Dataset Information

Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models.

ABSTRACT: OBJECTIVES:The CES-D is a widely used depression screening instrument. While numerous studies have analysed its psychometric properties using exploratory and various kinds of confirmatory factor analyses, only few studies used Rasch models and none a multidimensional one. METHODS:The present study applies a multidimensional Rasch model using a sample of 518 respondents representative for the Austrian general population aged 18 to 65. A one-dimensional model, a four-dimensional model reflecting the subscale structure suggested by [1], and a four-dimensional model with the background variables gender and age were applied. RESULTS:While the one-dimensional model showed relatively good fit, the four-dimensional model fitted much better. EAP reliability indices were generally satisfying and the latent correlations varied between 0.31 and 0.88. In the analysis involving background variables, we found a limited effect of the participants' gender. DIF effects were found unveiling some peculiarities. The two-items subscale Interpersonal Difficulties showed severe weaknesses and the Positive Affect subscale with the reversed item wordings also showed unexpected results. CONCLUSIONS:While a one-dimensional over-all score might still contain helpful information, the differentiation according to the latent dimension is strongly preferable. Altogether, the CES-D can be recommended as a screening instrument, however, some modifications seem indicated.

SUBMITTER: Alexandrowicz RW

PROVIDER: S-EPMC5969764 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models.

Alexandrowicz Rainer W RW Jahn Rebecca R Wancata Johannes J

PloS one 20180525 5

<h4>Objectives</h4>The CES-D is a widely used depression screening instrument. While numerous studies have analysed its psychometric properties using exploratory and various kinds of confirmatory factor analyses, only few studies used Rasch models and none a multidimensional one.<h4>Methods</h4>The present study applies a multidimensional Rasch model using a sample of 518 respondents representative for the Austrian general population aged 18 to 65. A one-dimensional model, a four-dimensional mod ...[more]

PMID: 29799866

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Project description:BackgroundMobile health (mHealth) apps offer great opportunities to deliver large-scale, cost-efficient digital solutions for implementing lifestyle changes. Furthermore, many mHealth apps act as medical devices. Yet, there is little research on how to assess user satisfaction with an mHealth solution.ObjectiveThis study presents the development of the mHealth Satisfaction Questionnaire and evaluates its measurement properties.MethodsRespondents who took part in the Health Integrator Study and were randomized to use the Health Integrator smartphone app for lifestyle changes (n=112), with and without additional telephone coaching, rated their satisfaction with the app using the new 14-item mHealth Satisfaction Questionnaire. The ratings were given on a 5-point Likert scale and measurement properties were evaluated using Rasch measurement theory (RMT).ResultsOptimal scoring was reached when response options 2, 3, and 4 were collapsed, giving three response categories. After omitting two items that did not fit into the scale, fit residuals were within, or close to, the recommended range of ±2.5. There was no differential item functioning between intervention group, age group, or sex. The Person Separation Index was 0.79, indicating that the scale's ability to discriminate correctly between person leniency was acceptable for group comparisons but not for individual evaluations. The scale did not meet the criterion of unidimensionality; 16.1% (18/112) of the respondents were outside the desired range of -1.96 to 1.96. In addition, several items showed local dependency and three underlying dimensions emerged: negative experiences, positive experiences, and lifestyle consequences of using the mHealth solution.ConclusionsIn times where mHealth apps and digital solutions are given more attention, the mHealth Satisfaction Questionnaire provides a new possibility to measure user satisfaction to ensure usability and improve development of new apps. Our study is one of only a few cases where RMT has been used to evaluate the usability of such an instrument. There is, though, a need for further development of the mHealth Satisfaction Questionnaire, including the addition of more items and consideration of further response options. The mHealth Satisfaction Questionnaire should also be evaluated in a larger sample and with other mHealth apps and in other contexts.Trial registrationClinicalTrials.gov NCT03579342; http://clinicaltrials.gov/ct2/show/NCT03579342.

Dataset Information

Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models.

Publications

Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models.

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