The cultural adaptation and psychometric evaluation of the Mothers on Respect Index for Native Hawaiians and Pacific Islanders.


Journal

BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799

Informations de publication

Date de publication:
25 Oct 2024
Historique:
received: 28 07 2024
accepted: 23 09 2024
medline: 26 10 2024
pubmed: 26 10 2024
entrez: 25 10 2024
Statut: epublish

Résumé

Native Hawaiian and Pacific Islanders (NHPI) are disproportionately burdened by pregnancy-related deaths in the United States and have the lowest engagement in prenatal care compared to all other US racial groups. Aside from access barriers, studies suggest that NHPI face challenges with patient-clinician communication, perceived discrimination, and cultural conflicts within healthcare settings. This paper describes the cultural adaptation of the 14-item Mothers On Respect index for NHPI, originally developed by Vedam et al. (2017) for diverse communities in British Columbia, Canada, and reports the findings of the preliminary psychometric assessment of the adapted measure. Data from 26 interviews with NHPI women, expert, and cognitive interviews were conducted to inform the adaptation. An online survey was administered to a sample of 90 NHPI women to assess construct validity, convergent validity, and internal reliability of the adapted measure using exploratory and confirmatory factor analyses. The adaptation resulted in substantial changes to the original measure, mainly by the addition of items related to 'feeling cared for by and connected to the provider' and 'perceived threats hindering communication.' The psychometric analyses identified a three-factor structure for the culturally adapted index and confirmatory factor analyses were employed to refine the measure. The result was a 25-item index with acceptable goodness of fit indices, high internal reliability (Cronbach's alpha of 0.96, 95% CI = .94-.97) and convergent validity with a related scale. Overall, participants in this sample indicated high levels of respectful care; however, people who received < 8 prenatal care visits had significantly lower ratings on average. Our findings suggest that the elements valued by NHPI are not fully captured in existing measures of respectful maternity care. Efforts to assess more discrete aspects of the patient-provider relationship for culturally distinct and racialized groups could help improve the quality of care and advance equity in maternal and perinatal health marginalized communities.

Sections du résumé

BACKGROUND BACKGROUND
Native Hawaiian and Pacific Islanders (NHPI) are disproportionately burdened by pregnancy-related deaths in the United States and have the lowest engagement in prenatal care compared to all other US racial groups. Aside from access barriers, studies suggest that NHPI face challenges with patient-clinician communication, perceived discrimination, and cultural conflicts within healthcare settings. This paper describes the cultural adaptation of the 14-item Mothers On Respect index for NHPI, originally developed by Vedam et al. (2017) for diverse communities in British Columbia, Canada, and reports the findings of the preliminary psychometric assessment of the adapted measure.
METHODS METHODS
Data from 26 interviews with NHPI women, expert, and cognitive interviews were conducted to inform the adaptation. An online survey was administered to a sample of 90 NHPI women to assess construct validity, convergent validity, and internal reliability of the adapted measure using exploratory and confirmatory factor analyses.
RESULTS RESULTS
The adaptation resulted in substantial changes to the original measure, mainly by the addition of items related to 'feeling cared for by and connected to the provider' and 'perceived threats hindering communication.' The psychometric analyses identified a three-factor structure for the culturally adapted index and confirmatory factor analyses were employed to refine the measure. The result was a 25-item index with acceptable goodness of fit indices, high internal reliability (Cronbach's alpha of 0.96, 95% CI = .94-.97) and convergent validity with a related scale. Overall, participants in this sample indicated high levels of respectful care; however, people who received < 8 prenatal care visits had significantly lower ratings on average.
CONCLUSIONS CONCLUSIONS
Our findings suggest that the elements valued by NHPI are not fully captured in existing measures of respectful maternity care. Efforts to assess more discrete aspects of the patient-provider relationship for culturally distinct and racialized groups could help improve the quality of care and advance equity in maternal and perinatal health marginalized communities.

Identifiants

pubmed: 39455922
doi: 10.1186/s12884-024-06856-7
pii: 10.1186/s12884-024-06856-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

702

Subventions

Organisme : NIH HHS
ID : U54MD007601
Pays : United States
Organisme : NIH HHS
ID : U54MD007601
Pays : United States
Organisme : NIH HHS
ID : U54MD007601
Pays : United States
Organisme : NIH HHS
ID : U54MD007601
Pays : United States
Organisme : NIH HHS
ID : U54MD007601
Pays : United States
Organisme : NIH HHS
ID : U54MD007601
Pays : United States

Informations de copyright

© 2024. The Author(s).

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Auteurs

Rebecca Delafield (R)

Department of Native Hawaiian Health, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, 96813, USA. delafiel@hawaii.edu.

Eunjung Lim (E)

Department of Quantitative Health Sciences, University of Hawai'i, John A. Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA.

Ann Chang (A)

Department of Obstetrics, Gynecology, and Women's Health, University of Hawai'i, John A. Burns School of Medicine, 1319 Punahou Street, Room 824, Honolulu, HI, 96826, USA.

Crystal VangTung (C)

Office of Public Health Studies, University of Hawai'i, Thompson School of Social Work and Public Health, 1960 East-West Road, Honolulu, HI, 96822, USA.

Jocelyn Howard (J)

We Are Oceania, 720 North King St., Honolulu, HI, 96817, USA.

Adrienne Dillard (A)

Department of Native Hawaiian Health, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, 96813, USA.
Kula No Nā Po'e Hawai'i, 2150 Tantalus Dr., Honolulu, HI, 96813, USA.

Sunny Chen (S)

Healthy Mothers Healthy Babies Coalition of Hawai'i, 245 Kukui St., Suite 102A, Honolulu, HI, 96817, USA.

Princess Lei Ebbay (PL)

Healthy Mothers Healthy Babies Coalition of Hawai'i, 245 Kukui St., Suite 102A, Honolulu, HI, 96817, USA.

Joseph Keawe'aimoku Kaholokula (JK)

Department of Native Hawaiian Health, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI, 96813, USA.

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