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      Prevalencia de síntomas depresivos e invarianza factorial de la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D) en población indígena mexicana Translated title: Prevalence of depressive symptoms and factorial invariance of the Center for Epidemiologic Studies (CES-D) Depression Scale in a group of Mexican indigenous population

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          Abstract

          Resumen Introducción. La versión breve de la Escala de Depresión del Centro de Estudios Epidemiológicos (CES- D) es un recurso factible para la tamización de los síntomas de depresión en la población general, pero no se ha reportado la prevalencia en la población indígena, ni su invarianza factorial en Latinoamérica. Objetivo. Describir la prevalencia de los síntomas dedepresión y la invarianza factorial de la versión breve de la escala CES-D en población indígena mexicana. Materiales y métodos. Se hizo un estudio transversal en una muestra representativa de 37.165 adultos mexicanos de 20 a 59 años de edad. La identidad indígena se determinó mediante el propio reporte de la persona como hablante de una lengua indígena. Se conformaron ocho grupos de análisis según el sexo, el alfabetismo y el ser indígena. Se describió la prevalencia de los síntomas depresivos en cada grupo, así como la invarianza factorial de la configuración de los perfiles mediante un análisis factorial exploratorio. Las matrices de varianza y covarianza se compararon entre pares de perfiles usando el test modificado de Mantel. Resultados. La prevalencia de síntomas depresivos en mujeres indígenas que sabían leer fue de 16,8 % (IC95%: 13,4-20,3); en mujeres indígenas que no sabían leer, de 21,3 % (IC95%: 15,5-27,1); en hombres indígenas que sabían leer de 8,5 % (IC95%: 6,0-11,1), y en hombres indígenas que no sabían leer de 10,4 % (IC95%: 5,2-15,6). No se encontraron diferencias significativas en las cargas factoriales entre los perfiles. Conclusión. Se reportó una menor prevalencia de síntomas depresivos en indígenas que en la población no indígena. La escala CES-D en su versión breve mostró invarianza factorial al emplearla en la población indígena.

          Translated abstract

          Abstract Introduction: The short version of the Center for Epidemiologic Studies (CES-D) Depression Scale is a viable tool for screening depressive symptomatology in the general population, but its factorial invariance for indigenous populations in Latin America has not been reported. Objective: To describe the differences in the prevalence of depressive symptomatology and the factorial invariance of the short version of the CES-D scale for the Mexican indigenous population. Materials and methods: We conducted a cross-sectional study with a representative sample of 37,165 Mexican adults aged 20 to 59 years. Indigenous identity was determined by self-report of being a speaker of an indigenous language. Eight groups of analysis were created according to gender, literacy, and being indigenous. An exploratory factor analysis was used to describe the prevalence of depressive symptoms as measured by the short version of the CES-D, as well as the configuration factorial invariance of the profiles. The variance-covariance matrices of the pairs of profiles were compared using the modified Mantel test. Results: The prevalence of depressive symptoms was 16.8% (95% CI: 13.4-20.3) for indigenous women who could read, 21.3% (95% CI: 15.5% 27.1) for indigenous women who could not read, 8.5% (95% CI: 6.0-11.1) for indigenous men who could read, and 10.4% (95% CI: 5.2-15.6) for indigenous men who could not read. No significant differences in the factorial loads of the profiles were found. Conclusion: The prevalence of depressive symptoms in indigenous people is lower than in the non-indigenous population. The factorial invariance of the CES-D scale was high for the indigenous population.

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          An essay on measurement and factorial invariance.

