The Re-Engineered Discharge for Diabetes Computer Adaptive Test (REDD-CAT): New patient-reported outcome measures that evaluate social determinants of health for persons with Type 2 Diabetes Mellitus

Research Objectives To detail the development of patient-reported outcome measures (PROs) that capture social determinants of health (SDOH) among individuals with Type 2 diabetes mellitus (T2DM). Design Observational survey study. Setting Academic medical center. Participants 225 individuals with T2DM. Interventions N/A. Main Outcome Measures Participants completed five item pools: Healthcare Access (54 items), Medication Adherence (58 items), Illness Burden (47 items), Health-seeking Behavior (56 items), Housing Stability (22 items). Classical test and item response theory analyses were used to develop item banks, computer adaptive tests (CATs), and short forms (SFs). Results Eight new measures were established: Healthcare Access (44 items); Medication Adherence (27 items); Illness Burden (27 items); Housing Stability (20 items); and four Health-Seeking Behavior instruments: Primary Care Provider-Specific (6-item SF), General Beliefs (13 items), Family/Friends-Specific (5-item SF), and Internet-Specific (4-item SF). Exploratory and confirmatory factor analysis (EFA/CFA) supported unidimensionality for all measures. For EFAs, eigenvalue 1-to-2 ratio was >4 and proportion of variance accounted for by eigenvalue 1 was >0.40. Model fit criteria for CFAs (e.g., CFI ≥0.90, TLI ≥0.90, RMSEA Conclusions These PROs are part of the REDD-CAT comprehensive measurement system for SDOH and are candidates for inclusion as standard outcomes measures for use with discharge planning to mitigate readmission risk in people with T2DM. Author(s) Disclosures The authors have no conflicts of interest.