Measurement bias in caregiver‐report of early childhood behavior problems across demographic factors in an ECHO‐wide diverse sample
Shuting Zheng,
Maxwell Mansolf,
Monica McGrath,
Marie L. Churchill,
Traci A. Bekelman,
Patricia A. Brennan,
Amy E. Margolis,
Sara S. Nozadi,
Theresa M. Bastain,
Amy J. Elliott,
Kaja Z. LeWinn,
Julie A. Hofheimer,
Leslie D. Leve,
Brandon Rennie,
Emily Zimmerman,
Carmen A. Marable,
Cindy T. McEvoy,
Chang Liu,
Alexis Sullivan,
Tracey J. Woodruff,
Samiran Ghosh,
Bennett Leventhal,
Assiamira Ferrara,
Johnnye Lewis,
Somer Bishop,
Environmental influences on Child Health Outcomes
Affiliations
Shuting Zheng
Department of Psychiatry and Behavioral Sciences University of California San Francisco CA USA
Maxwell Mansolf
Department of Medical Social Sciences Feinberg School of Medicine Northwestern University Chicago IL USA
Monica McGrath
Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
Marie L. Churchill
Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
Traci A. Bekelman
Department of Epidemiology Colorado School of Public Health Aurora CO USA
Patricia A. Brennan
Department of Psychology Emory University Atlanta GA USA
Amy E. Margolis
Department of Psychiatry Columbia University Irving Medical Center New York State Psychiatric Institute New York NY USA
Sara S. Nozadi
Community Environmental Health College of Pharmacy Health Sciences Center University of New Mexico Albuquerque NM USA
Theresa M. Bastain
Department of Population and Public Health Sciences University of Southern California Los Angeles CA USA
Amy J. Elliott
Avera Research Institute Sioux Falls SD USA
Kaja Z. LeWinn
Department of Psychiatry and Behavioral Sciences University of California San Francisco CA USA
Julie A. Hofheimer
Department of Pediatrics Division of Neonatal‐Perinatal Medicine North Carolina at Chapel Hill Chapel Hill NC USA
Leslie D. Leve
Prevention Science Institute University of Oregon Eugene OR USA
Brandon Rennie
Health Sciences Center Department of Pediatrics Center for Development and Disability University of New Mexico Navajo Birth Cohort Study Albuquerque NM USA
Emily Zimmerman
Communication Sciences & Disorders Northeastern University Boston MA USA
Carmen A. Marable
School of Medicine University of North Carolina at Chapel Hill Neuroscience Curriculum Chapel Hill NC USA
Cindy T. McEvoy
Department of Pediatrics Pape Pediatric Research Institute Oregon Health & Science University Portland OR USA
Chang Liu
Department of Psychology Washington State University Pullman WA USA
Alexis Sullivan
Center for Health and Community University of California San Francisco CA USA
Tracey J. Woodruff
Department of Psychiatry and Behavioral Sciences University of California San Francisco CA USA
Samiran Ghosh
Department of Biostatistics and Data Science & Coordinating Center for Clinical Trials (CCCT) University of Texas School of Public Health Houston TX USA
Bennett Leventhal
University of Chicago Navajo Birth Cohort Study University of New Mexico Albuquerque NM USA
Assiamira Ferrara
Division of Research Kaiser Permanente Northern California Oakland CA USA
Johnnye Lewis
Navajo Birth Cohort Study Community Environmental Health Program College of Pharmacy University of New Mexico Albuquerque NM USA
Somer Bishop
Department of Psychiatry and Behavioral Sciences Weill Institute for Neurosciences University of California San Francisco CA USA
Abstract Background Research and clinical practice rely heavily on caregiver‐report measures, such as the Child Behavior Checklist 1.5–5 (CBCL/1.5‐5), to gather information about early childhood behavior problems and to screen for child psychopathology. While studies have shown that demographic variables influence caregiver ratings of behavior problems, the extent to which the CBCL/1.5‐5 functions equivalently at the item level across diverse samples is unknown. Methods Item‐level data of CBCL/1.5‐5 from a large sample of young children (N = 9087) were drawn from 26 cohorts in the Environmental influences on Child Health Outcomes program. Factor analyses and the alignment method were applied to examine measurement invariance (MI) and differential item functioning (DIF) across child (age, sex, bilingual status, and neurodevelopmental disorders), and caregiver (sex, education level, household income level, depression, and language version administered) characteristics. Child race was examined in sensitivity analyses. Results Items with the most impactful DIF across child and caregiver groupings were identified for Internalizing, Externalizing, and Total Problems. The robust item sets, excluding the high DIF items, showed good reliability and high correlation with the original Internalizing and Total Problems scales, with lower reliability for Externalizing. Language version of CBCL administration, education level and sex of the caregiver respondent showed the most significant impact on MI, followed by child age. Sensitivity analyses revealed that child race has a unique impact on DIF over and above socioeconomic status. Conclusions The CBCL/1.5‐5, a caregiver‐report measure of early childhood behavior problems, showed bias across demographic groups. Robust item sets with less DIF can measure Internalizing and Total Problems equally as well as the full item sets, with slightly lower reliability for Externalizing, and can be crosswalked to the metric of the full item set, enabling calculation of normed T scores based on more robust item sets.
