Bayesian multilevel mimic modeling for studying measurement invariance in cross-group comparisons

Luk Bruyneel, Baoyue Li, Allison Squires, Sara Spotbeen, Bart Meuleman, Emmanuel Lesaffre, Walter Sermeus

Research output: Contribution to journalArticlepeer-review


Background: Recent methodological advancements should catalyze the evaluation of measurement invariance across groups, which is required for conducting meaningful cross-group comparisons. Objective: The aim of this study was to apply a state-of-the-art statistical method for comparing latent mean scores and evaluating measurement invariance across managers' and frontline workers' ratings of the organization of hospital care. Methods: On the 87 nursing units in a single institution, French-speaking and Dutch-speaking nursing unit managers' and staff nurses' ratings of their work environment were measured using the multidimensional 32-item practice environment scale of the nursing work index (PES-NWI). Measurement invariance and latent mean scores were evaluated in the form of a Bayesian 2-level multiple indicators multiple causes model with covariates at the individual nurse and nursing unit level. Role (manager, staff nurse) and language (French, Dutch) are of primary interest. Results: Language group membership accounted for 7 of 11 PES-NWI items showing measurement noninvariance. Cross-group comparisons also showed that covariates at both within-level and between-level had significant effects on PES-NWI latent mean scores. Most notably, nursing unit managers, when compared with staff nurses, hold more positive views of several PES-NWI dimensions. Conclusions: Using a widely used instrument for measuring nurses' work environment, this study shows that precautions for the potential threat of measurement noninvariance are necessary in all stages of a study that relies on survey data to compare groups, particularly in multilingual settings. A Bayesian multilevel multiple indicators multiple causes approach can accommodate for detecting all possible instances of noninvariance for multiple covariates of interest at the within-level and between-level jointly.

Original languageEnglish (US)
Pages (from-to)e25-e35
JournalMedical Care
Issue number4
StatePublished - 2017


  • Bayesian structural equation modeling
  • cross-sectional studies
  • hospital work environment
  • nursing
  • psychometrics
  • statistics and numerical data

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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