Early Half Day Seminars

Wednesday, March 20, 2013 - 12:00 pm - 2:45 pm

Seminar 05: Introduction to Item Response Theory (IRT) and its Applications for Questionnaire Design and Evaluation in Behavioral Medicine

Lead Presenter: Bryce B. Reeve, PhD, University of North Carolina-Chapel Hill, Chapel Hill, NC
Co-Presenter: Angela Stover, Doctoral Student, University of North Carolina-Chapel Hill, Chapel Hill, NC

There is a great need in behavioral medicine research to develop instruments that accurately measure a person's health status with minimal response burden. This need for psychometrically sound and clinically meaningful measures calls for better analytical tools beyond the methods available from traditional measurement theory. Applications of item response theory (IRT) modeling have increased considerably because of its utility for instrument development and evaluation, assessment of differential item functioning (DIF) in subgroups, instrument linking, and computerized adaptive testing.

The IRT framework encompasses a group of models that examine the relationship, in probabilistic terms, between a person's response to a survey question and his/her standing on a behavioral medicine construct such as depression or self-efficacy. Differential item functioning (DIF) involves detection of items behaving differently in subgroups after controlling for the level of the measured construct. IRT and DIF information allows instrument developers to develop reliable and efficient behavioral measures tailored for an individual or group.

This introductory seminar will discuss the basics of IRT models and applications of these models to improve behavioral medicine measurement. Illustrations will be used throughout the presentation that focus on measuring key behavioral health domains in different disease and healthy populations. The NIH Patient-Reported Outcomes Measurement Information System (PROMIS) initiative will be discussed for its relevance for assessing patient-reported outcomes using modern psychometric methods, employing technology to better understand behavioral health, and enhancing clinicians' capabilities to deliver patient-centered medicine.

Seminar 06: An End to Brilliant and Irrelevant Research and Practice: Integrating Behavioral Medicine Research into the Patient Centered Medical Home

Lead Presenter: Rodger Kessler, PhD ABPP. Family Medicine, University of Vermont College of Medicine, Burlington, VT

There is a brilliant research literature demonstrating the efficacy of psychological and behavioral interventions in response to medical presentations. Such research is made irrelevant by its lack of knowledge or use in on the ground medical practice. There is an equally brilliant implementation of models of non single diagnosis specific care integraiting behavioral health clinicians into primary care offices. Such efforts are made irrelevant by lack of effectiveness and cost data and lack of use of evidence based treatments in such settings. The Patient Centered Medical Home (PCMH) is seen as the locus of evidence supported whole person care, with particular attention to lifestyle modifiction and medical, particularly chronic medical conditions. However recent data suggests that a minority of NCQA patient centered medical homes organizationally and clinically respond to behavioral health and health behavioror have evidence based protocols for lifestyle and health behavior change. After this discussion we will review the content and findings from an evidence supported clinical and research program which moves past brilliant and irrelevant towards research and practice integrated into the core of panel based PCMH care. It is supported by an integrated electronic health record that produces behavioral screening which generates point of service provider decision support and quality improvement data for research and evaluation purposes. The presentation will report outcomes in excess of previously reported implementation science literature. We will present progress on development of an integrated health risk appraisal integrating lifestyle assessment measure that will ultimately supplant behavioral health screening and be associated with protocolized data driven behavioral health services.

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