Psychometric validation of a patient‐reported experience measure of obstetric racism© (The PREM‐OB Scale™ suite). Issue 3 (17th March 2022)

• Record Type: Journal Article
• Authors: White VanGompel, Emily; Lai, Jin‐Shei; Davis, Dána‐Ain; Carlock, Francesca; Camara, Tamentanefer L.; Taylor, Brianne; Clary, Chakiya; McCorkle‐Jamieson, Ashlee M.; McKenzie‐Sampson, Safyer; Gay, Caryl; Armijo, Amanda; Lapeyrolerie, Lillie; Singh, Lavisha; Scott, Karen A.
• Is Part Of: Birth. Volume 49:Issue 3(2022)
• Page Start: 514
• Page End: 525
• Publication Date: 2022-03-17
• Subjects: black mothers -- obstetric racism -- psychometrics -- quality improvement; Childbirth -- Periodicals; Obstetrics -- Periodicals; Newborn infants -- Care -- Periodicals; Natural childbirth -- Periodicals; 618.1
• DOI: 10.1111/birt.12622
• Languages: English
• ISSNs: 0730-7659

Abstract

Abstract: Background: Perinatal quality improvement lacks valid tools to measure adverse hospital experiences disproportionately impacting Black mothers and birthing people. Measuring and mitigating harm requires using a framework that centers the lived experiences of Black birthing people in evaluating inequitable care, namely, obstetric racism. We sought to develop a valid patient‐reported experience measure (PREM) of Obstetric Racism © in hospital‐based intrapartum care designed for, by, and with Black women as patient, community, and content experts. Methods: PROMIS© instrument development standards adapted with cultural rigor methodology. Phase 1 included item pool generation, modified Delphi method, and cognitive interviews. Phase 2 evaluated the item pool using factor analysis and item response theory. Results: Items were identified or written to cover 7 previously identified theoretical domains. 806 Black mothers and birthing people completed the pilot test. Factor analysis concluded a 3 factor structure with good fit indices (CFI = 0.931‐0.977, RMSEA = 0.087‐0.10, R 2 > .3, residual correlation < 0.15). All items in each factor fit the IRT model and were able to be calibrated. Factor 1, "Humanity, " had 31 items measuring experiences of safety and accountability, autonomy, communication, and empathy. A 12‐item short form was created to ease respondent burden. Factor 2, "Racism, " had 12 items measuring experiences of neglect and mistreatment. Factor 3, "Kinship, " had 7 items measuring hospital denial and disruption of relationships between Black mothers and their child or support system. Conclusions: The PREM‐OB Scale™ suite is a valid tool to characterize and quantify obstetric racism for use in perinatal improvement initiatives.