Background
Measurement invariance
Systematic review
Research questions
Methods
Search terms | “Measurement invariance”, “factorial invariance”, “measurement equivalence”, “differential item functioning”, “item bias” |
Filter terms | Chronic*, diagn*, patient*, rehab*, cancer, arthrit*, inflam*, diab*, rheum*, orthop*, respir*, asthm*, copd, health, quality of life, self management, self-management, empowerment, diseas*, depress*, anxiety, trauma, injury |
Inclusion criteria | (a) empirical study of MI among different chronic conditions |
(b) generic questionnaire | |
(c) adults | |
(d) English or German language | |
Exclusion criteria | (a) only MI between factor correlations were studied, although scales were not combined to a total score; |
(b) instruments measure disease-related constructs such as disease-specific quality of life; | |
(c) only specific subgroups of a chronic conditions were studied (e.g., patients with right- vs. left-hemispheric lesions). |
Results
Study selection
Constructs and instruments
Number of patients and disease groups
Statistical methods
Number of invariant items, magnitude, impact and recommendations
Explanations for DIF
Summary
Empirical investigation of MI in the heiQ™
Research question
Methods
Sample
The Health Education Impact Questionnaire (heiQ™)
Data analysis
Results
Sample
Number, kind and magnitude of non-invariant parameters
Gender
Disease groups
Scale | Model | Chi2(df) | p | CFI | RMSEA |
---|---|---|---|---|---|
Positive and active engagement in life
| SI | 212.21 (99) | <0.001 | 0.868 | 0.079 |
PI | 121.99 (68) | <0.001 | 0.947 | 0.053 | |
Health directed activites
| SI | 85.72 (49) | <0.001 | 0.975 | 0.052 |
PI | 69.16 (47) | 0.019 | 0.985 | 0.041 | |
Skill and technique acquisition
| SI | 62.966 (50) | 0.103 | 0.986 | 0.030 |
PI | 45.08 (47) | 0.552 | 1.000 | 0.000 | |
Constructive attitudes and approaches
| SI | 164.04 (88) | <0.001 | 0.940 | 0.063 |
PI | 142.26 (72) | <0.001 | 0.952 | 0.059 | |
Self-monitoring and insight
| SI | 434.91 (108) | <0.001 | 0.696 | 0.104 |
PI | 141.97 (92) | <0.001 | 0.953 | 0.044 | |
Health service Navigation
| SI | 259.45 (76) | <0.001 | 0.870 | 0.095 |
PI | 160.20 (72) | <0.001 | 0.941 | 0.066 | |
Social integration and support
| SI | 155.52 (76) | <0.001 | 0.960 | 0.061 |
PI | -- | -- | -- | -- | |
Emotional distress
| SI | 255.75 (108) | <0.001 | 0.944 | 0.070 |
PI | 208.14 (105) | <0.001 | 0.961 | 0.051 |
Scale | Configural MI | Metric MI | Scalar MI | Strict MI | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Diag | Item | EPC | Diag | Item | EPC | Diag | Item | EPC | ||
Positive and active engagement in life
| ✓ | ✓ | ortho | 2 | -0.24 | copd | 2 | 0.13 | ||
ortho | 5 | -0.18 | ||||||||
asthma | 2 | -0.17 | ||||||||
asthma | 10 | 0.12 | ||||||||
Health-directed activities
| ✓ | ✓ | copd | 19 | 0.24 | (✓) | ||||
Skill and technique acquisition
| ✓ | ✓ | copd | 23a | -0.17 | ortho | 30 | 0.19 | ||
asthma | 23a | -0.09 | ||||||||
Constructive attitudes and approaches
| ✓ | copd | 36 | 0.16 | rheuma | 36 | 0.13 | (✓) | ||
Self-monitoring and insight
| ✓ | ortho | 11a | -0.14 | ortho | 3 | -0.10 | orthob | 11 | -0.13 |
ortho | 17 | -0.13 | ||||||||
asthma | 3a | -0.22 | ||||||||
asthma | 17a | -0.20 | ||||||||
copd | 3a | -0.31 | ||||||||
cancer | 11a | -0.15 | copd | 6 | 0.34 | |||||
copd | 17a | -0.21 | ||||||||
cancer | 6 | -0.28 | ||||||||
Health-service navigation
| ✓ | ✓ | ortho | 33a | -0.21 | (✓) | ||||
rheuma | 33a | -0.29 | ||||||||
Social integration and support
| ✓ | ✓ | ✓ | ✓ | ||||||
Emotional distress
| ✓ | ✓ | cancer | 12 | -0.19 | ortho | 7 | -0.16 |
Impact on latent mean differences
Gender
Disease groups
Disease group | Ortho | Rheu | Asthma | COPD | Cancer | ||
---|---|---|---|---|---|---|---|
Positive and active engagement in life
| |||||||
Ortho
| 0.32a | 0.27a | 0.31a | 0.24a |
ES
PI-ALL
| ||
0.09 | 0.17 | 0.06 | 0.03 |
ES
PI-RED
| |||
Rheu
|
PI
Diff
| 0.59 | 0.08 | 0.02 | 0.10 |
ES
PI-ALL
| |
ES
SI-PI
| 0.27a | 0.14 | 0.05 |
b
|
ES
PI-RED
| ||
Asthma
|
PI
Diff
| 0.20 | -0.43 | 0.06 | 0.02 |
ES
PI-ALL
| |
ES
SI-PI
| 0.28a | -0.02 | 0.09 | 0.04 |
ES
PI-RED
| ||
COPD
|
PI
Diff
| 0.47 | -0.13 | 0.27 | 0.08 |
ES
PI-ALL
| |
ES
SI-PI
| 0.27a | -0.13 | 0.01 | 0.12 |
ES
PI-RED
| ||
Cancer
|
PI
Diff
| -0.03 | -0.64 | -0.24 | -0.52 | ||
ES
SI-PI
| 0.28a | > - 0.01 | 0.01 | > - 0.01 | |||
Self-monitoring and insight
| |||||||
Ortho
| 0.11 | 0.22a | 0.12 | 0.10 |
ES
PI-ALL
| ||
0.02 | 0.06 | 0.02 | 0.04 |
ES
PI-RED
| |||
Rheu
|
PI
Diff
| 0.24 | 0.32a | 0.22a | 0.21a |
ES
PI-ALL
| |
ES
SI-PI
| 0.08 | 0.13 | 0.08 | 0.10 |
ES
PI-RED
| ||
Asthma
|
PI
Diff
| -0.34 | -0.56 | 0.09 | 0.13 |
ES
PI-ALL
| |
ES
SI-PI
| -0.05 | -0.13 | 0.03 | 0.02 |
ES
PI-RED
| ||
COPD
|
PI
Diff
| -0.16 | -0.38 | 0.16 | 0.03 |
ES
PI-ALL
| |
ES
SI-PI
| -0.03 | -0.10 | 0.03 | 0.02 |
ES
PI-RED
| ||
Cancer
|
PI
Diff
| -0.31 | -0.55 | 0.04 | -0.15 | ||
ES
SI-PI
| <0.01 | -0.08 | 0.06 | 0.02 |