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. 2015 Oct;16(7):978-86.
doi: 10.1007/s11121-015-0545-z.

Increasing the Sensitivity of Measures to Change

Free PMC article

Increasing the Sensitivity of Measures to Change

Carlotta Ching Ting Fok et al. Prev Sci. .
Free PMC article


Little attention is paid in prevention research to the ability of measures to accurately assess change, termed "responsiveness" or "sensitivity to change." This paper reviews definitions and measures of responsiveness, and suggests five strategies for increasing sensitivity to change, with central focus on prevention research with small samples: (a) improving understandability and cultural validity, (b) assuring that the measure covers the full range of the latent construct being measured, (c) eliminating redundant items, (d) maximizing sensitivity of the device used to collect responses; and (e) asking directly about change. Examples of the application of each strategy are provided. The discussion focuses on using the issues as a checklist for improving measures and the implications of sensitivity to change for prevention research with small samples.

Keywords: Alaska Native; Item response theory; Sensitivity to change; Small sample methodology.

Conflict of interest statement

The authors declare that they have no conflict of interest.


Figure 1
Figure 1
Illustrations of scales whose items do and do not cover the full range of a latent trait as it is found in the population. Circles represent items and the rug plot represents persons. The bottom scale would be sensitive to change only in the highest ranges of the latent trait, whereas the top scale could detect change at any level of the latent trait.
Figure 2
Figure 2
Comparison of trace lines for the five- (A) and three-category (B) calibrations for an item in the Multicultural Mastery Scale (Fok et al., 2011a).

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