Development of an Attribution of Racial/Ethnic Health Disparities Scale

Price, James H.; Braun, Robert E.; Khubchandani, Jagdish; Payton, Erica; Bhattacharjee, Prasun

doi:10.1007/s10900-014-9833-y

Cited by 8 publications

(12 citation statements)

References 23 publications

(20 reference statements)

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“…The principal components can be used as a criterion variable in the consequent analysis [35,36]. A varimax rotation (orthogonal rotation) method was used with the assumption that there is no correlation between components [9,16,37]. Furthermore, the association was checked between the PHQ-2, GAD-2, and PHQ-4 scores for respondents who had reported suicidal thoughts or social dysfunction versus those who had not reported suicidal thoughts or social dysfunction in the past 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

The psychometric properties of PHQ-4 anxiety and depression screening scale among out of school adolescent girls and young women in Tanzania: a cross-sectional study

et al. 2020

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Background: Literature suggests that most mental disorders have their onset in childhood and adolescence, but go undiagnosed until adulthood. Shorter versions of the screening tools such as the Patient Health Questionnaire with four items (PHQ-4) may help to improve screening coverage. This study assessed the psychometric properties of the PHQ-4 in screening for core symptoms of depression and anxiety among out of school adolescent girls and young women (AGYW). Methods: This is a cross-sectional analysis of data from a cluster randomized controlled trial conducted among AGYW between June and July 2018 in NorthWest Tanzania. Two thousand four hundred twenty-six out-of-school AGYW aged 15 to 23 years were included. Data were collected on tablets using audio computer-assisted self-interviews (ACASI). Cronbach's α was used to measure the reliability of the PHQ-4 while confirmatory factor analysis (CFA) and principal components analysis (PCA) were used for construct validity assessment. In CFA, three criteria were used to assess how well the model fits the data: Standardized Root Mean Square Residual (SRMR), the Comparative Fit Index (CFI), the Root Mean Square Error of Approximation (RMSEA) and 90% confidence interval for RMSEA. Results: Of the 2426 participants, 33.8 and 35.5% screened positive for core symptoms of anxiety (GAD-2 ≥ 3) and depression (PHQ-2 ≥ 3), respectively. Cronbach's α of the PHQ-4 was 0.81. Both items-correlation and corrected items-correlation of the PHQ-4 had total correlations above 0.5 (p < 0.01). CFA showed that all items loaded significantly onto the single factor, and loadings were strong, ranging from 0.67 to 0.77 (p < 0.01). CFA indicates that the PHQ-4 scale stand for a unidimensional construct with good model fit (CFI = 0.995, SRMR = 0.013, RMSEA = 0.054 and 90% CI for RMSEA (0.031-0.079)). PCA confirmed two distinct components; GAD-2 (anxiety) and PHQ-2 (depression). Those who reported having suicidal thoughts and social function problems had significantly higher scores on PHQ-2, GAD-2, and PHQ-4 screening items (p < 0.01). Conclusions: The findings suggest that the PHQ-4 scale can reliably and validly screen for core symptoms of depression and anxiety among out of school AGYW. This tool is short and easy to administer. Thus, the PHQ-4 scale can be very useful in screening for anxiety and depression symptoms in the community, primary health facilities, research and programmatic settings.

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Section: Discussionmentioning

confidence: 99%

The psychometric properties of PHQ-4 anxiety and depression screening scale among out of school adolescent girls and young women in Tanzania: a cross-sectional study

et al. 2020

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“…The instrument used in this assessment included the AREHD. 12 The survey instrument assessed the participant’s views of racial/ethnic health disparities and their etiology. The questions were split between two characteristics: SDH and IR.…”

Section: Methodsmentioning

confidence: 99%

“…10 The results of these SDH on health outcomes lead to shorter life spans for those disadvantaged populations. 11,12…”

