Psychometric Testing of the Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE) in Patients With Heart Failure and Coronary Heart Disease

Abstract

The social determinants of health (SDOH) have been recognized as an important contributor to an individual's health status. A valid and reliable instrument is needed for researchers and clinicians to measure SDOH. However, there is considerable variability in the screening methodologies, as well as a lack of standardization in definitions and methods for capturing and reporting SDOH data for both electronic health record software vendors and national experts on SDOH. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE) is a commonly used instrument for measuring SDOH. We evaluated the psychometric properties of the PRAPARE instrument in patients with coronary heart disease (CHD) and heart failure (HF), focusing on its reliability and validity for assessing SDOH. We assessed internal consistency, test-retest reliability, and construct validity using data from 234 patients with CHD and/or HF recruited from outpatient clinics in Kentucky. The PRAPARE instrument demonstrated high internal consistency (KR-20 score: 0.76) and test-retest reliability (correlation coefficient: 0.88). Factor analysis identified three distinct factors (Factor I: basic necessities and services, Factor II: housing and personal well-being, and Factor III: insurance, education, and work situation) of SDOH. PRAPARE scores were significantly correlated with depressive symptoms (PHQ-9 scores) and functional outcomes of sleep (FOSQ-10 scores). PRAPARE is a reliable and valid instrument for assessing SDOH in patients with CHD and HF, highlighting its potential for clinical and research applications.