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Minimal impact of response shift for SF-12 mental and physical health status in homeless and vulnerably housed individuals: an item-level multi-group analysis
Authors:Anne M. Gadermann  Richard Sawatzky  Anita Palepu  Anita M. Hubley  Bruno D. Zumbo  Tim Aubry  Susan Farrell  Stephen W. Hwang
Affiliation:1.Centre for Health Evaluation and Outcome Sciences,Providence Health Care Research Institute,Vancouver,Canada;2.Human Early Learning Partnership, School of Population and Public Health,University of British Columbia,Vancouver,Canada;3.School of Nursing,Trinity Western University,Langley,Canada;4.Measurement, Evaluation, and Research Methodology Program, Department of Educational and Counselling Psychology and Special Education,University of British Columbia,Vancouver,Canada;5.School of Psychology,University of Ottawa,Ottawa,Canada;6.Centre for Research on Inner City Health, Keenan Research Centre in the Li Ka Shing Knowledge Institute,St. Michael’s Hospital,Toronto,Canada;7.Department of Medicine,University of Toronto,Toronto,Canada
Abstract:

Purpose

The purpose of this study was to examine whether homeless or vulnerably housed individuals experienced response shift over a 12-month time period in their self-reported physical and mental health status.

Methods

Data were obtained from the Health and Housing in Transition study, a longitudinal multi-site cohort study in Canada (N = 1190 at baseline). Multi-group confirmatory factor analysis (MG-CFA) and methods for response shift detection at the item level, based on the approach by Oort, were used to test for reconceptualization, reprioritization, and recalibration response shift on the SF-12 in four groups of individuals who were homeless (n = 170), housed (n = 437), or who reported a change in their housing status [from homeless to housed (n = 285) or housed to homeless (n = 73)] over a 12-month time period. Mean and variance adjusted weighted-least squares estimation was used to accommodate the ordinal and binary distributions of the SF-12 items.

Results

Using MG-CFA, a strict invariance model showed that the measurement model was equivalent for the four groups at baseline. Although we found small but statistically significant response shift for several measurement model parameters, the impact on the predicted average mental and physical health scores within each of the groups was small.

Conclusions

Response shift does not appear to be a significant concern when using the SF-12 to obtain change scores over a 12-month period in this population.
Keywords:
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