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Ron Hays
Works at UCLA
Attended UC Riverside
Lives in Cerritos
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Drake, C., Hays, R. D., Morlock, R., Wang, F., Shikiar, R., Frank, L., Downey, R., & Roth, T.  (in press).  Development and evaluation of a measure to assess restorative sleep.  Journal of Clinical Sleep Medicine.

ABSTRACT
Background:  There are validated measures assessing insomnia and disturbed sleep, but few psychometrically sound instruments to assess perceptions of the restorative or inadequate properties of sleep are available.
Study Objectives:  To develop and evaluate a new instrument, the Restorative Sleep Questionnaire (RSQ).
Design and Setting:  Focus groups were conducted using participants with and without nonrestorative sleep complaints. Questions were designed to elicit the feelings and experiences people have about their sleep and their view of daytime consequences of sleep. Expert panels confirmed the importance of nonrestorative sleep (NRS) as a frequently encountered problem either with or without other sleep complaints. The resulting RSQ was administered in three studies: 1) a telephone interview with healthy controls and individuals with sleep problems; 2) a randomized clinical trial of patients with primary insomnia assessed by polysomnography (PSG); 3) a PSG study of subjects with NRS complaints.
Measurement and Results: Across all studies, the new measures were shown to be significantly correlated with health-related quality of life (HRQL) domains hypothesized to be related to NRS.  The RSQ had good psychometric properties (α > .90; rtest-retest  > .80) and factor analysis confirmed the unidimensionality of the measure. The RSQ was able to distinguish between healthy controls, patients with primary insomnia, and insomnia patients with isolated NRS complaints but without PSG defined sleep onset, duration, or maintenance problems.  Normal sleepers reported sleep that was about a standard deviation more restorative than that of those with NRS on the RSQ.
Conclusions:  The results of the study provide support for the reliability and validity of the RSQ as a measure of NRS in subjects with and without self-reported or PSG confirmed sleep initiation and maintenance difficulties.

http://www.aasmnet.org/jcsm/AcceptedPapers/JC-328-13.pdf
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Weidmer, B., Cleary, P. D., Keller, S., Evensen, C., Hurtado, M., Kosiak, B., Gallagher, P., Levine, R., & Hays, R. D. (in press).  Development and testing of a CAHPS® in-center hemodialysis survey.  American Journal of Kidney Diseases.

Abstract
Background. The U.S. Centers for Medicare & Medicaid Services (CMS) assesses patient experiences of care as part of the End Stage Renal Disease (ESRD) Prospective Payment System and Quality Incentive Program. This article describes the development and evaluation of the Consumer Assessment of Healthcare Providers and Systems In-Center Hemodialysis survey (CAHPS® ICH survey).
Study Design. We conducted formative research to generate survey questions and conducted statistical analyses of survey responses to evaluate the survey’s measurement properties.
Setting and Participants. Formative research included 5 focus groups (2 with hemodialysis patients, 2 with caregivers, 1 with nephrologists) and 56 cognitive interviews with dialysis patients. We collected field test responses to the survey from 1454 dialysis patients receiving care at 32 facilities.
Measurements & Outcomes. We assessed the CAHPS ICH Survey.
Results. Response rate was 46%. Analyses support 3 multi-item scales: Nephrologists’ Communication and Caring (7 items, Cronbach’s alpha = 0.89); Quality of Dialysis Center Care and Operations (22 items, alpha = 0.93); and, Providing Information to Patients (11 items, alpha = 0.75). The communication scale was the most strongly correlated with the global rating of the ‘kidney doctor’ (r = 0.78). The Dialysis Center Care and Operations scale was most strongly correlated with the global ratings of staff (r = 0.75) and of the center (r = 0.69). Providing Information to Patients was most strongly correlated with the global rating of the staff (r=0.41).
Limitations. Males and younger patients were over-represented in the field test compared to the general U.S. population of dialysis patients. A relatively small number of patients completed the survey in Spanish.
Conclusions. This study provides support for the reliability and validity of the CAHPS ICH survey for assessing ESRD patient experiences of care at dialysis facilities. The survey can be used to compare care provided at different facilities.
 
