The Brief Human Immunodeficiency Virus (HIV) Index: A Rapid 3-Item Scale to Measure Engagement in HIV Care.
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ABSTRACT:
SUBMITTER: Sauceda JA
PROVIDER: S-EPMC10425192 | biostudies-literature | 2023 Aug
REPOSITORIES: biostudies-literature
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The Brief Human Immunodeficiency Virus (HIV) Index: A Rapid 3-Item Scale to Measure Engagement in HIV Care.
Sauceda John A JA Lisha Nadra E NE Ludwig-Barron Natasha N Salazar Jorge J Dilworth Samantha E SE Johnson Mallory O MO Christopoulos Katerina A KA Koester Kimberly A KA Moore Richard D RD Mayer Kenneth H KH Fredericksen Rob J RJ Mugavero Michael J MJ Neilands Torsten B TB
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20230801 3
We created a brief version of The Index, a validated patient-reported measure that has potential to quickly identify patients at risk for poor retention. We analyzed Index scores from 2406 patients from 2016 to 2017 in a national cohort of patients in human immunodeficiency virus (HIV) care. Index scores predicted poor retention 12 months after administered. ...[more]
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Project description:BackgroundWe investigated the prospective association between a brief self-report measure of engagement in human immunodeficiency virus (HIV) care (the Index of Engagement in HIV Care; hereafter "Index") and suboptimal retention and viral suppression outcomes.MethodsThe Centers for AIDS Research Network of Integrated Clinical Systems cohort study combines medical record data with patient-reported outcomes from 8 HIV clinics in the United States, which from April 2016 to March 2017 included the 10-item Index. Multivariable logistic regression was used to estimate the risk and odds ratios of mean Index scores on 2 outcomes in the subsequent year: (1) not keeping ≥75% of scheduled HIV care appointments; and (2) for those with viral suppression at Index assessment, having viral load >200 copies/mL on ≥1 measurement. We also used generalized linear mixed models (GLMMs) to estimate the risk and odds ratios of appointment nonattendance or unsuppressed viral load at any given observation. We generated receiver operating characteristic curves for the full models overlaid with the Index as a sole predictor.ResultsThe mean Index score was 4.5 (standard deviation, 0.6). Higher Index scores were associated with lower relative risk of suboptimal retention (n = 2576; logistic regression adjusted risk ratio [aRR], 0.88 [95% confidence interval, .87-.88]; GLMM aRR, 0.85 [.83-.87]) and lack of sustained viral suppression (n = 2499; logistic regression aRR, 0.75 [.68-.83]; GLMM aRR, 0.74 [.68-.80]). The areas under the receiver operating characteristic curve for the full models were 0.69 (95% confidence interval, .67-.71) for suboptimal retention and 0.76 (.72-.79) for lack of sustained viral suppression.ConclusionsIndex scores are significantly associated with suboptimal retention and viral suppression outcomes.
| S-EPMC8492226 | biostudies-literature
Project description:To map the 12-item Multiple Sclerosis Walking Scale (MSWS-12) onto the EuroQol 5-dimension (EQ-5D) health-utility index in multiple sclerosis (MS) patients participating in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry.Cross-sectional MSWS-12 to EQ-5D cross-walking analysis.NARCOMS registry spring 2010 biannual update and supplemental survey.North American patients completing both the MSWS-12 and the EQ-5D randomly split into derivation and validation cohorts.Ordinary least squares regression was performed within the derivation cohort, with participants' EQ-5D as the dependent variable. Results of the MSWS-12 were input as independent variable(s) into six regression models. Model goodness-of-fit was subsequently assessed in the validation cohort using the mean absolute error (MAE), root mean square error (RMSE) and the adjusted R(2). The best performing model was refined in the entire cohort and utilised for additional analyses.A total of 3505 NARCOMS participants were included. Their mean±SD EQ-5D and MSWS-12 scores were 0.74±0.18 and 50.8±33.5, respectively, and these assessments were found to be moderately correlated (r=-0.553, p<0.001). The model using all individual MSWS-12 item scores as independent variables was found to have the best fit (MAE=0.109±0.096, RMSE=0.145, adjusted R(2)=0.329). The percentage of EQ-5D estimates within 0.05 and 0.10 of the actual value were 30% and 61%, respectively. This mapping equation was more precise in patients with moderate mobility impairment (MAE=0.087±0.061 at patient-determined disease step (PDDS) of 3-6) and less precise in patients with no (MAE=0.141±0.128 at PDDS of 0-2) or severe mobility impairment (MAE=0.121±0.049 at PDDS ?7).The EQ-5D scores can be predicted using the MSWS-12 item scores with reasonable precision in North American patients with MS. Prediction estimates were more precise in patients with moderate mobility impairment.
