Skip to main content

Advertisement

SpringerLink
Log in

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

  • Published:
Quality of Life Research Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hwang, S. W., Aubry, T., Palepu, A., Farrell, S., Nisenbaum, R., Hubley, A. M., et al. (2011). The health and housing in transition study: A longitudinal study of the health of homeless and vulnerably housed adults in three Canadian cities. International Journal of Public Health, 56, 609–623.

    Article  CAS  PubMed  Google Scholar 

  2. Laird, G. (2007). Shelter: Homelessness in a growth economy: Canada’s 21st century paradox. A report for the Sheldon Chumir Foundation for Ethics in Leadership, Calgary.

  3. Research Alliance for Canadian Homelessness, Housing, and Health (REACH3) (2010). Housing vulnerability and health: Canada’s hidden emergency. http://www.pshp.ca/documents/resources/2010-REACH-Housing-Vulnerability.pdf. Accessed 16 March 2016.

  4. Breakey, W. R., Fischer, P. J., Kramer, M., Nestadt, G., Romanoski, A. J., Ross, A., et al. (1989). Health and mental health problems of homeless men and women in Baltimore. Journal of the American Medical Association, 262, 1352–1357.

    Article  CAS  PubMed  Google Scholar 

  5. Fischer, P. J., & Breakey, W. R. (1991). The epidemiology of alcohol, drug, and mental disorders among homeless persons. American Psychologist, 46, 1115–1128.

    Article  CAS  PubMed  Google Scholar 

  6. Frankish, C. J., Hwang, S. W., & Quantz, D. (2005). Homelessness and health in Canada: Research lessons and priorities. Canadian Journal of Public Health, 96(Suppl 2), S23–S29.

    PubMed  Google Scholar 

  7. Hwang, S. W. (2001). Homelessness and health. Canadian Medical Association Journal, 164, 229–233.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Hwang, S. W. (2000). Mortality among men using homeless shelters in Toronto, Ontario. Journal of the American Medical Association, 283, 2152–2157.

    Article  CAS  PubMed  Google Scholar 

  9. Hwang, S. W., Wilkins, R., Tjepkema, M., O’Campo, P. J., & Dunn, J. R. (2009). Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 year follow-up study. British Medical Journal, 339, b4036.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sprangers, M. A. G., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine, 48, 1507–1515.

    Article  CAS  PubMed  Google Scholar 

  11. Schwartz, C. E., Bode, R., Repucci, N., Becker, J., Sprangers, M. A. G., & Fayers, P. M. (2006). The clinical significance of adaptation to changing health: A meta-analysis of response shift. Quality of Life Research, 15, 1533–1550.

    Article  PubMed  Google Scholar 

  12. Bray, J. H., Maxwell, S. E., & Howard, G. S. (1984). Methods of analysis with response-shift bias. Educational and Psychological Measurement, 44, 781–804.

    Article  Google Scholar 

  13. Fitzpatrick-Lewis, D., Ganann, R., Krishnaratne, S., Ciliska, D., Kouyoumdjian, F., & Hwang, S. W. (2011). Effectiveness of interventions to improve the health and housing status of homeless people: A rapid systematic review. BMC Public Health, 11, 638–651.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Patterson, M., Moniruzzaman, A., Palepu, A., Zabkiewicz, D., Frankish, C. J., Krausz, M., et al. (2013). Housing first improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia. Social Psychiatry and Psychiatric Epidemiology, 48, 1245–1259.

    Article  PubMed  Google Scholar 

  15. Ogden, J., & Lo, J. (2012). How meaningful are data from Likert scales? An evaluation of how ratings are made and the role of the response shift in the socially disadvantaged. Journal of Health Psychology, 17, 350–361.

    Article  PubMed  Google Scholar 

  16. Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.

    Article  PubMed  Google Scholar 

  17. Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical and mental health summary scales: A user’s manual. Boston, MA: The Health Institute, New England Medical Center.

    Google Scholar 

  18. Salyers, M. P., Bosworth, H. B., Swanson, J. W., Lamb-Pagone, J., & Osher, F. C. (2000). Reliability and validity of the SF-12 health survey among people with severe mental illness. Medical Care, 38, 1141–1150.

    Article  CAS  PubMed  Google Scholar 

  19. Larson, C. O. (2002). Use of the SF-12 instrument for measuring the health of homeless persons. Health Services Research, 37, 733–750.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Tsemberis, S., McHugo, G., Williams, V., Hanrahan, P., & Stefancic, A. (2007). Measuring homelessness and residential stability: The residential time-line follow-back inventory. Journal of Community Psychology, 35, 29–42.

    Article  Google Scholar 

  21. Lix, L. M., Chan, E. K. H., Sawatzky, R., Sajobi, T. T., Liu, J., Hopman, W., et al. (2016). Response shift and disease activity in inflammatory bowel disease. Quality of Life Research, 25, 1751–1760.

