Defining and measuring service awareness among elders and caregivers of Mexican descent

Mexican American elders' and their caregivers' awareness of available home care services is one of nine factors hypothesized to be associated with underuse of home care services. Previous instruments did not fully measure service awareness. The objective of this study was to explore the conceptual foundation of service awareness, generate items, and establish language equivalence in Spanish and English for the Service Awareness Scale. A hybrid use of the literature and fieldwork were used to develop the concept and generate items. The team used back-translation and community collaboration to test for language equivalence. Concept development and language equivalence were achieved for the Service Awareness Scale. Teaching/learning theories contributed to the definition and inductive validity of service awareness and item generation and can shape future interventions. Bicultural/bilingual community and research team partners refined its measure. The scale will be usable in research and practice designed to promote equity in health care use.