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验证基于群体的医学不信任量表在讲英语和西班牙语的拉丁裔青少年父母中的适用性。

Validating the Group-Based Medical Mistrust Scale with English and Spanish Speaking Latino Parents of Adolescents.

机构信息

From the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles (BM, JH, JT).

出版信息

J Am Board Fam Med. 2022 Mar-Apr;35(2):244-254. doi: 10.3122/jabfm.2022.02.210307.

Abstract

BACKGROUND

Medical mistrust can be a barrier to health care utilization. While the Group-Based Medical Mistrust Scale (GBMMS) has been validated among diverse populations, we know little about its psychometric performance among English-Speaking (ES) and Spanish-Speaking (SS) Latinos. We aim to examine the factor structure of GBMMS among Latino parents and explore whether scale latent factor structures would be different across preferred languages.

METHODS

Parents of adolescents participating in an urban academic enrichment program for low-income students completed an online survey as part of a cross-sectional study about Human Papillomavirus (HPV) prevention. We tested the validity of the GBMMS in ES and SS respondents and performed exploratory factor analysis to identify latent factors. We examined scale scores, item means, item endorsement, and residual variance across language groups.

RESULTS

2-factor latent structure was identified for both ES and SS groups; factors were labeled as 'Suspicion' and 'System-wide discrimination.' Scale validity was better among SS (α = 0.76). Medical mistrust scores did not vary across language groups, but variation emerged in item endorsement by language.

DISCUSSION

Our results suggest that the factor structures of the medical mistrust construct, measured by the GBMMS, are similar across ES and SS Latinos and that the GBMMS is valid for both populations. High factor pattern loading reflects a shared mistrust of how health care systems view and treat people of their racial/ethnic background, independent of their preferred languages. Measurement of medical mistrust and identifying its underlying causes are needed within diverse populations to fully address structural- and community-level influences on health inequities.

摘要

背景

医学不信任可能是获得医疗保健的障碍。虽然群体医学不信任量表(GBMMS)已经在不同人群中得到验证,但我们对其在讲英语(ES)和西班牙语(SS)拉丁裔人群中的心理测量性能知之甚少。我们旨在检查 GBMMS 在拉丁裔父母中的结构,并探讨在首选语言中,量表潜在因素结构是否存在差异。

方法

参与城市学术强化计划的低收入学生的青少年父母作为关于人乳头瘤病毒(HPV)预防的横断面研究的一部分完成了在线调查。我们测试了 ES 和 SS 受访者中 GBMMS 的有效性,并进行了探索性因素分析以确定潜在因素。我们检查了语言群体之间的量表分数,项目均值,项目认可和残差方差。

结果

在 ES 和 SS 组中均确定了 2 因素潜在结构;这些因素被标记为“怀疑”和“系统歧视”。SS 组的量表效度更好(α=0.76)。医疗不信任评分在语言群体之间没有差异,但在语言认可方面存在差异。

讨论

我们的结果表明,由 GBMMS 衡量的医学不信任结构的因素结构在 ES 和 SS 拉丁裔之间是相似的,并且该 GBMMS 对这两个群体都是有效的。高因子模式负荷反映了对医疗保健系统如何看待和对待其种族/族裔背景的人的共同不信任,而与他们的首选语言无关。在不同人群中需要测量医学不信任并确定其潜在原因,以充分解决对健康不平等的结构和社区层面的影响。

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