          Analysis of subgroups such as different ethnic, language, or education groups selected from among a parent population is common in health disparities research. One goal of such analyses is to examine measurement equivalence, which includes both qualitative review of the meaning of items as well as quantitative examination of different levels of factorial invariance and differential item functioning. The purpose of this essay is to review the definitions and assumptions associated with factorial invariance, placing this formulation in the context of bias, fairness, and equity. The connection between the concepts of factorial invariance and item bias (differential item functioning) using a variant of item response theory is discussed. The situations under which different forms of invariance (weak, strong, and strict) are required are discussed. Establishing factorial invariance involves a hierarchy of levels that include tests of weak, strong, and strict invariance. Pattern (metric or weak) factorial invariance implies that the regression slopes are invariant across groups. Pattern invariance requires only invariant factor loadings. Strong factorial invariance implies that the conditional expectation of the response, given the common and specific factors, is invariant across groups. Strong factorial invariance requires that specific factor means (represented as invariant intercepts) also be identical across groups. Strict factorial invariance implies that, in addition, the conditional variance of the response, given the common and specific factors, is invariant across groups. Strict factorial invariance requires that, in addition to equal factor loadings and intercepts, the residual (specific factor plus error variable) variances are equivalent across groups. The concept of measurement invariance that is most closely aligned to that of item response theory considers the latent variable as a common factor measured by manifest variables; the specific factors can be characterized as nuisance variables. Invariance of factor loadings across studied groups is required for valid comparisons of scale score or latent variable means. Strong and strict invariance may be less important in the context of basic research in which group differences in specific factors are indicative of individual differences that are important for scientific exploration. However, for most applications in which the aim is to ensure fairness and equity, strict factorial invariance is required. Health disparities research often focuses on self-reported clinical outcomes such as quality of life that are not observed directly. Latent variable models such as factor analyses are central to establishing valid assessment of such outcomes.
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            Encuesta Nacional de Salud y Nutrición 2012: diseño y cobertura

            Objetivo. Describir el diseño y cobertura de la Encuesta Nacional de Salud y Nutrición 2012 (ENSANUT 2012). Material y métodos. Se presenta el diseño de la ENSANUT 2012, una encuesta poblacional probabilística con esquema de muestreo polietápico y estratificado, las capacidades inferenciales de la muestra, los aspectos logísticos de la misma y la cobertura alcanzada en campo. Resultados. La tasa de repuesta para hogar de la ENSANUT 2012 fue de 87%, con un total de 50 528 hogares con entrevista completa efectiva. En estos hogares, se obtuvieron un total de 96 031 entrevistas individuales completas, más 14 104 entrevistas completas de usuarios ambulatorios de los servicios de salud. Conclusión. El diseño probabilístico de la ENSANUT 2012 y la cobertura alcanzada permiten realizar inferencias sobre condiciones de salud y nutrición, cobertura de programas y acceso de la población a los servicios de salud. Al tratarse de un diseño complejo, es necesario que las estimaciones que se realicen a partir de la ENSANUT 2012 consideren el diseño muestral de la encuesta: factores de ponderación, unidades primarias de muestro y variables de estratificación.
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              The impact of culture on the cognitive structure of illness.

              This paper presents a theoretical framework for understanding the impact of culture on the processes of symptom recognition, labeling, and help-seeking and consequently on large-scale epidemiological studies involving different ethnic groups. We begin with the assumption that the subjective experience of illness is culture-bound and that the cognitive and linguistic categories of illness characteristic of any culture constrain the interpretative and behavioral options available to individuals in response to symptoms. We hypothesize the existence of learned cognitive structures, through which bodily experiences are filtered, that influence the interpretation of deviations from culturally-defined physical and mental health norms. Certain contradictory findings concerning the self-reported health of Mexican Americans are discussed in order to illustrate the impact of culture on perceived health status.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                bio
                Biomédica
                Biomédica
                Instituto Nacional de Salud (Bogotá, Cundinamarca, Colombia )
                0120-4157
                May 2018
                : 38
                : suppl 1
                : 127-140
                Affiliations
                [2] Bucaramanga Santander orgnameUniversidad Industrial de Santander orgdiv1Facultad de Salud orgdiv2Escuela de Medicina Colombia
                [1] Cuernavaca orgnameEscuela de Salud Pública de México México
                [3] Barranquilla Atlántico orgnameUniversidad del Norte orgdiv1Departamento de Salud Pública Colombia
                [4] Distrito Federal orgnameSecretaría de Salud orgdiv1Servicios de Atención Psiquiátrica México
                Article
                S0120-41572018000500127
                10.7705/biomedica.v38i0.3681
                27566406-5b9f-463f-b089-61aab097fa5a

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 06 October 2017
                : 18 November 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 14
                Product

                SciELO Colombia


                depression,Indigenous population,análisis multivariable,cultura,análisis factorial,salud mental,depresión,población indígena,multivariate analysis,culture,factor analysis,statistical,mental health

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