Development and Initial Validation of a Measure of Parental Racial/Ethnic Discrimination in Pediatric Healthcare.

AIM

The aim of this study was to create a tool capable of measuring parents' experiences of discrimination when obtaining healthcare for their children, capturing their parental identities and perceptions of discrimination in the healthcare setting.

BACKGROUND

Discrimination experiences, including racial, ethnic, and healthcare discrimination, have negative health effects across the lifespan. Parents have an essential role in pediatric healthcare, which is distinct from the role of other caregivers in pediatric and non-pediatric healthcare settings. Though measures of discrimination in healthcare settings exist, few psychometrically valid tools evaluating parents' experiences of healthcare discrimination are readily available.

METHODS

A measure of parental racial/ethnic discrimination in healthcare was developed. Items were generated with theoretical and empirical literature followed by expert panel review. Items were tested among a population of US-based adult parents via online survey using exploratory factor analysis. Reliability, construct, and criterion validity were assessed.

FINDINGS

Item generation resulted in an acceptable pool of test items based on relevance and clarity (mean CVI = 0.94 and 0.70, respectively). Exploratory factor analysis resulted in a two-factor solution, one of which was related to discrimination experiences and demonstrated reliability ( α = 0.90) and construct and criterion validity (r = 0.52-0.74) with existing scales. The final six-item scale measuring parental discrimination experiences offers a way to better understand discrimination experiences unique to parents in the pediatric healthcare setting. Further validation with larger samples utilizing more traditional recruitment practices is recommended.