Section: Introductionmentioning

confidence: 99%

“…attempted to identify college students’ beliefs and relevancy about these root causes by developing their Attribution of Racial/Ethnic Health Disparities (AREHD) questionnaire. 12 The Attribution Theory attempts to understand how people explain the causes of one’s behavior. 13 One psychologist describes two main tenants (attributions) that influence an individual: (a) dispositional (internal causes) and (b) situational (external causes).…”

Section: Introductionmentioning

confidence: 99%

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Teaching a Health Equity Course at a Midwestern Private University—A Pilot Study

Braun

Nevels

Frey

2019

Int Q Community Health Educ

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Teaching about health disparities and health equity at a 4-year institution is imperative. Unfortunately, there is a lack of empirical research demonstrating this concept and the proper way to develop a course. As a result, this research attempted to assess the effectiveness of developing and teaching this course centered on the social determinants of health (SDH). Using a 30-question Attribution of Health Disparities Assessment, data were collected on students’ attitudes and beliefs about the relevancy of these two concepts before and after they took the health equity course. All participants ( n = 42) were seniors, 80% self-identify as Caucasian and 66% were female. Overall, there was a statistically significant change in attitudes and beliefs about health disparities and the relevancy of these issues. It appears that in the eyes of the students, the SDH are more relevant and related to these issues than a person’s individual responsibility. As a result, the relevancy of many of the SDH discussed in class had a profound effect on the students who took this course as indicated by their statistically significant change. Finally, our research demonstrates how a health equity course could be taught to effectively change undergraduate students’ views on issues related to the SDH.

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“…In most studies on providers' perceptions of health care disparities, much of the discussion on who is responsible for health care disparities has focused on the individual-either the individual patient or provider-and the belief that individual health behaviors are the most important determinants of health. [44][45][46] However, recent approaches to health care disparities have moved beyond individual responsibility to embrace a social determinant perspective. 47,48 This theoretical perspective sees organizational contexts and structures, sociohistorical factors, inequalities, and political ideologies as influencing health behaviors.…”

Section: Discussionmentioning

confidence: 99%

Veterans Affairs Providers' Beliefs About the Contributors to and Responsibility for Reducing Racial and Ethnic Health Care Disparities

Eliacin

Cunningham²,

Partin

et al. 2019

Health Equity

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Purpose: Providers' beliefs about the causes of disparities and the entities responsible for addressing these disparities are important in designing disparity-reduction interventions aimed at providers. This secondary analysis of a larger study is aimed at evaluating perceptions of providers regarding the underlying causes of racial health care disparities and their views of who is responsible for reducing them. Methods: We surveyed 232 providers at 3 Veterans Affairs (VA) Medical Centers. Results: Sixty-nine percent of participants believed that minority patients in the United States receive lower quality health care. Most participants (64%) attributed differences in quality of care for minority patients in the VA health care system primarily to patients' socioeconomic status, followed by patient behavior (43%) and provider behaviors (33%). In contrast, most participants believed that the VA and other health care organizations (75%) and providers (70%) bear the responsibility for reducing disparities, while less than half (45%) believed that patients were responsible. Among provider-level contributors to disparities, providers' poor communication was the most widely endorsed (48%), while differences in prescribing of medications (13%) and in provision of specialty referrals (12%) were the least endorsed. Conclusions: Although most providers in the study did not believe that providers contribute to disparities, they do believe that they, along with health care organizations, have the responsibility to help reduce them. Interventions might focus on directly offering providers concrete ways that they can help reduce disparities, rather than focusing on simply raising awareness about disparities and their contributions to them.

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Development of an Attribution of Racial/Ethnic Health Disparities Scale

Cited by 8 publications

References 23 publications

The psychometric properties of PHQ-4 anxiety and depression screening scale among out of school adolescent girls and young women in Tanzania: a cross-sectional study

The psychometric properties of PHQ-4 anxiety and depression screening scale among out of school adolescent girls and young women in Tanzania: a cross-sectional study

Teaching a Health Equity Course at a Midwestern Private University—A Pilot Study

Veterans Affairs Providers' Beliefs About the Contributors to and Responsibility for Reducing Racial and Ethnic Health Care Disparities

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