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Hays, R. D., Berman, L. J., Kanter, M. H., Hugh, M., Oglesby, R. R., Kim, C. Y., Cui, M., & Brown, J.  (in press).  Evaluating the psychometric properties of the CAHPS patient-centered medical home survey.  Clinical Therapeutics.

Abstract:                                                             
Purpose. To evaluate the reliability and validity of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Patient-Centered Medical Home Survey.  Methods. We conducted a field test of the CAHPS patient-centered medical home (PCMH) survey with 2,740 adults collected by mail (n = 1,746), phone (n = 672), and web (n = 322) from 6 sites of care affiliated with a west-coast staff model health maintenance organization.  Findings. An overall response rate of 37% was obtained. Internal consistency reliability estimates for 7 multi-item scales were as follows: access to care (5 items, alpha = 0.79), communication with providers (6 items, alpha = 0.93), office staff courtesy and respect (2 items, alpha = 0.80), shared decision-making about medicines (3 items, alpha = 0.67), self-management support (2 items, alpha = 0.61), attention to mental health issues (3 items, alpha = 0.80), and care coordination (4 items, alpha = 0.58).   The number of responses needed to get reliable information at the site of care level for the composites was generally acceptable (< 300 for 0.70 reliability-level) except for self-management support and shared decision-making about medicines. Item-scale correlations provided support for distinct composites except for access to care and shared decision-making about medicines, which overlapped with the communication with providers scale. Shared decision-making and self-management support were significantly uniquely associated with the global rating of the provider (dependent variable) along with access and communication in a multiple regression model.  Implications. This study provides further support for the reliability and validity of the CAHPS PCMH survey, but refinement of the self-management support and shared decision-making scales is needed.  The survey can be used to provide information about the performance of different health plans on multiple domains of health care, but future efforts to improve some of the survey items is needed.
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Arthritis Care Res (Hoboken). 2014 Apr 1. doi: 10.1002/acr.22337.
Nagaraja V1, Hays RD, Khanna PP, Spiegel BM, Chang L, Melmed GY, Bolus R, Khanna D.
Construct validity of the Patient Reported Outcomes Measurement Information System (PROMIS®) gastrointestinal symptom scales in systemic sclerosis.

Abstract
Objective: Gastrointestinal (GI) involvement is common in patients with systemic sclerosis (SSc). The Patient-Reported Outcomes Measurement Information System (PROMIS®) GI Symptom item bank captures upper and lower GI symptoms (reflux, disrupted swallowing, nausea/vomiting, belly pain, gas /bloating /flatulence, diarrhea, constipation, and fecal incontinence). The objective of this study was to evaluate the construct validity of the PROMIS-GI bank in SSc. Methods: 167 patients with SSc were administered the PROMIS GI bank and the UCLA Scleroderma Clinical Trials Consortium Gastrointestinal Scale (GIT 2.0) instrument. GIT 2.0 is a multi-item instrument that measures SSc-associated GI symptoms. Product-moment correlations and a multitrait-multimethod analysis of the PROMIS GI scales with the GIT 2.0 symptom scales were used to evaluate convergent and discriminant validity. Results: Patients with SSc GI involvement had PROMIS GI scale scores 0.2-0.7 SD worse than US population. Correlations among scales measuring the same domains for the PROMIS GI and GIT 2.0 measures were large, ranging from 0.61 to 0.87 (average r = 0.77). The average correlation between different symptom scales was 0.22, supporting discriminant validity. Conclusion: This study provides support for the construct validity of the PROMIS GI scales in SSc. Future research is needed to assess the responsiveness to change of these scales in patients with SSc.
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CAHPS care coordination
DOI: 10.1177/1077558713508205 http://mcr.sagepub.com/content/early/2013/11/11/1077558713508205 Med Care Res Rev published online 13 November 2013              Ron D. Hays, Steven Martino, Julie A. Brown, Mike Cui, Paul Cleary...
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Ron Hays

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Riley, W. et al.  (2013).  Sources of comparability between probability sample estimates and nonprobability web sample estimates.  Proceedings of the 2013 Federal Committee on Statistical Methodology (FCSM) Research Conference.
http://www.fcsm.gov/13papers/B4_Riley_2013FCSM.pdf
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Cappelleri, J. C., Lundy, J.J., & Hays, R. D.  (in press).  Overview of classical test theory and item response theory for quantitative assessment of items in developing patient-reported outcome measures.  Clinical Therapeutics.

