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Development and Initial Validation of a Measure of Parental Racial/Ethnic Discrimination in Pediatric Healthcare

Ashleigh B Harlow1, Margaret Fletcher2, Michael D Green3

  • 1School of Nursing, Duke University, Durham, NC, USA. Ashleigh.harlow@duke.edu.

Journal of Racial and Ethnic Health Disparities
|August 20, 2025
PubMed

Insights

This study developed a new tool to measure parental discrimination in pediatric healthcare. The six-item scale offers a reliable way to understand unique parental discrimination experiences.

Area of Science:

  • Health Services Research
  • Sociology of Health and Illness
  • Pediatric Health Equity

Background:

  • Discrimination, including racial and ethnic, negatively impacts health across the lifespan.
  • Parents play a crucial role in pediatric healthcare, distinct from other caregivers.
  • Existing measures of healthcare discrimination lack specific focus on parental experiences.

Purpose of the Study:

  • To develop a psychometrically valid tool measuring parents' experiences of discrimination in pediatric healthcare.
  • To capture parental identities and perceptions of discrimination within healthcare settings.
  • To address the gap in available instruments for assessing parental healthcare discrimination.

Main Methods:

  • Developed a measure of parental racial/ethnic discrimination in healthcare.
  • Generated items based on literature review and expert panel feedback.
  • Tested items with US-based adult parents via online survey, employing exploratory factor analysis, reliability, and validity assessments.

Main Results:

  • Generated an acceptable pool of items (mean CVI = 0.94 for relevance, 0.70 for clarity).
  • Exploratory factor analysis yielded a two-factor solution, with one factor demonstrating high reliability (α = 0.90) and strong construct/criterion validity (r = 0.52-0.74).
  • A final six-item scale effectively measures parental discrimination experiences in the pediatric setting.

Conclusions:

  • The developed six-item scale provides a novel instrument for assessing parental discrimination in pediatric healthcare.
  • This tool enhances understanding of discrimination unique to parents within the healthcare system.
  • Further validation with larger, diverse samples and traditional recruitment methods is recommended.
Abstract

Keywords:
DiscriminationHealthcareMeasurementParenting

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