| S-EPMC3664349 | biostudies-other
Project description:Background and objectivesTechnology has the potential to provide assistance and enrichment to older people; however, the desired outcomes are dependent on users' acceptance and usage. The senior technology acceptance model (STAM) was developed as a multidimensional measure assessing older people's acceptance of general technology. It contained 11 constructs measured by 38 items and had shown satisfactory psychometric properties. However, the length of the questionnaire increased respondent burden and limited its utilization. The study aimed to develop a brief, reliable, and valid version of scale to measure older people's technology acceptance by shortening the full, 38-item STAM questionnaire.Research design and methodsThe research method included (1) a sequential item-reduction strategy maximizing internal consistency, (2) convergent and discriminant validity analysis based on confirmative factor analysis, and (3) an expert review of resultant items. Data previously collected for developing the original STAM questionnaire were used to create the brief version. The data were collected from 1,012 community-dwelling individuals aged 55 and older in Hong Kong. Internal consistency and construct validity of the shortened questionnaire were examined. Two experts were invited for reviewing content validity.ResultsThe final 14-item, brief version of the STAM questionnaire consisted of a 4-factor structure, representing classical technology acceptance constructs and age-related health characteristics. Theoretical relationships in the brief version showed similar patterns to the original STAM. The 14-item STAM demonstrated robustness in psychometrics by preserving the reliability and validity of the original STAM questionnaire.Discussion and implicationsThe availability of a reliable and valid assessment tool of the short STAM can help researchers and practitioners to measure older adults' acceptance of technology and its effective usage. The short STAM could save administration time, reduce the burden on respondents, and be included in large-scale surveys.
| S-EPMC7320876 | biostudies-literature
Project description:Aims and method The mean delay for bipolar disorder diagnosis is 10 years. Identification of patients with previous hypomania is challenging, sometimes resulting in misdiagnosis. The aims of this study were: (a) to estimate the proportion of primary care patients with depression currently taking antidepressants who have undiagnosed bipolar disorder and (b) to compare a brief 3-item manic features questionnaire with the Hypomania Checklist (HCL-13). The sample comprised patients with a recorded diagnosis of depression, either on long-term antidepressant therapy or with previous multiple courses of antidepressants. Results Of 149 participants assessed, 24 (16.1%) satisfied criteria for bipolar disorder. Areas under the curve (AUC) for the 3-item questionnaire and the HCL-13 were similar (0.79 and 0.72, respectively) but positive predictive values (PPV) were low. Clinical implications Bipolar disorder may be underdiagnosed in primary care. A 3-item questionnaire could be used by general practitioners to screen for bipolar disorder in their patients with depression.
| S-EPMC5537571 | biostudies-other
Project description:BackgroundAlthough family satisfaction is recognized as a critical indicator of quality for patients with advanced cancer, it is rarely assessed as part of routine clinical care. Measurement burden may be one barrier to widespread use of family satisfaction measures.ObjectiveThe goal of this study was to test the ability of a new, brief 5-item measure of family satisfaction with care to accurately capture differences across hospital settings.DesignUsing data from the Palliative Care for Cancer Patients study, a prospective study of 1979 patients and caregivers, we used multivariate regression analysis to detect significant differences across five sites.SettingsHospitalized patients with advanced cancer and their caregivers Methods: We used both the shortened 5-item version of the FAMCARE scale (previously developed using Item Response Theory) and the original 20-item FAMCARE to measure family satisfaction.ResultsOn the 5-item FAMCARE, sites ranged from mean scores of 5.5-6.9 out of a possible high score of 10. Family members at one care site (n?=?783) were significantly (p?<?0.05) less satisfied with their care than family members at four other care sites. The original 20-item measure failed to differentiate satisfaction levels between all hospital sites.DiscussionVariability in family satisfaction with advanced cancer care across hospital settings can be more sensitively detected using a brief 5-item questionnaire versus longer measures. The development of less lengthy and burdensome measures for monitoring family satisfaction, which are still valid, can facilitate routine assessments to maintain and promote high-quality care across care settings.
