269458 Evaluation of the factor structure and validity of the Group-Based Medical Mistrust Scale (GBMMS) among a racially and ethnically diverse sample of college students

Tuesday, October 30, 2012 : 1:30 PM - 1:50 PM

Stephanie Kolar, MSPH , Department of Epidemiology, University of South Florida College of Public Health, Tampa, FL
Christopher Wheldon, MSPH, MEd , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Natalie D. Hernandez, MPH , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Ellen Daley, PhD , Community and Family Health, University of South Florida College of Public Health, Tampa, FL
Lauren Young, BA , Department of Epidemiology, College of Public Health, University of South Florida, Tampa, FL
Rasheeta Chandler, PhD, MS, ARNP, FNP-BC , College of Nursing, University of South Florida, Tampa, FL
Nancy Romero-Daza, PhD , Department of Anthropology, University of South Florida, Tampa, FL
BACKGROUND: A growing number of empirical studies have investigated the contributing role of medical mistrust in observed health disparities among racial/ethnic minorities in the U.S. The Group-Based Medical Mistrust Scale (GBMMS) was developed to measure an individual's beliefs regarding the unequal treatment of minorities by medical providers and institutions. Previous research indicates that the GBMMS consists of three factors including “Suspicion” of doctors and healthcare workers, beliefs about “group-based disparities in healthcare,” and beliefs about the “lack of support” from healthcare providers. The psychometric properties of the GBMMS have not yet been established on a sample of young racial/ethnic minorities. The goals of the current study were to (1) explore the latent factor structure of the GBMMS on a diverse sample of young racial/ethnic minorities and (2) assess the reliability/convergent validity of the GBMMS. METHODS: Exploratory and confirmatory factor analyses were conducted on data from a cross-sectional survey of 956 minority students at a large university in the Southeast. The total sample was randomly divided into two split-half samples to explore the factor structure and to validate a modified model. RESULTS: Evidence for the three-factor structure of the GBMMS was not supported. Parallel analysis of the real and randomly generated eigenvalues, as well as an examination of the scree plot, indicated a two-factor solution as the most empirically plausible. These two-factors accounted for 61% of the variance and encompassed the original “suspicion” and “group-based disparities” factors, which were significantly correlated (r=.59). Internal consistency for the “suspicion” and “group-based disparities” subscales were sufficient (.87 and .82, respectively). A modified two-factor model including these subscales garnered some empirical support for its construct validity (RMSEA=.06, CFI=.98). Evidence of convergent validity was found in significant positive correlations between “suspicion” and beliefs in “group-based disparities” with perceived difficulty in talking to a healthcare provider about health concerns (r = .20 and .22, respectively). CONCLUSION: It is important to understand the causes of medical mistrust as it may explain high levels of disengagement of racial/ethnic minorities from healthcare organizations. Comprehension of factors should be considered in clinical practice to facilitate trust building and improve health care provided to racial/ethnic minorities. The continued development of valid instruments to measure medical mistrust will facilitate a deeper theoretical understanding of health disparities in racial/ethnic minorities. The current study provides some support for the psychometric properties of the GBMMS and offers a modified model to improve its construct validity.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
Discuss the importance of measurement instruments for medical mistrust in health disparities research. Identify alternative models of measuring multiple dimensions of group-based medical mistrust among racial and ethnic minorities in the United States.

Keywords: Health Disparities, Minority Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in survey development, data collection, and data analysis for the study from which data for this abstract was drawn. I have worked on a study of an under-served population attending health clinics and several studies focusing on social and behavioral aspects of HPV vaccine uptake and intentions.
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.

Back to: 4231.0: Social Sciences in Health