    Article  PubMed  Google Scholar 

  22. Millsap, R. E., & Yun-Tein, J. (2004). Assessing factorial invariance in ordered-categorical measures. Multivariate Behavioral Research, 39, 479–515.

    Article  Google Scholar 

  23. Byrne, B. M. (2012). Structural equation modeling with Mplus: Basic concepts, applications, and programming. New York: Routledge Academic.

    Google Scholar 

  24. Oort, F. J. (2005). Using structural equation modeling to detect response shifts and true change. Quality of Life Research, 14, 587–598.

    Article  PubMed  Google Scholar 

  25. Verdam, M. G., Oort, F. J., & Sprangers, M. A. (2016). Using structural equation modeling to detect response shifts and true change in discrete variables: An application to the items of the SF-36. Quality of Life Research, 25, 1361–1383.

    Article  PubMed  Google Scholar 

  26. Muthén, B., & Muthén, L. (2013). MPlus (version 7). Los Angeles, CA: Statmodel.

    Google Scholar 

  27. Beauducel, A., & Herzberg, P. Y. (2006). On the performance of maximum likelihood versus means and variance adjusted weighted least squares estimation in CFA. Structural Equation Modeling, 13, 186–203.

    Article  Google Scholar 

  28. Finney, S. J., & DiStefano, C. (2006). Non-normal and categorical data in structural equation modeling. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (pp. 269–314). Greenwich, CT: Information Age.

    Google Scholar 

  29. Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3, 4–69. doi:10.1177/109442810031002.

    Article  Google Scholar 

  30. Yu, C. Y. (2002). Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes. Dissertation Abstracts International, 63(10), 3527B.

    Google Scholar 

  31. Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing MI. Structural Equation Modeling, 9, 235–255.

    Google Scholar 

  32. Hwang, S. W., Ueng, J. J., Chiu, S., Kiss, A., Tolomiczenko, G., Cowan, L., et al. (2010). Universal health insurance and health care access for homeless persons. American Journal of Public Health, 100, 1454–1461.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Hubley, A. M., Russell, L. B., Palepu, A., & Hwang, S. W. (2014). Subjective quality of life among individuals who are homeless: A review of current knowledge. Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, 115, 509–524.

    Article  Google Scholar 

  34. Oort, F. J., Visser, M. R., & Sprangers, M. A. (2005). An application of structural equation modeling to detect response shifts and true change in quality of life data from cancer patients undergoing invasive surgery. Quality of Life Research, 14, 599–609.

    Article  PubMed  Google Scholar 

  35. Visser, M. R., Oort, F. J., & Sprangers, M. A. (2005). Methods to detect response shift in quality of life data: A convergent validity study. Quality of Life Research, 14, 629–639.

    Article  PubMed  Google Scholar 

  36. Bland, J. M., & Altman, D. G. (1995). Multiple significance tests: The Bonferroni method. British Medical Journal, 310, 170.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This project was supported by an Operating Grant (MOP-86765) from the Canadian Institutes of Health Research. Dr. Gadermann also acknowledges support from the Michael Smith Foundation for Health Research and Canadian Institutes of Health Research. We would like to acknowledge the following individuals from our community partner organizations: Laura Cowan, Liz Evans, Sarah Evans, Stephanie Gee, Clare Haskel, Erika Khandor, and Wendy Muckle. The authors also thank the study coordinators and interviewers in each of the three cities as well as the shelter, drop-in, municipal and provincial staff for their assistance with participant recruitment and follow-up.

Funding

This project was supported by an Operating Grant (MOP-86765) from the Canadian Institutes of Health Research. Dr. Gadermann also acknowledges support from the Michael Smith Foundation for Health Research and Canadian Institutes of Health Research.

Author information

Authors and Affiliations

  1. Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada

    Anne M. Gadermann, Richard Sawatzky & Anita Palepu

  2. Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Anne M. Gadermann

  3. School of Nursing, Trinity Western University, Langley, Canada

    Richard Sawatzky

  4. Measurement, Evaluation, and Research Methodology Program, Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, Canada

    Anita M. Hubley & Bruno D. Zumbo

  5. School of Psychology, University of Ottawa, Ottawa, Canada

    Tim Aubry & Susan Farrell

  6. Centre for Research on Inner City Health, Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada

    Stephen W. Hwang

  7. Department of Medicine, University of Toronto, Toronto, Canada

    Stephen W. Hwang

Authors
  1. Anne M. Gadermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard Sawatzky
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anita Palepu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anita M. Hubley
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bruno D. Zumbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tim Aubry
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Susan Farrell
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Stephen W. Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne M. Gadermann.

Ethics declarations

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gadermann, A.M., Sawatzky, R., Palepu, A. et al. 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. Qual Life Res 26, 1463–1472 (2017). https://doi.org/10.1007/s11136-016-1464-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-016-1464-6

Keywords

Search

Navigation