Abstract
Title. Overview of Classical Test Theory and Item Response Theory for Quantitative Assessment of Items in Developing Patient-Reported Outcome Measures
Introduction. The U.S. Food and Drug Administration’s patient-reported outcome (PRO) guidance document defines content validity as “the extent to which the instrument measures the concept of interest” (FDA, 2009, p. 12).  “Construct validity is now generally viewed as a unifying form of validity for psychological measurements, subsuming both content and criterion validity” (Strauss & Smith, 2009, p. 7).  Hence both qualitative and quantitative information are essential in evaluating the validity of measures. 
Methods. We review classical test theory and item response theory approaches to evaluating PRO measures including frequency of responses to each category of the items in a multi-item scale, the distribution of scale scores, floor and ceiling effects, the relationship between item response options and the total score, and the extent to which hypothesized “difficulty” (severity) order of items is represented by observed responses. 
Conclusion. Classical test theory and item response theory can be useful in providing a quantitative assessment of items and scales during the content validity phase of patient-reported outcome measures.  Depending on the particular type of measure and the specific circumstances, either one or both approaches should be considered to help maximize the content validity of PRO measures.
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Diabetes Educ. 2014 Mar 27.
Calderón JL1, Shaheen M, Hays RD, Fleming ES, Norris KC, Baker RS.
Improving Diabetes Health Literacy by Animation.
Abstract
Purpose and ScopeTo produce a Spanish/English animated video about diabetes; to qualitatively assess cultural and linguistic appropriateness; and to test effectiveness at improving diabetes health literacy among Latino/Hispanics.MethodsParticipatory research and animation production methods guided development of the video. Cultural appropriateness was assessed through focused discussion group methods. A prospective randomized controlled trial tested the effectiveness of the Spanish version at improving diabetes health literacy, compared to "easy to read" diabetes information from the National Institute of Diabetes and Digestive and Kidney Diseases. Functional health literacy was measured by the Short Test of Functional Health Literacy in Adults. Diabetes health literacy was measured by the Diabetes Health Literacy Survey (DHLS).ResultsNo significant differences were recorded between experimental (n = 118) and control groups (n = 122) at baseline on demographic characteristics, Short Test of Functional Health Literacy in Adults score, or DHLS score. Fifty-eight percent of the study participants had inadequate functional health literacy. Mean DHLS score for all participants and those having adequate functional health literacy were 0.55 and 0.54, respectively (inadequate diabetes health literacy). When adjusting for baseline DHLS score, sex, age, and insurance status, DHLS scores improved significantly more in the experimental group than the control group (adjusted mean = 55% vs 53%, F = 4.7, df = 1, P = .03). Interaction between experimental group and health literacy level was significant (F = 6.37, df = 2, P = .002), but the experimental effect was significant only for participants with inadequate health literacy (P = .009).ConclusionsThe positive effect on DHLS scores suggests that animation has great potential for improving diabetes health literacy among Latinos having limited functional health literacy. A study is needed that targets participants with inadequate health literacy and that uses the English and Spanish versions of the video.
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Ron, Pam, Annie, and Tom (celebrating birthday in advance)
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  • UCLA
    Professor, present
  • RAND
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Cerritos
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Long Beach
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Introduction

Ron Hays (PhD, University of California, Riverside, Psychology) is Professor of Medicine at UCLA and a Senior Health Scientist at RAND.    He is one of the Principal Investigators for CAHPS®, a project that has developed measures to assess consumer evaluations of hospitals, nursing homes, group practices, and individual physicians as well as tools to report these assessments to health care providers and consumers.  Dr. Hays has published 430 research articles and 36 book chapters.  He is a member of the special methodology panel for the Journal of General Internal Medicinea former editor-in-chief of Quality of Life Research, and former deputy editor of Medical Care

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  • UC Riverside
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One problem was that the in-room heating system was set on automatic and woke me up when it came on in the wee hours of the morning. The front desk said the next day that maintenance could have been called to change it, but when one is tired and not dressed the last thing you want is to have a visit at 2:30am. Upon checkout the front desk staff gave me a complimentary breakfast voucher, but there was only 10 minutes before my shuttle to a meeting and the wait staff wasn't able to even get me coffee that fast.
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