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

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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.

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References

  1. Williams, J. S., Walker, R. J., & Egede, L. E. (2016). Achieving equity in an evolving healthcare system: Opportunities and challenges. The American Journal of the Medical Sciences, 351(1), 33–43.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Mahajan, S., Caraballo, C., Lu, Y., Valero-Elizondo, J., Massey, D., Annapureddy, A. R., Roy, B., Riley, C., Murugiah, K., & Onuma, O. (2021). Trends in differences in health status and health care access and affordability by race and ethnicity in the United States, 1999–2018. Jama, 326(7), 637–648.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bazargan, M., Cobb, S., & Assari, S. (2021). Discrimination and medical mistrust in a racially and ethnically diverse sample of California adults. The Annals of Family Medicine, 19(1), 4–15.

    Article  PubMed  Google Scholar 

  4. Griffith, D. M., Bergner, E. M., Fair, A. S., & Wilkins, C. H. (2021). Using mistrust, distrust, and low trust precisely in medical care and medical research advances health equity. American Journal of Preventive Medicine, 60(3), 442–445.

    Article  PubMed  Google Scholar 

  5. López-Cevallos, D. F., Harvey, S. M., & Warren, J. T. (2014). Medical mistrust, perceived discrimination, and satisfaction with Health Care among Young-Adult Rural latinos. The Journal of Rural Health, 30(4), 344–351.

    Article  PubMed  Google Scholar 

  6. Thompson, H. S., Manning, M., Mitchell, J., Kim, S., Harper, F. W., Cresswell, S., Johns, K., Pal, S., Dowe, B., & Tariq, M. (2021). Factors associated with racial/ethnic group–based medical mistrust and perspectives on COVID-19 vaccine trial participation and vaccine uptake in the US. JAMA Network Open, 4(5), e2111629–e2111629.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bogart, L. M., Ojikutu, B. O., Tyagi, K., Klein, D. J., Mutchler, M. G., Dong, L., Lawrence, S. J., Thomas, D. R., & Kellman, S. (2021). COVID-19 related medical mistrust, health impacts, and potential vaccine hesitancy among Black americans living with HIV. JAIDS Journal of Acquired Immune Deficiency Syndromes, 86(2), 200–207.

    Article  CAS  PubMed  Google Scholar 

  8. Minaya, C., McKay, D., Benton, H., Blanc, J., & Seixas, A. A. (2022). Medical mistrust, COVID-19 stress, and intent to vaccinate in racial–ethnic minorities. Behavioral Sciences, 12(6), 186.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. National Academies.

  10. Mateo, C. M., Furtado, K., Plaisime, M. V., & Williams, D. R. (2024). The Sociopolitical Context of the Unequal Treatment Report (p. 43). In. The Urban Institute.

  11. Salsberg, E., Richwine, C., Westergaard, S., Martinez, M. P., Oyeyemi, T., Vichare, A., & Chen, C. P. (2021). Estimation and comparison of current and future racial/ethnic representation in the US health care workforce. JAMA Network Open, 4(3), e213789–e213789.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cain, L., Brady, M., Inglehart, M. R., & Istrate, E. C. (2022). Faculty diversity, equity, and inclusion in academic dentistry: Revisiting the past and analyzing the present to create the future. Journal of Dental Education, 86(9), 1198–1209.

    Article  PubMed  Google Scholar 

  13. Kamran, S. C., Winkfield, K. M., Reede, J. Y., & Vapiwala, N. (2022). Intersectional analysis of US medical faculty diversity over four decades. New England Journal of Medicine, 386(14), 1363–1371.

    Article  PubMed  Google Scholar 

  14. Hispanic Heritage Month (2023). [https://www.census.gov/newsroom/facts-for-features/2023/hispanic-heritage-month.html]

  15. Census Bureau. (2020). Demographic turning points for the United States: Population projections for 2020 to 2060 (p. 15). In. U.S. Department of Commerce.

