Detecting psychometric and diagnostic performance of the RU_SATED v2.0 multidimensional sleep health scale in community-dwelling adults combining exploratory graph analysis and ROC analysis

Runtang Meng; Nongnong Yang; Yi Luo; Ciarán O'Driscoll; Haiyan Ma; Alice M Gregory; Joseph M Dzierzewski

doi:10.1016/j.genhosppsych.2024.12.001

Detecting psychometric and diagnostic performance of the RU_SATED v2.0 multidimensional sleep health scale in community-dwelling adults combining exploratory graph analysis and ROC analysis

Gen Hosp Psychiatry. 2024 Dec 3:92:75-83. doi: 10.1016/j.genhosppsych.2024.12.001. Online ahead of print.

Authors

Runtang Meng¹, Nongnong Yang², Yi Luo³, Ciarán O'Driscoll⁴, Haiyan Ma⁵, Alice M Gregory⁶, Joseph M Dzierzewski⁷

Affiliations

¹ School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China; Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou 311121, Zhejiang, China. Electronic address: [email protected].
² School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China.
³ School of Nursing, Ningbo College of Health Sciences, Ningbo, 315100, Zhejiang, China.
⁴ CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, London, WC1E 6BT, UK.
⁵ School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China; Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou 311121, Zhejiang, China.
⁶ Department of Psychology, Royal Holloway, University of London, Egham Hill, Egham TW20 0EX, UK.
⁷ National Sleep Foundation, Washington, DC 20036, USA.

PMID: 39740364
DOI: 10.1016/j.genhosppsych.2024.12.001

Abstract

Objective: The RU_SATED scale is increasingly used across the globe to measure sleep health. However, there is a lack of consensus around its psychometric and diagnostic performance. We conducted an empirical investigation into the psychometrics of the Chinese version of the RU_SATED (RU_SATED-C) scale, with a focus on structural validity and diagnostic performance.

Methods: 1171 adults were enrolled from three communities in Hangzhou, China in July 2022. The dataset was spilt in half, and we ran a bootstrapped exploratory graph analysis (bootEGA) in one half and a confirmatory factor analysis (CFA) in the other half to assess structural validity. Correlations with insomnia, wellness, anxiety, and depression symptoms were examined in order to assess concurrent validity; and Cronbach's α and McDonald's ω were calculated to assess internal consistency. Additionally, a Receiver Operating Characteristic (ROC) analysis established and externally validated the optimal score for identifying insomnia symptoms.

Results: A one-dimensional structure, as identified by bootEGA, was corroborated in the CFA [comparative fit index = 0.934, root mean square error of approximation = 0.088, standardized root mean square residual = 0.051]. A moderate correlation was shown with insomnia symptoms, while weak correlations were observed with wellness, anxiety, and depression symptoms. The RU_SATED-C scale displayed sub-optimal internal consistency where coefficients dropped if any item was removed. A recommended cutoff score of ≤13 was derived for probable insomnia with a satisfactory diagnostic performance.

Conclusion: The RU_SATED-C scale displayed a one-dimensional model, along with adequate concurrent validity, internal consistency, and diagnostic performance. Further work necessitates multi-scenario testing and additional validation using objective sleep assessments.

Keywords: Bootstrap exploratory graph analysis; Community-dwelling adults; Confirmatory factor analysis; Diagnostic performance; Multidimensional sleep health; Psychometric performance; RU_SATED.