Use of the SF-36 in low-income Chinese American primary care patients

BACKGROUND. Measures of health status have been increasingly utilized but most research in the United States has been conducted on middle-class, English-speaking white persons. Although Asians reportedly often have a better health status than white persons, previously surveyed samples may not be representative of low-income non-English-speaking Asian immigrant populations. MATERIALS AND METHODS. This cross-sectional study surveyed a convenience sample of low-income Chinese patients attending a community health center in Chinatown (New York City). We sought to evaluate the known-groups validity of self-administered Chinese and English versions of the Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36) and to determine if scores differed from a community-based sample of Chinese Americans and the United States general population. RESULTS. Eight hundred fifty-six persons were approached and data were obtained from 523 participants (61%); 90% completed the questionnaire in Chinese and 74% earned less than $15,000. Known-group comparisons based upon differences in age, gender, and number of medical problems yielded support for the validity of the SF-36 in this sample. The sample's SF-36 subscale scores were lower than scores from the community-based sample of Chinese Americans and tended to be lower than scores from the United States general population. Mean scores were lowest for persons reporting depression, anxiety, or an emotional problem. CONCLUSIONS. The SF-36 demonstrated known-groups validity in this low-income Chinese sample. Collecting data in the primary care setting enables both a better understanding of the relative burden of disease in low-income Chinese and targeted program planning for preventive interventions.