262306 Considering social determinants in maternal and child health: Methods and preliminary findings from the Healthy Beginnings Study

Tuesday, October 30, 2012

Tetine Sentell, PhD , Office of Public Health Studies, Univerisity of Hawaii at Manoa, Honolulu, HI
Kamila Mistry, PhD, MPH , Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
Maria Trent, MD, MPH , Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
Tashi Rowe, BA , Johns Hopkins School of Medicine, Baltimore, MD
Elizabeth McFarlane, PhD, MPH , Hawaii Child Health Research Project Offices, Johns Hopkins University School of Medicine, Honolulu, HI
Tina L. Cheng, MD, MPH , School of Medicine, Johns Hopkins University, Baltimore, MD
Judy Schaechter, MD , Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL
The National Children's Study Formative Research Group on Child Health Disparities , Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
Objective: The appropriate measurement and interpretation of complex constructs, such as discrimination and acculturation across cultural, racial/ethnic, linguistic, and geographical groups is critical to understanding the impact of social determinants on maternal child health. Our objectives are 1) to describe the methods of a formative project of the National Children's Study (the Healthy Beginnings Study) designed to refine and develop instruments to address child health disparities across diverse groups and 2) to present preliminary findings.

Methods: This project utilizes the Dela Cruz method for adapting measures validated for other cultures to produce content, technical, experiential, semantic and conceptual equivalence. Semi-structured cognitive interviews of African-American, Asian/Pacific Islander, White, and Latino mothers with children 0-5 years are being are being conducted across four sites in the United States (Miami, Honolulu, Baltimore and Los Angeles). Respondents are asked to consider measures of discrimination and acculturation and optimal methodologies for reliable data collection.

Results: Preliminary findings (N=9, Target N= 51) demonstrate the variation in the interpretation of discrimination for: (1) differentiation between “unfair treatment” vs. “discrimination”; (2) the salience of race/ethnicity and linguistic attributes as discrimination factors; and (3) geographic context in discrimination. Differences in the conceptualization of acculturation were seen in: (1) the meaning of “US” culture; (2) factors that define culture generally; and (3) the importance of language to cultural inclusion.

Conclusions: Conceptualization and interpretation of key social concepts across diverse respondents must be considered when integrating established measures into national projects. Cognitive interviews can illuminate differences to refine data collection procedures.

Learning Areas:
Diversity and culture
Public health or related research

Learning Objectives:
1. Identify differences in the conceptualization and interpretation of discrimination and acculturation measures across diverse groups. 2. Compare cognitive interview results across diverse racial/ethnic, cultural, linguistic, and geographic groups in order to strengthen our understanding of key constructs in the measurement of discrimination and acculturation.

Keywords: Maternal and Child Health, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I played a key role in this portion of the study analysis and interpretation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.