Hung Dorothy Y, Lubetkin Erica I, Fahs Marianne C, Shelley Donna R
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA.
Med Care. 2009 Feb;47(2):262-7. doi: 10.1097/MLR.0b013e3181844de4.
Health status measures are being used in increasingly diverse populations. However, there are no known studies to date that examine the SF-12 in US Chinese populations. This study reports on the performance and validity of the SF-12 among Chinese immigrants residing in New York City, and evaluates the impact of multiple behavioral risk factors on physical and mental health status.
We used cross-sectional survey data from a multistage probability sample of 2537 Chinese adults. SF-12 scores were examined according to sociodemographic, cultural, and clinical characteristics. Regression analyses were used to examine associations between health status and co-occurring behavioral risk factors of smoking, risky drinking, physical inactivity, and overweight/obesity.
SF-12 scores were significantly lower among women, those with less education, lower incomes, and more health problems (P < 0.001). Older adults had worse physical but better mental health (P < 0.05). Individuals with 1, 2, 3, and 4 behavioral risk factors reported decreases of 1.91, 2.92, 4.86, and 9.21 points on the PCS-12, respectively, in comparison with the reference group having zero risk factors (P < 0.01). Similar trends up to 2 co-occurring risks were observed with MCS-12 scores (P < 0.01).
The SF-12 exhibited known-groups validity in a US Chinese immigrant population. Co-occurring behavioral risk factors were associated with progressive declines in physical health, independent of sociodemographic and clinical characteristics traditionally associated with impairments in health status. Targeting patients with multiple risks for behavior change may be effective in improving health across diverse populations.
健康状况测量方法正应用于越来越多样化的人群。然而，迄今为止尚无研究在美国华裔人群中检验SF-12。本研究报告了居住在纽约市的华裔移民中SF-12的性能和效度，并评估了多种行为危险因素对身心健康状况的影响。
我们使用了来自2537名中国成年人的多阶段概率样本的横断面调查数据。根据社会人口学、文化和临床特征对SF-12得分进行了检查。采用回归分析来检验健康状况与吸烟、危险饮酒、缺乏身体活动和超重/肥胖等同时存在的行为危险因素之间的关联。
女性、受教育程度较低、收入较低以及健康问题较多的人群SF-12得分显著较低（P<0.001）。老年人的身体健康状况较差，但心理健康状况较好（P<0.05）。与没有危险因素的参照组相比，有1、2、3和4种行为危险因素的个体在PCS-12上的得分分别下降了1.91、2.92、4.86和9.21分（P<0.01）。在MCS-12得分方面，观察到了类似的趋势，直至同时存在2种危险因素（P<0.01）。
SF-12在美国华裔移民人群中表现出已知群体效度。同时存在的行为危险因素与身体健康的逐渐下降相关，独立于传统上与健康状况受损相关的社会人口学和临床特征。针对具有多种风险的患者进行行为改变可能对改善不同人群的健康有效。
