Measuring barriers to incontinence care seeking

Area of Science:

• Urology
• Health Services Research
• Psychometrics

Background:

• Urinary incontinence affects a significant number of women.
• Barriers to seeking medical care can exacerbate health disparities.
• Existing measures may not adequately capture these barriers in diverse populations.

Purpose of the Study:

• To establish the factor validity of a modified Melnyck's Barrier Scale.
• To estimate the reliability of this scale in an ethnically diverse group of incontinent women.
• To introduce a validated tool for studying healthcare access.

Main Methods:

• Computer-assisted telephone interviews (CATI) were used with 275 incontinent women.
• A modified 14-item Melnyck's Barrier Scale was administered using a 4-point Likert scale.
• Confirmatory factor analysis and Cronbach's alpha were employed to assess validity and reliability.

Main Results:

• The modified scale demonstrated good factor validity with 5 distinct factors: inconvenience, relationship, site-related, cost, and fear.
• Factor loadings ranged from 0.452 to 0.960.
• The overall scale reliability (Cronbach's alpha) was 0.828, with subscale reliabilities ranging from 0.57 to 0.79.

Conclusions:

• The Barriers to Incontinence Care Seeking questionnaire (BICS-Q) is a valid and reliable instrument.
• The BICS-Q is suitable for epidemiologic research.
• This tool can operationalize barriers in studies examining ethnicity and healthcare disparities.