the Needs of Patients With Limited English Proficiency. The Journal of Medical Practice Management, 17, 1-5.

Sattler, J.M. (2001). Assessment Of Children: Cognitive Applications (4 ed.). San Diego: Jerome M. Sattler Publisher.

Schwartz, D. (2007). Is inequality making us sick? Monitor on Psychology, 38, 36.

Shealy, R., & Stout, W. (1993). A model-based standardization approach that separates true bias/ DIF from group ability differences and detects test bias/ DTF as well as item-bias/ DIF. Psychometrika, 58, 159-194.

Shinagawa, S.M. (2000). The excess burden of breast carcinoma in minority and medically underserved communities: Application, research, and redressing institutional racism. Cancer 88, 1217-1223.

Shtatland, E.S., Moore, S., & Barton, M.B. (2000, April). Why we need an R2 measure of fit (and not only one) in PROC LOGISTIC and PROC GENMOD. Proceedings of the 25th annual SAS® users group international conference, Indianapolis, IN, USA, Paper 256-25.

Skeel, R.T. (1989). Quality of life assessment in cancer clinical trials- It’s time to catch up. Journal of the National Cancer Institute, 81, 472-473.

Swaminathan, H., & Rogers, H.J. (1990). Detecting differential item functioning using logistic regression procedures. Journal of Educational Measurement, 27, 361-370.

Tchen, N., Bedard, P., Yi,Q-L., Klein,M., Cella, D., Eremenco, S., & Tannock, I.F. (2003). Quality of life and understanding of disease status among cancer patients of different ethnic origin. British Journal of Cancer, 89, 641-647.

The Health Institute, New England Medical Center. (1993). SF-36 Health Survey: Manual & Interpretation Guide. Boston: John Ware.

Thompson, I., Tangen, C.M., Tolcher, A., Crawford, E.D., Eisenberger, M., & Moinpour, C.M. (2001). Association of African American ethnic background with survival in men with metastatic prostate cancer. Journal of the National Cancer Institute, 93, 219-225.

Turk, D.C., & Okifuji, A. (2002). Psychological factors in chronic pain: Evolution and revolution. Journal of Consulting and Clinical Psychology, 70, 678-690.

Utsey, S.O., Chae, M.H.,Brown,C.F., & Kelly,D. (2002). Effect of ethnic group membership on ethnic identity, race-related stress, and quality of life. Cultural Diversity & Ethnic Minority Psychology 8, 366-377.

Vazquez, E. (2007, September/ October). Complications and Emerging Infections: Monitoring is important. Positively Aware.

Whaley, A.L., & Davis, K.E. (2007). Cultural Competence and Evidence-Based Practice in Mental Health Ser- vices: A Complementary Perspective. American Psychologist, 62, 563-574.

Wool, M.S., & Mor, V. (2005). A multidimensional model for understanding cancer pain. Cancer Investigation, 23, 727-734.

Zickler, P. (2009). When the body suffers, the mind suffers. Monitor on Psychology, 40, 31-34.

Zumbo, B.D. (1999). A handbook on the theory and methods of differential item functioning (DIF): Logistic regression modeling as a unitary framework for binary and Likert-type (ordinal) item scores. Ottawa, ON: Directorate of Human Resources Research and Evaluation, Department of National Defense.