New English and Spanish social health measures will facilitate evaluating health determinants.
OBJECTIVE
To develop psychometrically sound, culturally relevant, and linguistically equivalent English and Spanish self-report measures of social health guided by a comprehensive conceptual model and applicable across chronic illnesses.


METHODS
The Patient-Reported Outcomes Measurement Information System (PROMIS) Social Health Workgroup implemented a mixed methods approach to evaluate earlier results (v1.0); expand and refine domain definitions and items; translate items into Spanish; and obtain qualitative feedback. Computer-based and paper/pencil questionnaire administration was conducted with a variety of U.S. respondent samples during 2009-2012. Analyses included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), two-parameter logistic item response theory (IRT) modeling, evaluation of differential item functioning (DIF), and evaluation of criterion and construct validity.


RESULTS
Qualitative feedback supported the conceptualization of the Social Health domain framework (Social Function and Social Relationships subcomponents). Validation testing participants (n = 2,208 English; n = 644 Spanish) were diverse in terms of gender, age, education, and ethnicity/race. EFA, CFA, and IRT identified 7 unidimensional factors with good model fit. There was no DIF by language, and good evidence of criterion and construct validity.


CONCLUSIONS
PROMIS English and Spanish language instruments (v2.0), including computer-adaptive tests and fixed-length short forms, are publicly available for assessment of Social Function (Ability to Participate in Social Roles and Activities, and Satisfaction with Social Roles and Activities) and Social Relationships (Companionship; Emotional, Informational and Instrumental Support; and Social Isolation). Measures of social health will play a key role in applications that use ecologic (or determinants of health) models that emphasize how patients' social environments influence their health.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine.
Elizabeth A
EA
Hahn
Division of General Internal Medicine, University of North Carolina School of Medicine.
Darren A
DA
DeWalt
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine.
Rita K
RK
Bode
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine.
Sofia F
SF
Garcia
Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill.
Robert F
RF
DeVellis
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine.
Helena
H
Correia
David
D
Cella
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D054521:Cultural Competency; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011594:Psychometrics; D036301:Qualitative Research; D015203:Reproducibility of Results; D057566:Self Report; D064890:Social Determinants of Health; D055815:Young Adult