Longitudinal Measurement Invariance of Constitution in Chinese Medicine Questionnaire
Objective To explore the longitudinal measurement invariance of standardized Constitution in Chinese Medicine Questionnaire(CCMQ)among Chinese adult populations,and to provide evidence for the longitudinal effect analysis of this questionnaire.Methods A total of 509 adults who voluntarily received 26 weeks of comprehensive traditional Chinese medicine(TCM)constitution fitness intervention were included(3 time points:before interven-tion,13 weeks intervention,and 26 weeks intervention),evaluated by CCMQ with 9 subscales.A single-group confirmatory factor analysis was performed to establish a single-group baseline model with a well-fitting model,and then nested models,that is multiple groups of confirmatory factors analysis,are used to analyze the longitudinal mea-surement invariance,followed by configural invariance,metric invariance,scalar invariance,and strict invariance.Comparative Fit Index(CFI),Root Mean Square Error of Approximation(RMSEA),and Standardized Root Mean Square Residual(SRMR)were used as model fit indicators for the analysis.Results The single-group confirmatory factors analysis proved that the 9 subscales of CCMQ fit well at the three time points(CFI:0.933～0.992,RMSEA:0.027～0.080,SRMR:0.022～0.045).The multiple-group confirmatory factors analysis showed that the configural,metric,scalar,and strict invariance across time of qi-stagnation and special diathesis constitution were established(△CFI＜0.01,△RMSEA＜0.01);the configural,metric,scalar,and partial strict invariance across time of phlegm-dampness constitution subscale were established(△CFI＜0.01,△RMSEA＜0.01);the configural,metric,partial scalar and partial strict invariance of 6 subscales,including gentleness,qi-deficiency,yang-deficiency,yin-deficiency,dampness-heat,and blood-stasis constitutions,were all established(△CFI＜0.01,△RMSEA＜0.01).Conclusion The CCMQ met at least metric invariance at 3 time points,which can be applied to the study of whether different time points have the same unit or meaning.The measurement invariance of the 3 subscales of phlegm-dampness,qi-stagnation and special diathesis,special diathesis have longitudinal measurement invariance,so the mean comparison over time could be made;while the 6 subscales of gentleness,qi-deficiency,yang-deficiency,yin-deficiency,dampness-heat,and blood-stasis constitutions meet partial scalar and partial strict invariance,which could be explained partially for the difference in the comparison of the mean over time.
Constitution in Chinese Medicine Questionnairelongitudinal measurement invarianceconfirmatory factor analysiscomparison over time
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