Validation of Outcome Measures Used in Hawai‘i's Rural, Integrated Healthcare Settings

As we continue to move toward a person-centered, evidence based healthcare model of integrated service delivery, a more comprehensive understanding of outcome measures is essential. Research indicates health disparities in rural populations in Hawai‘i, specifically among Native Hawaiians. Native Hawaiians experience significantly higher physical and behavioral health risks, poorer health status, and lower life expectancy rates compared to other ethnic groups in Hawai‘i. Contributing to this problem is a lack of valid assessment measures to identify and monitor treatment progress with rural populations. In order to bridge this gap, I Ola Lāhui serves as an organization that incorporates evidence-based practices with and conducts ongoing evaluations of patients served in rural communities. For the past 7 years, I Ola Lāhui has gathered health outcome data using the Short Form Health Survey-12 (SF-12) and Duke Health Profile, two widely used and validated health outcomes measures for different populations across the world but not for individuals from rural communities in Hawai‘i. These self-report questionnaires measure perceived change across physical and mental health domains and have been applied in various community, inpatient, and outpatient settings. Preliminary validity and reliability analyses of the SF-12 and Duke were conducted for patients recruited from various community health centers across the state, 37.8% of whom were Native Hawaiian, with comorbid physical and mental health conditions (N = 347). Results indicate good construct and convergent validity as well as adequate internal consistency for these measures which supports their use with a rural community sample in Hawai‘i.