Explicit discrimination and health: development and psychometric properties of an assessment instrument

Detalhes bibliográficos
Autor(a) principal: Bastos, João Luiz
Data de Publicação: 2012
Outros Autores: Faerstein, Eduardo, Celeste, Roger Keller, Barros, Aluisio J D
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/33102
Resumo: OBJECTIVE: To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events. METHODS: Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refined using cognitive interviews and pilot-testing. The final version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed. RESULTS: Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination. CONCLUSIONS: These findings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health.
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spelling Explicit discrimination and health: development and psychometric properties of an assessment instrument Discriminación explícita y salud: desarrollo y propiedades psicométricas de un instrumento Discriminação explícita e saúde: desenvolvimento e propriedades psicométricas de um instrumento PreconceitoRelações InterpessoaisFatores SocioeconômicosDesigualdades em SaúdePrejuicioRelaciones InterpersonalesFactores SocioeconómicosDesigualdades en la SaludPrejudiceInterpersonal RelationsSocioeconomic FactorsHealth Inequalities OBJECTIVE: To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events. METHODS: Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refined using cognitive interviews and pilot-testing. The final version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed. RESULTS: Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination. CONCLUSIONS: These findings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health. OBJETIVO: Desarrollar instrumento para evaluar los efectos de experiencias discriminatorias sobre condiciones y comportamientos en salud, distinguiendo efectos patológicos de la exposición a tratamientos diferenciales de su interpretación como eventos discriminatorios. MÉTODOS: Versiones sucesivas del instrumento fueron elaboradas con base en una revisión sistemática de la literatura sobre escalas de discriminación, grupos focales y apreciación por un panel de siete especialistas. El refinamiento del instrumento fue alcanzado por medio de entrevistas cognitivas y estudio piloto, de modo que la versión final fue aplicada en 424 estudiantes de pregrado en Rio de Janeiro, sureste de Brasil, en 2010. La estructura dimensional, dos tipos de confiabilidad y validez del constructo fueron evaluadas. RESULTADOS: El análisis factorial exploratorio corroboró la hipótesis de unidimensionalidad del instrumento y siete especialistas indicaron que el presentaba validez de orientación y contenido. La consistencia interna fue de 0,8 y la confiabilidad de la prueba y re-evaluación fue mayor a 0,5 para 14 de los 18 itens. El escore general fue más alto en individuos socialmente desafortunados y se asoció con comportamientos/condiciones de salud adversos, especialmente al considerarse tratamientos atribuidos a la discriminación. CONCLUSIONES: Estos resultados sugieren validez y confiabilidad del instrumento desarrollado. La escala presentada permitirá investigar aspectos innovadores de las relaciones entre discriminación y salud. OBJETIVO: Desenvolver instrumento para avaliar os efeitos de experiências discriminatórias sobre condições e comportamentos em saúde, capaz de distinguir efeitos patológicos da exposição a tratamentos diferenciais de sua interpretação como eventos discriminatórios. MÉTODOS: Versões sucessivas do instrumento foram elaboradas com base em uma revisão sistemática da literatura sobre escalas de discriminação, grupos focais e apreciação por um painel de sete especialistas. O refinamento do instrumento foi atingido por meio de entrevistas cognitivas e estudo-piloto, de modo que sua versão final foi aplicada em 424 estudantes de graduação no Rio de Janeiro, RJ, em 2010. A estrutura dimensional, dois tipos de confiabilidade e validade de construto foram avaliadas. RESULTADOS: A análise fatorial exploratória corroborou a hipótese de unidimensionalidade do instrumento e sete especialistas indicaram que este apresentava validade de face e conteúdo. A consistência interna foi de 0,8 e a confiabilidade teste-reteste foi maior do que 0,5 para 14 dos 18 itens. O escore foi estatisticamente mais alto em indivíduos socialmente desprivilegiados e associou-se com comportamentos/condições de saúde adversos, especialmente quando tratamentos atribuídos à discriminação foram considerados. CONCLUSÕES: Estes resultados sugerem validade e confiabilidade do instrumento desenvolvido. A escala apresentada permitirá investigar aspectos inovadores das relações entre discriminação e saúde. Universidade de São Paulo. Faculdade de Saúde Pública2012-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3310210.1590/S0034-89102012000200009Revista de Saúde Pública; Vol. 46 No. 2 (2012); 269-278 Revista de Saúde Pública; Vol. 46 Núm. 2 (2012); 269-278 Revista de Saúde Pública; v. 46 n. 2 (2012); 269-278 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/rsp/article/view/33102/35819Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessBastos, João LuizFaerstein, EduardoCeleste, Roger KellerBarros, Aluisio J D2012-07-11T23:10:38Zoai:revistas.usp.br:article/33102Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-11T23:10:38Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Explicit discrimination and health: development and psychometric properties of an assessment instrument
Discriminación explícita y salud: desarrollo y propiedades psicométricas de un instrumento
Discriminação explícita e saúde: desenvolvimento e propriedades psicométricas de um instrumento
title Explicit discrimination and health: development and psychometric properties of an assessment instrument
spellingShingle Explicit discrimination and health: development and psychometric properties of an assessment instrument
Bastos, João Luiz
Preconceito
Relações Interpessoais
Fatores Socioeconômicos
Desigualdades em Saúde
Prejuicio
Relaciones Interpersonales
Factores Socioeconómicos
Desigualdades en la Salud
Prejudice
Interpersonal Relations
Socioeconomic Factors
Health Inequalities
title_short Explicit discrimination and health: development and psychometric properties of an assessment instrument
title_full Explicit discrimination and health: development and psychometric properties of an assessment instrument
title_fullStr Explicit discrimination and health: development and psychometric properties of an assessment instrument
title_full_unstemmed Explicit discrimination and health: development and psychometric properties of an assessment instrument
title_sort Explicit discrimination and health: development and psychometric properties of an assessment instrument
author Bastos, João Luiz
author_facet Bastos, João Luiz
Faerstein, Eduardo
Celeste, Roger Keller
Barros, Aluisio J D
author_role author
author2 Faerstein, Eduardo
Celeste, Roger Keller
Barros, Aluisio J D
author2_role author
author
author
dc.contributor.author.fl_str_mv Bastos, João Luiz
Faerstein, Eduardo
Celeste, Roger Keller
Barros, Aluisio J D
dc.subject.por.fl_str_mv Preconceito
Relações Interpessoais
Fatores Socioeconômicos
Desigualdades em Saúde
Prejuicio
Relaciones Interpersonales
Factores Socioeconómicos
Desigualdades en la Salud
Prejudice
Interpersonal Relations
Socioeconomic Factors
Health Inequalities
topic Preconceito
Relações Interpessoais
Fatores Socioeconômicos
Desigualdades em Saúde
Prejuicio
Relaciones Interpersonales
Factores Socioeconómicos
Desigualdades en la Salud
Prejudice
Interpersonal Relations
Socioeconomic Factors
Health Inequalities
description OBJECTIVE: To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events. METHODS: Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refined using cognitive interviews and pilot-testing. The final version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed. RESULTS: Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination. CONCLUSIONS: These findings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health.
publishDate 2012
dc.date.none.fl_str_mv 2012-04-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/33102
10.1590/S0034-89102012000200009
url https://www.revistas.usp.br/rsp/article/view/33102
identifier_str_mv 10.1590/S0034-89102012000200009
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/33102/35819
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 46 No. 2 (2012); 269-278
Revista de Saúde Pública; Vol. 46 Núm. 2 (2012); 269-278
Revista de Saúde Pública; v. 46 n. 2 (2012); 269-278
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
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