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Open Access 01-12-2021 | Research

Confirmatory factor analysis and measurement invariance of the English, Mandarin, and Malay versions of the SF-12v2 within a representative sample of the multi-ethnic Singapore population

Authors: Jue Hua Lau, Edimansyah Abdin, Janhavi Ajit Vaingankar, Saleha Shafie, Rajeswari Sambasivam, Shazana Shahwan, Julian Thumboo, Siow Ann Chong, Mythily Subramaniam

Published in: Health and Quality of Life Outcomes | Issue 1/2021

Abstract

Background

The Short Form Health Survey (SF-12v2) is an increasingly popular measure of health-related quality of life (HRQoL) in Singapore. In order to examine whether the SF-12v2 was appropriate for use in the population, the factor structure and validity of the English, Mandarin, and Malay versions were assessed in a representative sample of the general population of Singapore.

Methods

6126 respondents were recruited for the Singapore Mental Health Study 2016 (SMHS 2016), a cross-sectional and population-based survey. Confirmatory factor analyses (CFA) were conducted to examine the fit of a two-factor model for the SF-12v2 within a representative sample and amongst the different language (English, Mandarin, Malay) subgroups. Multiple-group CFAs (MGCFA) were conducted to test measurement invariance across the different languages, ethnicities, and chronic illnesses subgroups. CFA-generated latent factor scores (FSCORE command in MPlus) were also compared with the composite scores derived from the developer’s scoring method via correlations. Sociodemographic correlates of the latent physical and mental health scores were explored.

Results

CFA results within the full sample supported a two-factor model (RMSEA = 0.044; CFI = 0.991; TLI = 0.988; SRMR = 0.044) in which physical functioning, role physical, bodily pain and general health items loaded onto a latent physical health factor, while role emotional, mental health, social functioning, and vitality items loaded onto a latent mental health factor. Physical and mental health factors were allowed to correlate, unlike the developer’s orthogonal scoring method. All standardized loadings were high and statistically significant. Both factors had high internal consistency. CFA within subsamples of English, Mandarin, and Malay languages indicated similar findings. MGCFA results indicate that measurement invariance held across the different languages, ethnicities, and those with and without chronic illnesses.

Conclusion

The present study identified a two-factor (physical and mental health) structure within the general population and amongst the three different languages and demonstrated the measurement invariance of SF-12v2 across different subgroups. Findings indicate that algorithm-derived PCS and MCS should be interpreted with caution as they may result in inaccurate conclusions regarding the relationships between HRQoL and its correlates. Future studies using the SF-12v2 within the general population of Singapore should consider utilizing the factor structure put forth in the present study to obtain more appropriate estimates of HRQoL.

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Title: Confirmatory factor analysis and measurement invariance of the English, Mandarin, and Malay versions of the SF-12v2 within a representative sample of the multi-ethnic Singapore population
Authors: Jue Hua Lau
Edimansyah Abdin
Janhavi Ajit Vaingankar
Saleha Shafie
Rajeswari Sambasivam
Shazana Shahwan
Julian Thumboo
Siow Ann Chong
Mythily Subramaniam
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2021
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-021-01709-9

At a glance: The STEP trials

Springer Medicine

Confirmatory factor analysis and measurement invariance of the English, Mandarin, and Malay versions of the SF-12v2 within a representative sample of the multi-ethnic Singapore population

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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