Paper
Friday, 21 July 2006
Testing Cultural Measurement Equivalence in the Asthma Screening Form
Susanne W. Cook, RN, PhD1, Judith Harris-Meier, RN, MS, CPNP2, and Karen H. Sousa, RN, PhD1. (1) College of Nursing, Arizona State University, Tempe, AZ, USA, (2) Department of Pulmonology, Phoenix Children's Hospital, Phoenix, AZ, USA
Background: The issue of asthma prevalence has received much attention in practice and policy development. Discussions of prevalence among culturally distinct populations are predominately centered on tangible, easily quantifiable measures. When health measures are used across cultural groups, investigators must demonstrate cultural appropriateness of assessment instruments prior to implementation. An issue of significance is the manner in which these groups are assessed using psychometric measures. Often there is cultural bias in the measures due to the population in which they were developed and tested (non-minority / English-speaking). The most common method for assessing cultural validity of psychometric measures is rooted in simple translation of language rather than attention to social or psychological factors about how members of cultural groups process information or answer items on assessment tools. The purpose of these analyses was to examine interrelationships among key dimensions of the Asthma Screening Form (ASF). Methods: The data were part of an urban school asthma-screening sample (n = 906: 498 English Speaking / 419 Spanish speaking). The adequacy of conceptual and measurement properties across the groups was tested within the framework of confirmatory factor analysis using structural equation modeling. The chi-square likelihood ratio statistic and other fit indices were used to assess model fit.
Results: The analyses indicate the factor structure between cohorts were not equivalent (RMSEA: English = 0.062; Spanish = 0.232). The invariance in the factor loadings will be discussed in detail.
Conclusions: confirmatory factor analysis is an imperative step to identify and develop culturally congruent assessment tools. Nurses need culturally congruent tools to increase the validity and appropriateness of research and practice. Testing cross-cultural construct validity of psychometric measures on the basis of cognitive equivalence is a primary step in addressing cultural bias in clinical practice and a prerequisite for evaluating group differences.
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