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Measuring subjective health among adolescents in Sweden

Hagquist, C. and Andrich, D. (2004) Measuring subjective health among adolescents in Sweden. Social Indicators Research, 68 (2). pp. 201-220.

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The cross-national WHO-study Health Behaviour in School-Aged Children (HBSC) is a comprehensive adolescent survey ongoing in Europe based on a public health perspective. The present study, examining the HBSC-instrument on subjective health, uses the unidimensional Rasch model. Items are analysed with respect to their operating characteristics across the whole range of the subjective health scale and the empirical operation of the response categories intended to be ordered for all items. The study is based on cross-sectional data collected in Sweden during the 1980s and 1990s among students in years five, seven and nine. The analyses reveal that the symptom checklist in the HBSC-instrument does not work consistently with the Rasch model when all eight items are analysed simultaneously. In particular, the response categories do not work as intended. Hence, the original set of eight items should not be used to construct a latent measure of subjective health. In order to bring the instrument to meet the requirements of the Rasch model, three items were removed. The reduced set of five items did work consistently with the model with respect to the response categories, and did show relative invariance across the latent trait. Since a few of the remaining items showed lack of invariance across genders and grades that problem should be solved, if the reduced item set is to be used for post-hoc analyses. Furthermore, the analysis of the reduced set of items suggests that both "somatic" and "psychological" complaints might be considered as parts of one higher order dimension of subjective health. In order to improve the questionnaire, further attention should be paid to the response format of the items.

Item Type: Journal Article
Publisher: Springer
Copyright: © 2004 Kluwer Academic Publishers
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