Response to Measurement of Health Panel

Gale Roid, PhD

This is a pleasure for me to be here. It combines two of my passions: the first is people with special needs and special education and the second one is anything to do with tests and measures. I've had the privilege to work on about 40 published tests over the last 30 years, so I come to this with some perspective on how well these folks are doing. I can say that they're following a lot of the really excellent development steps that we use for really big batteries like the Stanford Binet Intelligence Scale. I can say the steps they are going through are those that you really would desire to see in a project like this.

I want to talk about two things: conceptual issues and methodology issues. In terms of conceptual things, the group has really done some good work in having an expert panel. If we are going to make improvements in the quality of life that people have, we have to have multiple dimensions of that. Looking at physical, mental health, social, the values area- these are expansions over the measurement that has gone before. As you saw, with the BRFSS and with the SF-36, they have focused on physical and mental as two dimensions. This group has expanded it to at least two other areas of social and values but also, one of the most interesting things is the questions about the environment the person is in. If the person has no opportunity to get out into the community and as Peg mentioned, this social capital idea, if there may be things that are preventing that person from being able to participate and therefore affecting their quality of life. A couple of other ideas that are very important, I think, is this concept of resilience and how people adjust to their situation and sort of fight back and climb their way back up if they are down. The other thing that we're already been seeing in the data is a factor that I would call optimism. Hope or optimism seems to be a very important dimension of a person's feeling about their quality of life. We’ve already seen there are some very large factors in factor analyses we have been doing on these items that show a very large element of whether or not you feel like you're healthy and your quality of life is good is whether you believe that you have hope, you have a value system perhaps that is less pessimistic and more optimistic.

Let's talk about some methodology points. First of all, as I said that this group is really following some of the major steps that you want to do. We are going to try our best to make it less susceptible to specific backgrounds on the person whether it's their disability or gender or their economic situation or whatever that might be. The technology of doing that is called the study of differential item functioning (or d.i.f.)and we are instituting those analyses into this project and I applaud the group for including those kinds of studies. It's a statistical way of looking at whether the item functions differently. I applaud the group, too, for getting into things like PATH analysis and so on. There are a lot of details of methodology and stuff but I'm sure I might lose you into what's sometimes called the "sadistics" of tests rather than the statistics.