title: Scale refinement and initial evaluation of a behavioral health function measurement tool for work disability evaluation.
abstract: OBJECTIVE
  To use item response theory (IRT) data simulations to construct and perform initial psychometric testing of a newly developed instrument, the Social Security Administration Behavioral Health Function (SSA-BH) instrument, that aims to assess behavioral health functioning relevant to the context of work.
  
  
  METHODS
  Cross-sectional survey followed by IRT calibration data simulations.
  
  
  METHODS
  Community.
  
  
  METHODS
  Sample of individuals applying for Social Security Administration disability benefits: claimants (n=1015) and a normative comparative sample of U.S. adults (n=1000).
  
  
  METHODS
  None.
  
  
  METHODS
  SSA-BH measurement instrument.
  
  
  RESULTS
  IRT analyses supported the unidimensionality of 4 SSA-BH scales: mood and emotions (35 items), self-efficacy (23 items), social interactions (6 items), and behavioral control (15 items). All SSA-BH scales demonstrated strong psychometric properties including reliability, accuracy, and breadth of coverage. High correlations of the simulated 5- or 10-item computer adaptive tests with the full item bank indicated robust ability of the computer adaptive testing approach to comprehensively characterize behavioral health function along 4 distinct dimensions.
  
  
  CONCLUSIONS
  Initial testing and evaluation of the SSA-BH instrument demonstrated good accuracy, reliability, and content coverage along all 4 scales. Behavioral function profiles of Social Security Administration claimants were generated and compared with age- and sex-matched norms along 4 scales: mood and emotions, behavioral control, social interactions, and self-efficacy. Using the computer adaptive test-based approach offers the ability to collect standardized, comprehensive functional information about claimants in an efficient way, which may prove useful in the context of the Social Security Administration's work disability programs.
authors.affiliation: Health and Disability Research Institute, Boston University School of Public Health, Boston, MA 02118-2526, USA. emarfeo@bu.edu
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Marfeo
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Ni
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Haley
authors.forename: Kara
authors.initials: K
authors.lastname: Bogusz
authors.forename: Mark
authors.initials: M
authors.lastname: Meterko
authors.forename: Christine M
authors.initials: CM
authors.lastname: McDonough
authors.forename: Leighton
authors.initials: L
authors.lastname: Chan
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Rasch
authors.forename: Diane E
authors.initials: DE
authors.lastname: Brandt
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
mesh_terms: D000328:Adult; D000339:Affect; D001519:Behavior; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011594:Psychometrics; D020377:Self Efficacy; D012943:Social Security; D012959:Socioeconomic Factors; D014481:United States; D014938:Work Capacity Evaluation
keywords: CAT; DIF; Disability evaluation; IRT; Outcome assessment (health care); PROMIS; Patient Reported Outcomes Measurement Information System; Rehabilitation; SSA; SSA-BH; SSDI; Social Security Administration; Social Security Administration Behavioral Health Function; Social Security Disability Insurance; United States Social Security Administration; computer adaptive test; differential item functioning; item response theory
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