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验证一种经改良的基于群体的医疗不信任量表在美拉丁裔青年中的适用性。

Validation of a Modified Group-Based Medical Mistrust Scale Among Young Latinx Adults in the United States.

机构信息

Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N Pleasant St, Amherst, MA, 01003, USA.

College of Health, Oregon State University, Women's Building 124, Corvallis, OR, 97331, USA.

出版信息

J Community Health. 2024 Oct;49(5):942-949. doi: 10.1007/s10900-024-01373-2. Epub 2024 Jul 9.

Abstract

Medical mistrust is an important barrier to accessing health care among Latinx populations in the United States (US). However, research on the validity and reliability of medical mistrust scales is limited. We examined the validity and reliability of a modified bilingual version of the Group-Based Medical Mistrust scale (mGBMMS) among a sample of Latinx adults. Participants included 308 Latinx adults (ages 18-25), who responded in Spanish (n = 134) or English (n = 174). Following feedback from bilingual/bicultural staff during the English-Spanish translation process, we made three changes to the original GBMMS. Validation testing of our 12-item mGBMMS scale included: split-half and internal consistency reliability; discriminant, convergent, and predictive validity; and both exploratory and confirmatory factor analyses. The mGBMMS had good internal consistency (overall sample: Cronbach's α = 0.79; Spanish: Cronbach's α = 0.73; English: Cronbach's α = 0.83). The mGBMMS showed good convergent (moderately correlated with the experiences of discrimination scale, r = 0.46, p < 0.001) and discriminant (weakly correlated with the acculturation scale, r = 0.11, p = 0.06) validity. Split-half reliability was 0.71 (p < 0.001). Exploratory and confirmatory factor analyses found a two-factor solution. The mGBMMS was associated with satisfaction with care (OR = 0.60, 95%CI: 0.42-0.87), a sign of good predictive validity. Findings suggest that the mGBMMS is a valid and reliable scale to utilize among bilingual (Spanish/English) populations in the US. Further validation studies should be considered among Latinx respondents of different ages, backgrounds, languages, and US regions.

摘要

医疗不信任是美国拉丁裔人群获得医疗保健的一个重要障碍。然而,关于医疗不信任量表的有效性和可靠性的研究有限。我们在拉丁裔成年人样本中检验了经过修改的双语版群体医疗不信任量表(mGBMMS)的有效性和可靠性。参与者包括 308 名拉丁裔成年人(年龄在 18-25 岁之间),他们以西班牙语(n=134)或英语(n=174)作答。在双语/文化工作人员对英语-西班牙语翻译过程提出反馈后,我们对原始 GBMMS 进行了三项修改。我们对 12 项 mGBMMS 量表的验证测试包括:半分法和内部一致性可靠性;判别、收敛和预测有效性;以及探索性和验证性因素分析。mGBMMS 具有良好的内部一致性(总体样本:克朗巴赫的α=0.79;西班牙语:克朗巴赫的α=0.73;英语:克朗巴赫的α=0.83)。mGBMMS 表现出良好的收敛性(与歧视经历量表中度相关,r=0.46,p<0.001)和判别性(与文化适应量表弱相关,r=0.11,p=0.06)有效性。半分法可靠性为 0.71(p<0.001)。探索性和验证性因素分析发现了一个两因素解决方案。mGBMMS 与护理满意度相关(OR=0.60,95%CI:0.42-0.87),这是一个具有良好预测有效性的标志。研究结果表明,mGBMMS 是一个在具有双语(西班牙语/英语)的美国人群中使用有效且可靠的量表。应该考虑在不同年龄、背景、语言和美国地区的拉丁裔受访者中进行进一步的验证研究。

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