| S-EPMC5510049 | biostudies-literature
Project description:IntroductionPerception of e-health is a broad concept involving many aspects of values and thoughts related to e-health. It is an important precursor to using e-health technologies to promote health. The purpose of this study is to validate an instrument for measuring perceptions of e-health technology among healthcare professionals.MethodsThis methodological study was conducted in China. We based on an existing instrument to develop a new instrument (i.e. PETS-C Brief). In phase 1, we modified and translated the existing instrument into Chinese. Subsequently, we employed the modified and translated instrument to conduct a cross-sectional survey. In phase 2, we randomly selected data from 400 participants to run an exploratory factor analysis and item analysis to reduce the number of items and develop factors. In phase 3, we employed the data from the remaining participants to run a confirmatory factor analysis to confirm the instrument structure.ResultsIn phase 1, the modified and translated instrument showed good content and face validities (S-CVI = 0.96, mean comprehensibility = 93.5%). 1338 participants completed the survey. In phase 2, the number of items was reduced from 40 to 19, which demonstrated a 4-factor model. In phase 3, the goodness-of-fit of the 4-factor PETS-C Brief was shown to be acceptable (χ2/d.f. = 6.40, CFI = 0.93, RMR = 0.40, NFI = 0.92, RMSEA = 0.076, IFI = 0.93).DiscussionThis study suggests using this instrument to survey perceptions of e-health technology in Chinese people. Future studies should examine its other important psychometric properties, including convergent/discriminant and predictive validity on behaviors using e-health technology.
| S-EPMC9500267 | biostudies-literature
Project description:BackgroundThe purpose of this secondary analysis of clinical databases of people with neck pain was to use a mixed unique conceptual and statistical approach to develop a brief version of the Neck Disability Index (NDI).MethodsAn a priori framework of neck-related function based on the International Classification of Functioning, Disability and Health was used to identify items from the original 10-item NDI that do not conceptually fit. Remaining items were subject to Rasch analysis to identify items that did not statistically fit with axioms of quantitative measurement. Finally, approaches drawn from classical test theory were used to compare stability, responsiveness and concurrent validity of the original NDI, the new brief NDI and the linearly-transformed brief NDI.ResultsConceptual analysis identified 3 items that did not fit with the construct of self-reported ability to perform activity: pain intensity, headache, and sleeping. These items were removed, and responses to the remaining 7 items drawn from an assembled database of 316 physiotherapy patients with neck pain were subject to Rasch analysis. Two items were removed due to either considerable differential item functioning (reading) or statistical redundancy (lifting). The remaining items were considered the NDI-5. Test-retest reliability, responsiveness, sensitivity to change, and concurrent validity were all comparable across the original NDI, NDI-5 and linearly-transformed NDI-5. Sensitivity to change over a 1-month period of physiotherapy was the notable exception, where the linearly-transformed NDI-5 showed superiority over the other two forms.ConclusionsA shortened version of the NDI, the NDI-5, has been constructed that is conceptually and statistically sound. Implications for research and clinical practice are discussed. Comparison with the NDI-8 is provided that suggests overall similar function across the forms, although the latter may be more sensitive to change.
