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Biomedical subjects

Kendon J Conrad

Publications and source records attributed to Kendon J Conrad.

7 recordsLinked to original sources
PubMed2007

Relative precision, efficiency and construct validity of different starting and stopping rules for a computerized adaptive test: the GAIN substance problem scale.

Substance abuse treatment programs are being pressed to measure and make clinical decisions more efficiently about an increasing array of problems. This computerized adaptive testing (CAT) simulation examined the relative efficiency, precision and construct validity of different starting and stopping rules used to shorten the Global Appraisal of Individual Needs' (GAIN) Substance Problem Scale (SPS) and facilitate diagnosis based on it. Data came from 1,048 adolescents and adults referred to substance abuse treatment centers in 5 sites. CAT performance was evaluated using: (1) average standard errors, (2) average number of items, (3) bias in person measures, (4) root mean squared error of person measures, (5) Cohen's kappa to evaluate CAT classification compared to clinical classification, (6) correlation between CAT and full-scale measures, and (7) construct validity of CAT classification vs. clinical classification using correlations with five theoretically associated instruments. Results supported both CAT efficiency and validity.

Adolescent↗
PubMed2006

Randomized trial of psychiatric care with representative payeeship for persons with serious mental illness.

OBJECTIVES: This randomized clinical trial assessed whether a community-based representative payee program that was coordinated with psychiatric care from the Department of Veterans Affairs was more effective than customary treatment. METHODS: In the experimental condition representative payeeship was provided by a community agency that worked to enroll clients and coordinate payeeship with clinical care through communication with clinical staff. The control condition consisted of customary clinical care that included the typical availability of representative payeeship. Hypotheses were that, compared with the control group, the experimental group would experience greater enrollment in a representative payee program; improved residential status; improved quality of life, including fewer symptoms of mental illness; less substance abuse; and improved money management. Participants were interviewed at baseline and at six and 12 months. Outcomes were analyzed with analysis of covariance by using covariates from the baseline. RESULTS: A total of 184 participants were enrolled at baseline (94 in the experimental group and 90 in the control group). A total of 152 interviews were completed at six months, and 149 were completed at 12 months. At 12 months, 31 percent of patients in the experimental group and 14 percent of those in the control group were receiving representative payee services. At 12 months, significant positive effects were observed for the experimental group on enrollment in a representative payeeship, alcohol and drug use, quality of life, and money management. Residential status approached significance. CONCLUSIONS: Use of a coordinated representative payee program was found to be effective in improving outcomes at 12 months. Although this evidence supports the wider implementation of a coordinated representative payee program, only 31 percent of the experimental group had their money banked with a representative payee. Therefore, future studies should focus on achieving a better understanding of the causal components of the intervention.

Community Mental Health Services↗
PubMed2006

Development of a Money Mismanagement Measure and cross-validation due to suspected range restriction.

A measure of the tendency to mismanage money was developed in an evaluation of a representative payee program for individuals with serious mental illnesses. A conceptual model was composed to guide item development, and items were tested, revised, added, and rejected in three waves of data collection. Rasch analyses were used to examine measurement properties. The resulting Money Mismanagement Measure (M3) consisted of 28 items with a Rasch person reliability at .72. Restriction of range was likely responsible for the low Rasch reliability. Validity analyses supported the construct validity of the M3. Subsequently, a cross-validation study was conducted on an untreated sample not as susceptible to range restriction. The M3 produced a Rasch person reliability = .85 with good validity. The M3 fills a gap that can facilitate research in the understudied area of money mismanagement.

Cross-Sectional Studies↗
PubMed2004

Comparing traditional and Rasch analyses of the Mississippi PTSD Scale: revealing limitations of reverse-scored items.

This study examined whether Rasch analysis could provide more information than true score theory (TST) in determining the usefulness of reverse-scored items in the Mississippi Scale for Posttraumatic Stress Disorder (M-PTSD). Subjects were 803 individuals in inpatient PTSD units at 10 VA sites. TST indicated that the M-PTSD performed well and could be improved slightly by deleting one item. Factor analysis using raw scores indicated that the reverse-scored items formed the second factor and had poor relationships with normally scored items. However, since item-total correlations supported their usefulness, they were kept. The subsequent Rasch analysis indicated that five of the seven worst fitting items were reverse-scored items. We concluded that using reversed items with disturbed patients can cause confusion that reduces reliability. Deleting them improved validity without loss of reliability. The study supports the use of Rasch analysis over TST in health research since it indicated ways to reduce respondent burden while maintaining reliability and improving validity.

Adult↗
PubMed2002

Representative payee programs for persons with mental illness in Illinois.

OBJECTIVE: Representative payee programs can improve the community tenure of persons with mental illness by ensuring that their basic needs, such as housing, are met. The authors conducted a survey to assess the extent to which representative payee programs are provided by community mental health centers and the criteria used in enrolling clients in these services. METHODS: Community mental health centers under contract to the Illinois Department of Human Services participated in a census survey. Survey questions concerned provision of representative payee programs, service characteristics, and criteria for enrollment in the programs. RESULTS: Representative payee programs were directly provided by 59 percent of the 95 community mental health centers in the sample. More than a third of clients who were receiving intensive services had a representative payee. More than three times as many such clients had a representative payee when agencies provided representative payee programs directly rather than through referrals of family members. Frequently cited criteria for enrollment in a representative payee program included a lack of financial skills (89 percent), a lack of rent money (52 percent), substance abuse (50 percent), homelessness (33 percent), and frequent (37 percent) or long-term (30 percent) hospitalization. The majority of the representative payee programs (76 percent) provided this service to clients who received representative payee services under the mandate of the Social Security Administration. CONCLUSIONS: Given the high proportion of clients of agencies that directly provided representative payee services who were assigned to a representative payee, all community mental health centers that provide intensive services should also directly provide representative payee services in order to improve access to representative payee services.

Community Mental Health Centers↗
PubMed2002

The foot function index with verbal rating scales (FFI-5pt): A clinimetric evaluation and comparison with the original FFI.

OBJECTIVE: To assess the clinimetric value of the Dutch version of the Foot Function Index (FFI) in comparison with the original FFI using verbal rating scales (FFI-5pt) rather than visual analog scales (VAS). METHODS: A prospective study was performed on 206 patients with nontraumatic forefoot complaints. Scoring, internal consistency, and construct validity of the FFI-5pt were compared with those of the original FFI, which rates all items on VAS. We also studied agreement between the scores at baseline and after one and 8 weeks and the scale scores with regard to sex, age, presence of osteoarthritis, limitation of mobility, bodily pain, and poor physical functioning (using SF-36). RESULTS: Some items were not applicable; removal of these items left 2 scales (Pain and Disability) with high internal consistency (alpha = 0.88 to 0.94) and good agreement between both versions (intraclass correlation coefficient 0.64 to 0.79). Principal component analysis with varimax rotation using a forced 2 factor model fitted well (65% explained variance). Test-retest reliability was high (ICC 0.70 to 0.83), while the stability over 8 weeks was lower, but still good (ICC 0.63 to 0.71). Responsiveness to change was low to moderate. However, a small number of patients reported an overall change (19%). Scores of patients with limited mobility and poor physical health (SF-36) were higher than those of patients with fewer physical problems, indicating good concurrent validity. CONCLUSION: The FFI-5pt is a suitable generic measure. Its clinimetric properties are comparable with those of the original FFI. Its administration and data entry are less time consuming. However, responsiveness has to be more exactly assessed in an intervention study.

Aged↗