Scale refinement and initial evaluation of a behavioral health function measurement tool for work disability...

Area of Science:

• Psychometrics
• Health Services Research
• Disability Evaluation

Background:

• Assessing behavioral health functioning is crucial for determining work disability.
• Existing instruments may not adequately capture the nuances of behavioral health in the context of work.
• The Social Security Administration (SSA) requires reliable measures for disability claims.

Purpose of the Study:

• To develop and psychometrically test the SSA-BH instrument using item response theory (IRT).
• To assess behavioral health functioning relevant to work for SSA disability claimants.
• To evaluate the efficiency of a computer adaptive testing (CAT) approach for the SSA-BH instrument.

Main Methods:

• Cross-sectional survey design with IRT calibration simulations.
• Participants included SSA disability claimants (n=1015) and a U.S. adult normative sample (n=1000).
• IRT analyses were used to evaluate the psychometric properties of the SSA-BH instrument across four scales.

Main Results:

• The SSA-BH instrument demonstrated unidimensionality across four scales: mood/emotions, self-efficacy, social interactions, and behavioral control.
• All scales exhibited strong psychometric properties, including reliability, accuracy, and content coverage.
• Simulated 5- or 10-item CATs correlated highly with full item banks, indicating robust ability to characterize behavioral health function.

Conclusions:

• The SSA-BH instrument is a psychometrically sound tool for assessing behavioral health functioning relevant to work.
• The CAT-based approach enables efficient and standardized collection of comprehensive claimant functional information.
• This instrument and approach may significantly aid SSA's work disability programs.