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J Aging Health. 2012 Sep;24(6):992-1017. doi: 10.1177/0898264312440321. Epub 2012 Apr 10.

A framework for understanding modifications to measures for diverse populations.

Author information

  • 1Institute for Health & Aging, University of California, San Francisco, San Francisco, CA 94118, USA. anita.stewart@ucsf.edu



Research on health disparities and determinants of health disparities among ethnic minorities and vulnerable older populations necessitates use of self-report measures. Most established instruments were developed on mainstream populations and may need adaptation for research with diverse populations. Although information is increasingly available on various problems using these measures in diverse groups, there is little guidance on how to modify the measures. A framework of issues to consider when modifying measures for diverse populations is presented.


The authors describe reasons for considering modifications, the types of information that can be used as a basis for making modifications, and the types of modifications researchers have made. Recommendations are made to test modified measures to assure their appropriateness, and suggestions are provided on reporting modifications in publications using the measures.


The issues open a dialogue about what appropriate guidelines would be for researchers adapting measures in studies of ethnically diverse populations.

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