Adaptation of the Person-Centered Maternity Care scale for people of color in the United States

Abstract

Introduction: Mistreatment by healthcare providers disproportionately affects people of color in the United States (US). The goal of this study is to adapt the global Person-Centered Maternity Care (PCMC) scale to the experiences of people of color in the US using a community-engaged approach. Methods: We conducted expert reviews to improve content validity and cognitive interviews with potential respondents were conducted to assess relevance, comprehension, and comprehensiveness. Surveys of 297 postpartum people, 82% of whom identified as Black, were used for psychometric analysis in which we assessed construct and criterion validity and reliability. The University of California, San Francisco, California Preterm Birth Initiative Community Advisory Board (CAB), which consists of community members, community-based health workers, and social service providers in Northern California, provided input during all stages of the project. Results: Through an iterative process of factor analysis, discussions with the CAB, and a prioritization survey, we eliminated items that performed poorly in psychometric analysis, yielding a 35-item PCMC-US scale with sub-scales for dignity and respect, communication and autonomy, and responsive and supportive care. The Cronbach alpha for the full scale is 0.95 and for the sub-scales is 0.87. Standardized summative scores range from 0 to 100, with higher scores indicating higher PCMC. Correlations with related measures indicated high criterion validity. Conclusions: The 35-item PCMC-US scale and its sub-scales have high validity and reliability in a sample of predominantly Black women. This scale provides a tool to support efforts to reduce the disparities in birth outcomes among people of color.