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1.  Is a prostate cancer screening anxiety measure invariant across two different samples of age-appropriate men? 
Background
In order to explore the influence of anxiety on decision–making processes, valid anxiety measures are needed. We evaluated a prostate cancer screening (PCS) anxiety scale that measures anxiety related to the prostate–specific antigen (PSA) test, the digital rectal examination (DRE), and the decision to undergo PCS (PCS-D) using two samples in different settings.
Methods
We assessed four psychometric properties of the scale using baseline data from a randomized, controlled decision aid trial (n = 301, private clinic; n = 149, public).
Results
The 3-factor measure had adequate internal consistency reliability, construct validity, and discriminant validity. Confirmatory factor analyses indicated that the 3–factor model did not have adequate fit. When subscales were considered separately, only the 6–item PCS-D anxiety measure had adequate fit and was invariant across clinics.
Conclusions
Our results support the use of a 6–item PCS-D anxiety measure with age-appropriate men in public and private settings. The development of unique anxiety items relating to the PSA test and DRE is still needed.
doi:10.1186/1472-6947-12-52
PMCID: PMC3408324  PMID: 22681782
2.  Validity of a Low Literacy Version of the Decisional Conflict Scale 
Patient education and counseling  2011;85(3):521-524.
Objective
To evaluate the psychometric properties of the 4-factor low literacy Decisional Conflict Scale (DCS-LL) with men eligible for prostate cancer screening (PCS).
Methods
We used baseline (T0; n = 149) and post-intervention (T2; n = 89) data from a randomized, controlled trial of a PCS decision aid to assess internal consistency reliability and construct, discriminant, and factor validity.
Results
There was evidence of excellent internal consistency reliability (α’s ≥ .80) and fair construct validity (most r’s ≥ .40) for the DCS-LL except for the Supported subscale. The DCS-LL was able to discriminate between men who had decided and those who had not. There was evidence for the original 4-factor model at T0 but exploratory analysis suggested a 3-factor solution at T0 and T2 with Informed and Value Clarity as one factor.
Conclusion
For men eligible for PCS, feeling informed and feeling clear about values may not reflect distinct cognitive processes. Feeling supported may not be a factor contributing to uncertainty. Research should address whether current DCS subscales best represent the factors that contribute to uncertainty for PCS and for other screening decisions. Research should also explore the influence of health literacy on the factor structure of the DCS-LL.
doi:10.1016/j.pec.2010.12.012
PMCID: PMC3121898  PMID: 21300518
decisional conflict; decision making; prostate cancer screening; measurement; validity; psychometrics
3.  Sources of heterogeneity in hepatitis B virus (HBV) seroprevalence estimates from U.S. adult incarcerated populations: A systematic review and meta-regression analysis 
HBV seroprevalence estimates from U.S. incarcerated populations are relatively high. However, the usefulness of these estimates for guiding HBV-related correctional healthcare policy is limited by wide variation in estimates across studies and little understanding of the sources of this variation. The authors systematically reviewed studies indexed from 1975–2005, meeting pre-specified criteria and reporting HBV seroprevalence estimates from U.S. adult incarcerated populations. Using meta-regression techniques, the authors investigated report type, geographical region, serum collection year, facility type, serum source, sampling procedures, sample characteristics, and measurement procedures as potential study-level sources of heterogeneity in prevalence estimates for common HBV seromarkers. In bivariable meta-regression analyses, mean age ≥31 years was strongly associated with increased HBsAg prevalence (POR=2.6), and serum collection year before 1991 was strongly associated with increased prevalence of any positive marker (POR=2.0). Other moderate-to-strong associations were observed, but these were considered less certain because of small numbers of observations, influence of single studies, or potential confounding. Potential sources of heterogeneity should be considered when comparing HBV seroprevalence estimates in adult U.S. incarcerated populations and when developing HBV screening and vaccination protocols in correctional settings.
PMCID: PMC3089417  PMID: 21556292
hepatitis; prison; prisoner health; correctional healthcare; meta-analysis
4.  Heterogeneity in Hepatitis B Virus (HBV) Seroprevalence Estimates from U.S. Adult Incarcerated Populations 
Annals of epidemiology  2009;19(9):647-650.
doi:10.1016/j.annepidem.2009.04.001
PMCID: PMC2856929  PMID: 19596205
Hepatitis; Incarceration; Prison; Prisoners; Meta-Analysis

Results 1-4 (4)