测量青少年和成年人对研究的不信任:基于群体的医疗不信任量表改编版的效度和信度。

Measuring research mistrust in adolescents and adults: Validity and reliability of an adapted version of the Group-Based Medical Mistrust Scale.

机构信息

Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, Indiana, United States of America.

Office of Evaluation, Indiana University School of Nursing, Indianapolis, Indiana, United States of America.

出版信息

PLoS One. 2021 Jan 22;16(1):e0245783. doi: 10.1371/journal.pone.0245783. eCollection 2021.

Abstract

Mistrust of health care providers among persons of color is a significant barrier to engaging them in research studies. Underrepresentation of persons of color is particularly problematic when the health problem under study disproportionately affects minoritized communities. The purpose of this study was to test the validity and reliability of an abbreviated and adapted version of the Group Based Medical Mistrust Scale. The GBMMS is a 12-item scale with three subscales that assess suspicion, experiences of discrimination, and lack of support in the health care setting. To adapt for use in the research setting, we shortened the scale to six items, and replaced "health care workers" and "health care" with "medical researchers" and "medical research," respectively. Using panelists from a market research firm, we recruited and enrolled a racially and ethnically diverse sample of American adults (N = 365) and adolescents aged 14-17 (N = 250). We administered the adapted scale in a web-based survey. We used Cronbach's alpha to evaluate measure internal reliability of the scale and external factor analysis to evaluate the relationships between the revised scale items. Five of the six items loaded onto a single factor, with (α = 0.917) for adolescents and (α = 0.912) for adults. Mean scores for each item ranged from 2.5-2.9, and the mean summary score (range 6-25) was 13.3 for adults and 13.1 for adolescents. Among adults, Black respondents had significantly higher mean summary scores compared to whites and those in other racia/ethnic groups (p<0.001). There was a trend toward significance for Black adolescents as compared to white respondents and those in other racial/ethnic groups (p = 0.09). This five-item modified version of the GBMMS is reliable and valid for measuring research mistrust with American adults and adolescents of diverse racial and ethnic identities.

摘要

有色人种对医疗服务提供者的不信任是参与研究的一个重大障碍。在研究的健康问题不成比例地影响少数族裔社区的情况下,有色人种代表性不足尤其成问题。本研究的目的是测试群体基础医疗不信任量表(GBMMS)的简化和改编版本的有效性和可靠性。GBMMS 是一个由 12 个项目组成的量表,有三个分量表,评估在医疗保健环境中的怀疑、歧视经历和缺乏支持。为了适应研究环境,我们将量表缩短为六个项目,并分别将“医疗保健工作者”和“医疗保健”替换为“医学研究人员”和“医学研究”。我们使用市场研究公司的小组参与者,招募并纳入了一个种族和民族多样化的美国成年人(N = 365)和 14-17 岁的青少年(N = 250)样本。我们在一个基于网络的调查中使用了改编后的量表。我们使用 Cronbach's alpha 评估量表的内部信度,使用外部因子分析评估修订后的量表项目之间的关系。六个项目中的五个项目加载到一个单一因素上,青少年的(α = 0.917)和成年人的(α = 0.912)。每个项目的平均分数在 2.5-2.9 之间,成年人的平均总分(范围为 6-25)为 13.3,青少年的平均总分(范围为 6-25)为 13.1。在成年人中,黑人受访者的平均总分明显高于白人受访者和其他种族/族裔群体的受访者(p<0.001)。与白人受访者和其他种族/族裔群体的受访者相比,黑人青少年有显著的趋势(p = 0.09)。对于具有不同种族和族裔身份的美国成年人和青少年,这个五项目的 GBMMS 简化版本是可靠和有效的,用于衡量对研究的不信任。

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