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Measurement equivalence of osteoporosis-specific and general quality-of-life instruments in Aboriginal and non-Aboriginal women

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Abstract

Purpose

To test the measurement equivalence (i.e., invariance) of osteoporosis-specific and general health-related quality-of-life (HRQOL) instruments in Canadian Aboriginal and non-Aboriginal women.

Methods

A total of 258 Aboriginal and 181 non-Aboriginal women were recruited to the First Nations Bone Health Study from rural and urban sites in the province of Manitoba, Canada. The Medical Outcomes Study Short Form-36 (SF-36) and the mini-Osteoporosis Quality of Life Questionnaire (mini-OQLQ) were administered to study participants by trained interviewers. Confirmatory factor analysis techniques were adopted to test hypotheses about four forms of invariance for the two groups using likelihood ratio tests and other goodness-of-fit indices.

Results

For the mini-OQLQ instrument configural and metric invariance were satisfied, indicating that both groups have the same conceptualization of osteoporotic quality of life and the concepts have equivalent meaning. However, scalar and complete invariance were not satisfied for this instrument. The SF-36 exhibited complete invariance in the two groups.

Conclusions

Measurement equivalence, which is required to conduct valid group comparisons, was not demonstrated for the disease-specific quality-of-life instrument but was supported for the general instrument. Ethnicity appears to influence responses about the effects of osteoporosis on quality of life.

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Notes

  1. In Canada, the terms Aboriginal or Native are used to refer to “Indians,” and includes First Nations, Metis, and Inuit peoples. First Nations are Aboriginal peoples signatory to treaties and/or recognized by the federal government as a fiduciary responsibility. This paper reports on data derived exclusively from First Nations populations, which represent the large majority of Aboriginal persons living in Canada.

Abbreviations

ADL:

Activities of daily living

BP:

Bodily pain

CFA:

Confirmatory factor analysis

CFI:

Comparative fit index

CI:

Confidence interval

DF:

Degrees of freedom

EFA:

Exploratory factor analysis

FNBHS:

First Nations Bone Health Study

GH:

General health perceptions

HRQOL:

Health-related quality of life

LR:

Likelihood ratio

MH:

Mental health

mini-OQLQ:

Mini-Osteoporosis Quality of Life Questionnaire

NNFI:

Nonnormed fit index

OQLQ:

Osteoporosis Quality-of-Life Questionnaire

PF:

Physical functioning

RE:

Role limitations due to emotional problems

RMSEA:

Root-mean-square error of approximation

RP:

Role limitations due to physical health problems

SF:

Social functioning

SF-36:

Medical Outcomes Study Short Form-36

VT:

Vitality

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Acknowledgements

The authors would like to thank Kathleen Deering for her assistance with manuscript preparation and Elaine Ross for her assistance with data collection and entry. The authors would like to acknowledge the rest of the First Nations Bone Health Study Research Group: Dr. C. R. Greenberg, Dr. J. D. O’Neil, Dr. H. A. Weiler, Dr. M. Doupe, Dr. J. Krahn, Dr. L. Roos, Dr. E. A. Salamon, Ms. A. Walker Young, and Ms. P. Wood Steiman. The authors are indebted to the Health Information Management Branch of Manitoba Health and Healthy Living and to the First Nations and Inuit Health Branch and Indian and Northern Affairs Canada for permission to use the Status Verification System and to the Health Information Research Committee of the Assembly for Manitoba Chiefs for actively supporting this work. This research was supported by funds from the Canadian Institutes of Health Research and the Manitoba Health Research Council.

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Authors and Affiliations

  1. School of Public Health, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada

    Lisa M. Lix

  2. Faculty of Pharmacy, University of Manitoba, Winnipeg, MB, R3E 0T5, Canada

    Colleen Metge

  3. Department of Medicine, University of Manitoba, Winnipeg, MB, R2H 2A6, Canada

    William D. Leslie

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  1. Lisa M. Lix
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Correspondence to Lisa M. Lix.

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Lix, L.M., Metge, C. & Leslie, W.D. Measurement equivalence of osteoporosis-specific and general quality-of-life instruments in Aboriginal and non-Aboriginal women. Qual Life Res 18, 619–627 (2009). https://doi.org/10.1007/s11136-009-9470-6

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