Dimensionality, variance composition, and development of a brief form of the duke health profile, and its measurement invariance across five gender identity groups

Abstract

Objective

To conduct advanced psychometric analyses on the Duke Health Profile, a popular measure of health-related quality of life.

Design

Online survey. Data (N = 1233, 34.3% transgender) were from community and college participants. Dimensionality was assessed for the first time using exploratory factor analysis (EFA) with part of the sample, followed by single- and multi-group confirmatory factor analyses (CFA) with the balance of the sample.

Results

EFA resulted in a 14-item three factor structure: mental, physical and social health. CFA estimated four models (common factors, bifactor, hierarchical, unidimensional), none demonstrated adequate fit. From another EFA specifying one factor, the 6-item Duke Health Profile-Brief Form was developed based on updated guidelines for shortening composite measurement scales, which was assessed using CFA, finding good fit to the data. Measurement invariance by gender was assessed across the diverse gender spectrum, finding evidence for configural, metric, and partial scalar invariance.

Conclusions

There is insufficient evidence to use the general, mental, social and physical health scores of the DUKE Health Profile. However, there is evidence supporting the use of the unidimensional DUKE-BF, which is largely invariant between cisgender men and women, transgender men and women, and transgender men and non-binary participants.

Keywords:

• Health related quality of life
• Duke Health Profile
• transgender
• confirmatory factor analysis
• measurement equivalence/ invariance

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [RFL], upon reasonable request.