Children and adolescents in treatment for cancer or in survivorship and ranging from 8 to 17 years of age can complete multiple PROMIS pediatric measures using a computer interface during an outpatient clinic visit or inpatient admission. Findings establish known-group validity for PROMIS pediatric measures in pediatric oncology.

Although much has been written about the utility of applying transactional models to the study of parenting practices, relatively few researchers have used such an approach to examine how children influence maternal wellbeing throughout their development. Using a sample of males from predominantly low-income families, the current study explored reciprocal relations between boys' overt disruptive behavior (boys' ages 5 to 10 years) and maternal depressive symptoms. We then examined this model with youth-reported antisocial behaviors (ASB) and maternal depressive symptoms when the boys were older, ages 10 to 15. In middle childhood, evidence was found for both maternal and child effects from boys' ages 5 to 6 using both maternal and alternative caregiver report of child aggressive behavior. In the early adolescence model, consistent maternal effects were found, and child effects were evident during the transition to adolescence (boys' ages 11 to 12). The findings are discussed in reference to reciprocal models of child development and prevention efforts to reduce both maternal depression and the prevalence of child antisocial behavior. KeywordsMaternal depression; Externalizing behavior; Antisocial behavior; Reciprocal effects; Transactional model Parental psychopathology has been found to be a consistent and robust correlate of children's maladjustment (DelBello and Geller 2001;Goodman and Brumley 1990;Lapalme et al. 1997). Due to the prevalence of depression, especially in women, maternal depression has been the focus of numerous research studies on parental psychopathology and its association with child psychopathology. Findings in the extant literature provide substantial evidence for an association between maternal depression and negative child outcomes, including internalizing and externalizing child problem behaviors (for reviews of this literature, see Beardslee et al. 1998;Cummings and Davies 1994;Gelfand and Teti 1990).In addition to research on the relation between maternal depression and different forms of child psychopathology, associations have been found between child characteristics and parental behavior (Bell and Harper 1977;Elgar et al. 2004;Lytton 1990). Rather than consider parent effects on children and child effects on parents to be separate processes, reciprocal models of socialization regard parenting behaviors and child characteristics as recurrent, transactional exchanges over time, where both parties affect the other (Bell 1968;Sameroff 1995). Whereas there is an extensive body of research on reciprocal effects between child disruptive behavior and aspects of parenting (Bell and Harper 1977;Danforth et al. 1991 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript 2001), substantially less attention has been paid to potential bidirectional effects between child disruptive behavior and parental mental health, such as depressive symptoms, over time. As the social and economic cost of adult depression and its association with negative child outcomes is high (Pin...

Objective To assess minimally important differences (MID) for several pediatric self-report item banks from the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System® (PROMIS®). Methods We presented vignettes comprising sets of two completed PROMIS questionnaires and asked judges to declare whether the individual completing those questionnaires had an important change or not. We enrolled judges (including adolescents, parents, and clinicians) who responded to 24 vignettes (six for each domain of depression, pain interference, fatigue, and mobility). We used item response theory (IRT) to model responses to the vignettes across different judges and estimated MID as the point at which 50% of the judges would declare an important change. Results We enrolled 246 judges (78 adolescents, 85 parents, and 83 clinicians). The MID estimated with clinician data was about 2 points on the PROMIS T-score scale, and the MID estimated with adolescent and parent data was about 3 points on that same scale. Conclusions The MIDs enhance the value of PROMIS Pediatric measures in clinical research studies to identify meaningful changes in health status over time.

BackgroundPediatric self-report should be considered the standard for measuring patient reported outcomes (PRO) among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric proxy-report item banks.MethodsThe PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact). Caregivers (n = 25) of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads). Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432). In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52.ResultsItem content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%), married (70%), Caucasian (64%) and had at least a high school education (94%). Approximately 50% had children with a chronic health condition, primarily asthma, which was diagnosed or treated within 6 months prior to theinterview. The PROMIS proxy sample scored similar or better on the other proxy instruments compared to normative samples.ConclusionsThe initial calibration data was provided by a diverse set of caregivers of children with a variety of common chronic illnesses and racial/ethnic backgrounds. The PROMIS pediatric proxy-report item banks include physical function (mobility n = 23; upper extremity n = 29), emotional distress (anxiety n = 15; depressive symptoms n = 14; anger n = 5), social peer relationships (n = 15), fatigue (n = 34), pain interference (n = 13), and asthma impact (n = 17).

Objectives The objectives of the present study are to investigate the precision of static (fixed-length) short forms versus computerized adaptive testing (CAT) administration, response pattern scoring versus summed score conversion, and test-retest reliability (stability) of the Patient Reported Outcomes Measurement Information System (PROMIS®) pediatric self-report scales measuring the latent constructs of depressive symptoms, anxiety, anger, pain interference, peer relationships, fatigue, mobility, upper extremity functioning and asthma impact with polytomous items. Methods Participants (N = 331) between the ages of 8 and 17 were recruited from outpatient general pediatrics and subspecialty clinics. Of the 331 participants, 137 were diagnosed with asthma. Three scores based on item response theory (IRT) were computed for each respondent: CAT response pattern expected a posteriori estimates, short form response pattern expected a posteriori estimates, and short form summed score expected a posteriori estimates. Scores were also compared between participants with and without asthma. To examine test-retest reliability, 54 children were selected for retesting approximately two weeks after the first assessment. Results A short CAT (maximum 12 items with a standard error of 0.4) was found, on average, to be less precise than the static short forms. The CAT appears to have limited usefulness over and above what can be accomplished with existing static short forms (8–10 items). Stability of the scale scores over a two week period was generally supported. Conclusions The study provides further information on the psychometric properties of the PROMIS pediatric scales and extends the previous IRT analyses to include precision estimates of dynamic versus static administration, test-retest reliability, and validity of administration across groups. Both the positive and negative aspects of using CAT vs. short forms are highlighted.