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Project description:BackgroundEngagement in care is critical to achieving and sustaining optimal benefits of efficacious antiretroviral therapies for HIV infection. Current metrics of engagement in care, including problematic patterns of retention in care, adherence to treatment, and viral suppression, are often detected late in the disengagement process. We sought to develop and validate a patient-centered screener of engagement in care that can be used to identify deficits in patient perceptions of engagement before the development of poor outcomes, including loss to follow-up, treatment nonadherence, virologic failure, and the resulting increased likelihood of HIV-associated morbidity and mortality and onward transmission of HIV.Setting and methodsUsing input from patients, providers, and researchers through in-person focus groups and an online Delphi process, we developed a self-report measure of engagement in care that was validated with 3296 patients from 7 clinics across the United States.ResultsResults supported a single dimension of engagement in care measured by 10 items. Lower scores on the HIV Index were related to higher depression and anxiety symptoms, greater use of alcohol and stimulants, and increased likelihood of reporting internalized HIV stigma. Higher Index scores were positively associated with self-report measures of antiretroviral therapy adherence, corroborative clinic records documenting appointment attendance, and increased likelihood of recent viral load suppression.ConclusionsThe HIV Index offers promise as a patient-centered diagnostic and prognostic screener for engagement in care that can be used to trigger interventions to promote better clinical outcomes for persons living with HIV.
| S-EPMC6522296 | biostudies-literature
Project description:BackgroundReligion/religiosity plays an important role in the lives of most Indians. However, there are lack of validated instruments in regional languages to assess the various dimensions of religiosity in the Indian population. This limits evaluation of religion/religiosity and comparison of Indian data with western research for health-related issues.MethodsThe CRS, BRCOPE, and DUREL scales were translated into Hindi by using the standard translation-back-translation methodology as specified by the World Health Organization. Initially, the Hindi version of each scale was completed by 132 participants, and the second time, participants completed either the Hindi or the English version of the scales after 3-7 days. Data were evaluated for cross-language equivalence, test-retest reliability, internal consistency, and split half reliability.ResultsThe Hindi version of CRS, DUREL, and RCOPE had good cross-language equivalence with the English version for all the items and dimensions in all three scales, which was highly significant (P < 0.001). The test-retest reliability was also high for all three scales (Cohen's Kappa value >0.67 for various items and subscales P < 0.001). Cronbach's alpha for the Hindi version of the scales was 0.95, 0.76, and 0.89 for CRS, DUREL, and BRCOPE, respectively. The Spearman-Brown coefficient was 0.89, 0.70, and 0.43 for CRS, DUREL, and BRCOPE, respectively.ConclusionThe Hindi version of CRS, DUREL, and BRCOPE has good cross-language equivalence, internal consistency, split-half reliability, and test-retest reliability. It is expected that availability of these validated versions will provide impetus to research evaluating the association of clinical parameters and religiosity.
| S-EPMC6875839 | biostudies-literature
Project description:AimWork engagement is critical in both occupational and mental health contexts. However, no studies have compared the usefulness of the nine-, three-, and two-item measures from the Utrecht Work Engagement Scale (UWES). Therefore, this study aimed to examine the internal consistency and convergent validity of the two-item measure and compare its usefulness with the nine-item and three-item versions for assessing engagement at work among Japan Self-Defense Forces (JSDF) personnel.MethodsThis cross-sectional study included 229,383 participants who underwent an annual mental health check between October 19 and December 17, 2021. To test the internal consistency of the scales, Cronbach's alpha was used. To test the convergent validity, Pearson's correlation coefficients were examined for each item corresponding to job resources, job satisfaction, stress reactions, and job demands assessed by the Brief Job Stress Questionnaire.ResultsMost participants were men (89.8%). Cronbach's alpha coefficients for the nine-, three-, and two-item scales were 0.95, 0.85, and 0.80, respectively. All three versions showed significant and positive correlations with each of the items corresponding to job resources and job satisfaction. The correlation coefficients of the two-item scale were not inferior to those of the nine-item and three-item scales for job resources and job satisfaction items.ConclusionOur results showed the internal consistency and convergent validity for the two-item measure of engagement at work among JSDF personnel. The two-item measure may be useful for briefly and efficiently assessing the actual state of workers' engagement at work.
| S-EPMC11339131 | biostudies-literature