Assessing medical mistrust in organ donation across countries using item response theory

Area of Science:

• Psychometrics
• Public Health
• Cross-cultural Research

Background:

• Medical mistrust (MM) poses a significant barrier to public health interventions.
• Existing MM scales lack international validation.
• Item response theory (IRT) has not been applied to assess MM, limiting generalizability.

Purpose of the Study:

• To determine the dimensionality of a brief MM measure across four countries.
• To validate the measure for international public health research.
• To explore MM assessment using IRT.

Main Methods:

• Mokken analysis and Graded Response Modelling were employed.
• Data collected from 1468 participants across the UK, Ireland, India, and Malaysia.
• Investigated the psychometric properties of a brief MM scale.

Main Results:

• The MM items demonstrated a hierarchical and unidimensional structure.
• The measure proved highly informative for assessing high levels of MM.
• Potential for item reduction and scoring adjustments was identified.

Conclusions:

• The brief MM measure is suitable for international studies due to its unidimensionality and cross-cultural applicability.
• Minor adjustments to the measure will not compromise MM assessment.
• The study supports the use of this validated scale in global public health contexts.