Psychometric Properties of a Healthcare Discrimination Scale Among Young-Adult Latinos

Abstract

ObjectivesA growing body of research has found that healthcare discrimination is a significant barrier in accessing healthcare among Latino patients. Despite evidence of the effects of perceived discrimination among Latinos, psychometric testing of scales used in previous research is limited. The present study explored the psychometric properties of a healthcare discrimination scale (HDS) among young-adult Latinos.MethodsWe used data from a cross-sectional study of young-adult Latinos, primarily of Mexican heritage, living in rural Oregon. Bilingual, bicultural staff members conducted computer-assisted personal interviews matched by gender with 313 individuals who completed the interview in Spanish (n\u2009=\u2009137) or English (n\u2009=\u2009176). The interview guide included questions for the HDS and the experiences of discrimination (EOD) and acculturation scales, and satisfaction with healthcare services. Psychometric testing included exploratory factor analysis, internal consistency, split-half reliability, and convergent, discriminant, and predictive validity.ResultsThe HDS scale had high internal consistency (Cronbach’s α\u2009=\u20090.92), was strongly correlated with the EOD scale (r\u2009=\u20090.70, p\u2009<\u20090.001), and weakly correlated with the acculturation scale (r\u2009=\u20090.17, p\u2009<\u20090.01). Discriminant validity was stronger among English speakers (r\u2009=\u2009−\u20090.06, p\u2009=\u20090.422). Split-half reliability was 0.87 (p\u2009<\u20090.001). Confirmatory factor analysis yielded a one-factor solution for both Spanish and English language respondents. The HDS was significantly associated with satisfaction with healthcare services, indicative of good predictive validity.ConclusionsThese results suggest that the healthcare discrimination scale is a valid and reliable tool to use among Spanish and English-speaking young-adult Latinos. Further testing is needed among Latinos of other ages and background groups.