Racism in obstetric care: a psychometric study of the Gendered Racial Microaggressions Scale among Global Majority birthing people in obstetric contexts.

Autor: Howell FM; Department of Population Health Science Policy, Icahn School of Medicine at Mount Sinai, 722 W 168th Street, Room 722, New York, NY, 10032, USA. frances.howell28@gmail.com.; Department of Epidemiology, Columbia University Mailman School of Public Health, 1770 Madison Avenue, 2nd Floor, New York, NY, 10029, USA. frances.howell28@gmail.com.; Present Address: New York, USA. frances.howell28@gmail.com., McCarthy KJ; Department of Population Health Science Policy, Icahn School of Medicine at Mount Sinai, 722 W 168th Street, Room 722, New York, NY, 10032, USA.; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, 1770 Madison Avenue, 2nd Floor, New York, NY, 10029, USA., Boychuk N; Department of Population Health Science Policy, Icahn School of Medicine at Mount Sinai, 722 W 168th Street, Room 722, New York, NY, 10032, USA.; Department of Epidemiology, Columbia University Mailman School of Public Health, 1770 Madison Avenue, 2nd Floor, New York, NY, 10029, USA.; Present Address: New York, USA., Burdick M; Department of Women & Gender Studies, University of Delaware, 25N College Ave. 205 McDowell Hall, Newark, DE, 19716, USA.; Philadelphia, USA., Nowlin S; Department of Population Health Science Policy, Icahn School of Medicine at Mount Sinai, 722 W 168th Street, Room 722, New York, NY, 10032, USA.; Center for Nursing Research and Innovation, Mount Sinai Health System, 19 East 98th Street, 3rd Floor, Suite E, New York, NY, 10029, USA., Maru S; Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York, USA.; Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, 1216 Fifth Ave, 5th Floor, New York, NY, 10029, USA.; New York City Health + Hospitals/Elmhurst, 1216 Fifth Ave, 5th Floor, New York, NY, 10029, USA., Oshewa O; Department of Obstetrics and Gynecology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA., Monterroso M; Department of Obstetrics and Gynecology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA., Rodriguez A; Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York, USA.; Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, 1216 Fifth Ave, 5th Floor, New York, NY, 10029, USA., Katzenstein C; Icahn School of Medicine at Mount Sinai, Box 1199, One Gustave L. Levy Place, New York, NY, 10029, USA., Longley R; Icahn School of Medicine at Mount Sinai, Box 1199, One Gustave L. Levy Place, New York, NY, 10029, USA., Cabrera C; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Box 1199, One Gustave L. Levy Place, New York, NY, 10029, USA., Howell EA; Department of Obstetrics and Gynecology, University of Pennsylvania, 3400 Spruce Street, 5 Dulles, Philadelphia, PA, 19194, USA., Levine L; Department of Obstetrics and Gynecology, University of Pennsylvania, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA, 19104, USA., Janevic T; Department of Population Health Science Policy, Icahn School of Medicine at Mount Sinai, 722 W 168th Street, Room 722, New York, NY, 10032, USA.; Department of Epidemiology, Columbia University Mailman School of Public Health, 1770 Madison Avenue, 2nd Floor, New York, NY, 10029, USA.; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, 1770 Madison Avenue, 2nd Floor, New York, NY, 10029, USA.; Present Address: New York, USA., Gundersen DA; Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, USA.; Rutgers Institute for Nicotine and Tobacco Studies, Rutgers the State University of New Jersey, 303 George Street, Suite 500 New, Brunswick, NJ, 08901, USA.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2024 Jun 28; Vol. 24 (1), pp. 448. Date of Electronic Publication: 2024 Jun 28.
DOI: 10.1186/s12884-024-06642-5
Abstrakt: In the United States, maternal health inequities disproportionately affect Global Majority (e.g., Asian, Black, and Hispanic) populations. Despite a substantial body of research underscoring the influence of racism on these inequities, little research has examined how experiences of gendered racial microaggressions during pregnancy and birth impact racially and ethnically diverse Global Majority pregnant and birthing people in obstetric hospital settings. We evaluated the psychometric properties of an adapted version of Lewis & Neville's Gendered Racial Microaggressions Scale, using data collected from 417 Global Majority birthing people. Findings from our study indicate that our adapted GRMS is a valid tool for assessing the experiences of gendered racial microaggressions in hospital-based obstetric care settings among Global Majority pregnant and birthing people whose preferred languages are English or Spanish. Item Response Theory (IRT) analysis demonstrated high construct validity of the adapted GRMS scale (Root Mean Square Error of Approximation = 0.1089 (95% CI 0.0921, 0.1263), Comparative Fit Index = 0.977, Standardized Root Mean Square Residual = 0.075, log-likelihood c2 = -85.6, df = 8). IRT analyses demonstrated that the unidimensional model was preferred to the bi-dimensional model as it was more interpretable, had lower AIC and BIC, and all items had large discrimination parameters onto a single factor (all discrimination parameters > 3.0). Given that we found similar response profiles among Black and Hispanic respondents, our Differential Item Functioning analyses support validity among Black, Hispanic, and Spanish-speaking birthing people. Inter-item correlations demonstrated adequate scale reliability, α = 0.97, and empirical reliability = 0.67. Pearsons correlations was used to assess the criterion validity of our adapted scale. Our scale's total score was significantly and positively related to postpartum depression and anxiety. Researchers and practitioners should seek to address instances of gendered racial microaggressions in obstetric settings, as they are manifestations of systemic and interpersonal racism, and impact postpartum health.
(© 2024. The Author(s).)
Databáze: MEDLINE
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