Measurement equivalence of osteoporosis-specific and general quality-of-life instruments in Aboriginal and non-Aboriginal women
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To test the measurement equivalence (i.e., invariance) of osteoporosis-specific and general health-related quality-of-life (HRQOL) instruments in Canadian Aboriginal and non-Aboriginal women.
A total of 258 Aboriginal and 181 non-Aboriginal women were recruited to the First Nations Bone Health Study from rural and urban sites in the province of Manitoba, Canada. The Medical Outcomes Study Short Form-36 (SF-36) and the mini-Osteoporosis Quality of Life Questionnaire (mini-OQLQ) were administered to study participants by trained interviewers. Confirmatory factor analysis techniques were adopted to test hypotheses about four forms of invariance for the two groups using likelihood ratio tests and other goodness-of-fit indices.
For the mini-OQLQ instrument configural and metric invariance were satisfied, indicating that both groups have the same conceptualization of osteoporotic quality of life and the concepts have equivalent meaning. However, scalar and complete invariance were not satisfied for this instrument. The SF-36 exhibited complete invariance in the two groups.
Measurement equivalence, which is required to conduct valid group comparisons, was not demonstrated for the disease-specific quality-of-life instrument but was supported for the general instrument. Ethnicity appears to influence responses about the effects of osteoporosis on quality of life.
KeywordsQuality of life Women North American Indian Invariance Confirmatory factor analysis
Activities of daily living
Confirmatory factor analysis
Comparative fit index
Degrees of freedom
Exploratory factor analysis
First Nations Bone Health Study
General health perceptions
Health-related quality of life
Mini-Osteoporosis Quality of Life Questionnaire
Nonnormed fit index
Osteoporosis Quality-of-Life Questionnaire
Role limitations due to emotional problems
Root-mean-square error of approximation
Role limitations due to physical health problems
Medical Outcomes Study Short Form-36
The authors would like to thank Kathleen Deering for her assistance with manuscript preparation and Elaine Ross for her assistance with data collection and entry. The authors would like to acknowledge the rest of the First Nations Bone Health Study Research Group: Dr. C. R. Greenberg, Dr. J. D. O’Neil, Dr. H. A. Weiler, Dr. M. Doupe, Dr. J. Krahn, Dr. L. Roos, Dr. E. A. Salamon, Ms. A. Walker Young, and Ms. P. Wood Steiman. The authors are indebted to the Health Information Management Branch of Manitoba Health and Healthy Living and to the First Nations and Inuit Health Branch and Indian and Northern Affairs Canada for permission to use the Status Verification System and to the Health Information Research Committee of the Assembly for Manitoba Chiefs for actively supporting this work. This research was supported by funds from the Canadian Institutes of Health Research and the Manitoba Health Research Council.
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