Project Summary
The next-generation Patient-Reported Outcomes Measurement Information System (PROMIS®) has health measures for clinical, research, and population health uses. The project team developed a summary PROMIS-Preference (PROPr) score combining information from 7 PROMIS domains. They estimated crosswalks between PROPr and other summary measures of health. A crosswalk uses the score from one measure to predict another measure’s score, allowing the synthesis of information across surveys and studies.
Research Questions/Aims
- Can PROPr be used to measure the impacts of social determinants of health?
Actionability
- Provide a new measure to better detect the impacts of social determinants of health
- Improve evaluation of the health effects of upstream interventions Inform the prioritization of future interventions targeting social determinants
Outcomes
The primary outcome of this study is the PROPr score. It was compared to several other summary scores of health-related quality of life (HRQoL). The SDoH evaluated in this study include:
|
SDoH Category |
Variables |
|
Access to Care |
Unmet care needs, delay of needed care, paid sick leave, patient-clinician communication satisfaction, primary care providers in county, travel time to medical provider |
|
Demographics |
Age, gender, race, ethnicity |
|
Economic Factors |
Financial strain, household income, personal spending burden for health care, health insurance |
|
Education |
Years of education, health literacy |
|
Healthy Behaviors |
Activity level, overweight, tobacco use, alcohol dependence, stress |
|
Neighborhood Resources |
Access to healthy food, food security, access to parks, transportation, walkability, neighborhood education, neighborhood poverty, neighborhood employment rate, county crime rate |
|
Social Support |
Social support, social isolation, intimate partner violence |
Methodology
A nationally representative online survey will co-administer PROPr along with three other summary measures of health: EuroQol-5D, Health Utilities Index, and Short Form-6D. A bi-directional crosswalk will be developed for PROPr and each of these measures. Four models will be tested for validation (simple linear model using the summary score, two-part model using the summary score, simple linear model using domain-level responses, and two-part model using the domain-level response) with model fit statistics determining the best model.
Three sets of analyses will be performed to demonstrate the ability of PROPr scores to quantify the impact of different social determinants on health outcomes. Ordinary least squares linear regression models will be applied to evaluate the effect of each SDoH on PROPr scores and demonstrate the effect of including SDoH when estimating the impact of chronic health conditions. The impact of the inclusion of SDoH to chronic condition impacts on HRQoL will be assessed by comparing the R-squared of two models. Finally, ordinal logistic regression will be applied to provide head-to-head comparisons of PROPr with a single question about self-rated health.
