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Factor structure and measurement invariance of post-concussion symptom ratings on the Health and Behaviour Inventory across time, raters, and groups: An A-CAP study

Published online by Cambridge University Press:  04 August 2022

Cherri Zhang
Affiliation:
Department of Psychology, University of Calgary, Calgary, AB, Canada
Ken Tang
Affiliation:
Independent Statistical Consultant, Richmond, BC, Canada
Roger Zemek
Affiliation:
Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
Miriam H. Beauchamp
Affiliation:
Department of Psychology, Université de Montréal, Montreal, QC, Canada Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
William Craig
Affiliation:
Department of Pediatrics, University of Alberta, and Stollery Children’s Hospital, Edmonton, AB, Canada
Quynh Doan
Affiliation:
Department of Pediatrics, University of British Columbia, and BC Children’s Hospital Research Institute, Vancouver, BC, Canada
Keith Owen Yeates*
Affiliation:
Department of Psychology, University of Calgary, Calgary, AB, Canada Alberta Children’s Hospital Research Institute and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
*
Corresponding author: Keith O. Yeates, Email: kyeates@ucalgary.ca

Abstract

Objectives:

To validate the two-factor structure (i.e., cognitive and somatic) of the Health and Behaviour Inventory (HBI), a widely used post-concussive symptom (PCS) rating scale, through factor analyses using bifactor and correlated factor models and by examining measurement invariance (MI).

Methods:

PCS ratings were obtained from children aged 8–16.99 years, who presented to the emergency department with concussion (n = 565) or orthopedic injury (OI) (n = 289), and their parents, at 10-days, 3-months, and 6-months post-injury. Item-level HBI ratings were analyzed separately for parents and children using exploratory and confirmatory factor analyses (CFAs). Bifactor and correlated models were compared using various fit indices and tested for MI across time post-injury, raters (parent vs. child), and groups (concussion vs. OI).

Results:

CFAs showed good fit for both a three-factor bifactor model, consisting of a general factor with two subfactors (i.e., cognitive and somatic), and a correlated two-factor model with cognitive and somatic factors, at all time points for both raters. Some results suggested the possibility of a third factor involving fatigue. All models demonstrated strict invariance across raters and time. Group comparisons showed at least strong or strict invariance.

Conclusions:

The findings support the two symptom dimensions measured by the HBI. The three-factor bifactor model showed the best fit, suggesting that ratings on the HBI also can be captured by a general factor. Both correlated and bifactor models showed substantial MI. The results provide further validation of the HBI, supporting its use in childhood concussion research and clinical practice.

Type
Research Article
Copyright
Copyright © INS. Published by Cambridge University Press, 2022

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Factor structure and measurement invariance of post-concussion symptom ratings on the Health and Behaviour Inventory across time, raters, and groups: An A-CAP study
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