  16. Benkert, R., Cuevas, A., Thompson, H. S., Dove-Medows, E., & Knuckles, D. (2019). Ubiquitous yet unclear: A systematic review of medical mistrust. Behavioral Medicine, 45(2), 86–101.

    Article  PubMed  Google Scholar 

  17. Jaiswal, J., & Halkitis, P. N. (2019). Towards a more inclusive and dynamic understanding of Medical Mistrust informed by Science. Behavioral Medicine, 45(2), 79–85.

    Article  PubMed  Google Scholar 

  18. Thompson, H. S., Valdimarsdottir, H. B., Winkel, G., Jandorf, L., & Redd, W. (2004). The Group-Based Medical Mistrust Scale: Psychometric properties and association with breast cancer screening. Preventive Medicine, 38(2), 209–218.

    Article  PubMed  Google Scholar 

  19. Jaiswal, J. (2019). Whose responsibility is it to dismantle Medical Mistrust? Future directions for researchers and Health Care Providers. Behavioral Medicine, 45(2), 188–196.

    Article  PubMed  Google Scholar 

  20. Martinez, B., Huh, J., & Tsui, J. (2022). Validating the group-based medical mistrust scale with English and Spanish speaking latino parents of adolescents. The Journal of the American Board of Family Medicine, 35(2), 244–254.

    Article  PubMed  Google Scholar 

  21. Oakley, L. P., López-Cevallos, D. F., & Harvey, S. M. (2019). The Association of Cultural and Structural Factors with Perceived Medical Mistrust among Young Adult latinos in Rural Oregon. Behavioral Medicine, 45(2), 118–127.

    Article  PubMed  Google Scholar 

  22. Kimball, D., Rivera, D., Gonzales, M., & Blashill, A. J. (2020). Medical mistrust and the PrEP cascade among latino sexual minority men. AIDS and Behavior, 24, 3456–3461.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Shelton, R. C., Winkel, G., Davis, S. N., Roberts, N., Valdimarsdottir, H., Hall, S. J., & Thompson, H. S. (2010). Validation of the Group-Based Medical Mistrust Scale among Urban Black men. Journal of General Internal Medicine, 25(6), 549–555.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Valera, P., Boyas, J. F., Bernal, C., Chiongbian, V. B., Chang, Y., & Shelton, R. C. (2018). A validation of the group-based medical mistrust scale in formerly incarcerated black and latino men. American Journal of Men’s Health, 12(4), 844–850.

    Article  PubMed  Google Scholar 

  25. Hambleton, R. K., & Lee, M. K. (2013). Methods for Translating and Adapting Tests to Increase Cross-Language Validity. In: The Oxford Handbook of Child Psychological Assessment. edn. Edited by Saklofske DH, Reynolds CR, Schwean VL. New York, NY: Oxford University Press; : 172–181.

  26. Krieger, N., Smith, K., Naishadham, D., Hartman, C., & Barbeau, E. M. (2005). Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health. Social Science & Medicine, 61(7), 1576–1596.

    Article  Google Scholar 

  27. Benjamins, M. R. (2012). Race/Ethnic discrimination and preventive service utilization in a sample of whites, blacks, mexicans, and Puerto ricans. Medical Care, 50(10), 870–876.

    Article  PubMed  Google Scholar 

  28. Bird, S. T., & Bogart, L. M. (2001). Perceived race-based and socioeconomic status(SES)-based discrimination in interactions with health care providers. Ethnicity and Disease, 11(3), 554–563.

    CAS  PubMed  Google Scholar 

  29. Marin, G., Sabogal, F., Marin, B. V., Otero-Sabogal, R., & Perez-Stable, E. J. (1987). Development of a short acculturation scale for hispanics. Hispanic Journal of Behavioral Sciences, 9(2), 183–205.

    Article  Google Scholar 

  30. Peek, M. E., Nunez-Smith, M., Drum, M., & Lewis, T. T. (2011). Adapting the Everyday discrimination scale to medical settings: Reliability and validity testing in a sample of African American patients. Ethnicity and Disease, 21(4), 502–509.

