Validity and Reliability of a Bilingual Healthcare Discrimination Scale Among Churchgoing Latino Adults in Los Angeles

TL;DR

This study developed and tested a bilingual healthcare discrimination scale for churchgoing Latino adults in Los Angeles, finding it to be valid and reliable.

Contribution

The study introduces a validated bilingual healthcare discrimination scale for use with Latino populations.

Findings

The HCD scale showed high internal consistency (Cronbach’s α = 0.92) across the sample.

The scale demonstrated good convergent and discriminant validity with depression and acculturation scales.

Confirmatory factor analysis supported a one-factor structure for the HCD scale.

Abstract

Healthcare discrimination is an important barrier to accessing services among Latino populations in the United States. However, few validated scales have been developed to systematically examine this issue. In this study, we evaluated the validity and reliability of a bilingual healthcare discrimination scale in a sample of churchgoing Latino adults in Los Angeles, California. The study sample included 336 participants (foreign-born: 250; US-born: 86) who attended 12 Catholic churches in Los Angeles. Psychometric testing of the 7-item healthcare discrimination (HCD) scale included internal consistency; split-half reliability; convergent, discriminant, and predictive validity; and confirmatory factor analyses. The HCD had relatively high internal consistency (full sample Cronbach’s α = 0.92; foreign-born: 0.91; US-born: 0.92) and showed good convergent and discriminant validity, as it was moderately correlated with the depression scale (full sample r = 0.28, p < 0.001) and weakly correlated with the acculturation scale (full sample r = 0.15, p = 0.008). Confirmatory factor analyses yielded further support for a one-factor solution. Our study finds that the HCD is a valid and reliable scale for use among churchgoing Latino adult populations in the United States. Future studies should examine the psychometric properties of the HCD among Latinos of diverse backgrounds, geographic locations, religious beliefs, and languages.