Evaluating the longitudinal item and category stability of the SF-36 full and summary scales using rasch analysis

Introduction. The Medical Outcome Study Short Form 36 (SF-36) is widely used for measuring Health-Related Quality of Life (HRQoL) and has undergone rigorous psychometric evaluation using Classic Test Theory (CTT). However, Item Response Theory-based evaluation of the SF-36 has been limited with an overwhelming focus on individual scales and cross-sectional data. Purpose. This study aimed to examine the longitudinal item and category stability of the SF-36 using Rasch analysis. Method. Using data from the 1921-1926 cohort of the Australian Longitudinal Study on Women's Health, responses of the SF-36 from six waves of data collection were analysed. Rasch analysis using Winsteps version 3.92.0 was performed on all 36 items of the SF-36 and items that constitute the physical health and mental health scales. Results. Rasch analysis revealed issues with the SF-36 not detected using classical methods. Redundancy was seen for items on the total measure and both scales across all waves of data. Person separation indexes indicate that the measure lacks sensitivity to discriminate between high and low performances in this sample. The presence of Differential Item Functioning suggests that responses to items were influenced by locality and marital status. Conclusion. Previous evaluations of the SF-36 have relied on cross-sectional data; however, the findings of the current study demonstrate the longitudinal efficacy of the measure. Application of the Rasch Measurement Model indicated issues with internal consistency, generalisability, and sensitivity when the measure was evaluated as a whole and as both physical and mental health summary scales. Implications for future research are discussed

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: study protocol for a pragmatic randomised controlled trial

BACKGROUND: Restorative home care services help older people maximise their independence using a multidimensional approach. They usually include an exercise program designed to improve the older person’s strength, balance and function. The types of programs currently offered require allocation of time during the day to complete specific exercises. This is not how the majority of home care clients prefer to be active and may be one of the reasons that few older people do the exercises regularly and continue the exercises post discharge. This paper describes the study protocol to test whether a Lifestyle Functional Exercise (LiFE) program: 1) is undertaken more often; 2) is more likely to be continued over the longer term; and, 3) will result in greater functional gains compared to a standard exercise program for older people receiving a restorative home care service.METHODS/DESIGN: Design: A pragmatic randomised controlled trial (RCT) design was employed with two study arms: LiFE program (intervention) and the current exercise program (control). Setting: Silver Chain, a health and community care organisation in Perth, Western Australia. Participants: One hundred and fifty restorative home care clients, aged 65 years and older. Measurements: The primary outcome is a composite measure incorporating balance, strength and mobility. Other outcome measures include: physical functioning, falls efficacy, and levels of disability and functioning.DISCUSSION: If LiFE is more effective than the current exercise program, the evidence will be presented to the service management accompanied by the recommendation that it be adopted as the generic exercise program to be used within the restorative home care service

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: study protocol for a pragmatic randomised controlled trial

Background: Restorative home care services help older people maximise their independence using a multidimensionalapproach. They usually include an exercise program designed to improve the older person’s strength,balance and function. The types of programs currently offered require allocation of time during the day tocomplete specific exercises. This is not how the majority of home care clients prefer to be active and may be oneof the reasons that few older people do the exercises regularly and continue the exercises post discharge.This paper describes the study protocol to test whether a Lifestyle Functional Exercise (LiFE) program: 1) isundertaken more often; 2) is more likely to be continued over the longer term; and, 3) will result in greaterfunctional gains compared to a standard exercise program for older people receiving a restorative home careservice.Methods/Design: Design: A pragmatic randomised controlled trial (RCT) design was employed with two studyarms: LiFE program (intervention) and the current exercise program (control).Setting: Silver Chain, a health and community care organisation in Perth, Western Australia.Participants: One hundred and fifty restorative home care clients, aged 65 years and older.Measurements: The primary outcome is a composite measure incorporating balance, strength and mobility. Otheroutcome measures include: physical functioning, falls efficacy, and levels of disability and functioning.Discussion: If LiFE is more effective than the current exercise program, the evidence will be presented to theservice management accompanied by the recommendation that it be adopted as the generic exercise program tobe used within the restorative home care service.Trial registration: Australian and New Zealand Clinica

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial

Background: Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults. Methods: A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention) or the structured exercise program currently being used in the service (control). Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability. Results: There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program. Conclusion: Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes

Long-term Benefits of a Lifestyle Exercise Program for Older People Receiving a Restorative Home Care Service: A Pragmatic Randomized Controlled Trial

Restorative home care services are short term, individualized programs aimed at maximizing an older person’s ability to live independently and maintain their function. The services are made up of a number of components, including an exercise program to increase and maintain function of the older person. The aim of this study was to examine over the longer term, the effectiveness and maintenance of a (modified) lifestyle functional exercise program (LiFE) compared to the current, structured exercise program used in a restorative home care service. A pragmatic randomized controlled trial was employed with two study arms: LiFE (intervention) and a structured exercise program (control). Data were collected at baseline, post-intervention (eight weeks) and six months. No difference between the groups for exercise adherence was found. The LiFE group showed significantly better progress for 25% of the outcomes compared to the structured exercise group over the six months. Community and health care organizations delivering restorative home care services should consider this lifestyle exercise program for their clients. It is particularly appropriate for those older people who are not interested in structured types of exercise, those who will not keep using weights to offer resistance, or those who suggest they have limited time

The Effect of a Student Success Seminar on Student Retention at a Regional University

With approximately half of all students who enter colleges and universities graduating, the problem of student attrition continues to challenge higher education officials. Decades of research studies have been completed on the causes of student persistence and retention, but significant changes have not occurred to increase those numbers. This study attempted to integrate current research with a practical application to increase retention of first-year students. A first-year seminar, known as a student success seminar, was created at the university to teach advanced academic behaviors to incoming freshmen. This study involved a program evaluation of the new seminar as the independent variable and examined the results of those who participated in the seminar (SSS) and those who did not (No SSS). The design compared the two groups of students on five quantitative and two qualitative questions. The quantitative research included second semester retention, grade point average, completion of credit hours, pass rate of a freshmen transitions course, and academic and social integration to campus. The social and academic integration of the students was measured using the Institutional Integration Scale (IIS). The qualitative research included determining whether the students who participated in the seminar had a more positive perception of their overall college experience and an increased confidence in their ability to do well at the university. The study found: (a) no statistically significant difference between the two groups in second semester retention, mean grade point average, credit hours completed, and social integration to the campus. An inverse relationship was found regarding the pass rate of the freshmen transitions course, in which the No SSS students passed at a higher rate then the SSS students. In the area of academic integration, the SSS group showed a statistically significant difference in academic integration to campus, including visiting the library and the multicultural center more often. Additionally, the SSS group indicated a more positive perception of their overall college experience and possessed an increased confidence in their ability to do well in college