    PubMed  Google Scholar 

  31. Hendrickson, A. E., & White, P. O. (1964). PROMAX: A QUICK METHOD FOR ROTATION TO OBLIQUE SIMPLE STRUCTURE. British Journal of Statistical Psychology, 17(1), 65–70.

    Article  Google Scholar 

  32. Brown, T. A. (2014). Confirmatory factor analysis for applied research. Guilford.

  33. Stöber, J. (2001). The Social Desirability Scale-17 (SDS-17): Convergent validity, discriminant validity, and relationship with age. European Journal of Psychological Assessment, 17(3), 222–232.

    Article  Google Scholar 

  34. Dovidio, J. F., Gluszek, A., John, M. S., Ditlmann, R., & Lagunes, P. (2010). Understanding bias toward latinos: Discrimination, dimensions of difference, and experience of exclusion. Journal of Social Issues, 66(1), 59–78.

    Article  Google Scholar 

  35. Cano, M., Portillo, A. G. P., Figuereo, V., Rahman, A., Reyes-Martínez, J., Rosales, R., Cano, M. Á., Salas-Wright, C. P., & Takeuchi, D. T. (2021). Experiences of ethnic discrimination among US hispanics: Intersections of language, heritage, and discrimination setting. International Journal of Intercultural Relations, 84, 233–250.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Viruell-Fuentes, E. A. (2007). Beyond acculturation: Immigration, discrimination, and health research among mexicans in the United States. Social Science & Medicine, 65(7), 1524–1535.

    Article  Google Scholar 

  37. Zambrana, R. E., & Carter-Pokras, O. (2010). Role of acculturation research in advancing science and practice in reducing health care disparities among latinos. American Journal of Public Health, 100(1), 18.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lazarevic, V., Guan, S-S-A., & Weisskirch, R. S. (2022). Experiences of discrimination and language brokering: Exploring risks and protective factors. Cultural Diversity and Ethnic Minority Psychology.

  39. Gaffney, A., & McCormick, D. (2017). The affordable Care Act: Implications for health-care equity. The Lancet, 389(10077), 1442–1452.

    Article  Google Scholar 

  40. Harvey, S. M., Oakley, L. P., Gibbs, S. E., Mahakalanda, S., Luck, J., & Yoon, J. (2021). Impact of Medicaid expansion in Oregon on access to prenatal care. Preventive Medicine, 143, 106360.

    Article  PubMed  Google Scholar 

  41. Sáenz, R., & Mamani, D. (2022). The Demography of the Latino Spanish Speakers in the United States. In: The Spanish Language in the United States. edn. Edited by Cobas J, Urciuoli B, Feagin J, Delgado D. New York, NY: Routledge; : 48–62.

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Acknowledgements

We are grateful for all study participants and the bilingual/bicultural research team members whose expertise and community trust and connections made the project possible.

Funding

The parent study was funded by the Centers for Disease Control and Prevention (CDC, cooperative agreement U01DP000123A). The views expressed in this article are the responsibility solely of the authors and do not necessarily represent the official views of the CDC. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

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Authors and Affiliations

  1. 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

    Daniel F. López-Cevallos

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

    S. Marie Harvey

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  1. Daniel F. López-Cevallos
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Contributions

D.L-C: Writing – review & editing, Writing – original draft, Validation, Software, Methodology, Formal analysis, Data curation, Conceptualization. M.H: Writing – review & editing, Funding acquisition, Supervision, Project administration.

Corresponding author

Correspondence to Daniel F. López-Cevallos.

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Ethics Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research protocol was approved by the Institutional Review Board at Oregon State University (# 4052). Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no known competing commercial interests or personal relationships that could have appeared to influence the work reported in this paper.

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mGBMMS: The modified Group-Based Medical mistrust Scale (English & Spanish)

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López-Cevallos, D.F., Harvey, S.M. Validation of a Modified Group-Based Medical Mistrust Scale Among Young Latinx Adults in the United States. J Community Health (2024). https://doi.org/10.1007/s10900-024-01373-2

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