Katherine A Thurber1, Jennie Walker2, Philip J Batterham3, Gilbert C Gee4, Jan Chapman2, Naomi Priest5,6, Rubijayne Cohen2, Roxanne Jones2, Alice Richardson2, Alison L Calear3, David R Williams7, Raymond Lovett2,8. 1. National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT, 2601, Australia. katherine.thurber@anu.edu.au. 2. National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT, 2601, Australia. 3. Centre for Mental Health Research, Research School of Population Health, Australian National University, 63 Eggleston Road, Acton, ACT, 2601, Australia. 4. Department of Community Health, Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA. 5. Centre for Social Research and Methods, College of Arts and Social Sciences, Australian National University, Ellery Crescent, Acton, ACT, 2601, Australia. 6. Population Health, Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, 3052, Australia. 7. Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115, USA. 8. The Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS), 51 Lawson Cres, Acton ACT , 2601, Australia.
Abstract
BACKGROUND: It is well established that racism is a fundamental contributor to poor health and inequities. There is consistent evidence of high exposure to discrimination among Aboriginal and Torres Strait Islander (Indigenous Australian) peoples, but impacts have not been fully quantified, in part due to limited measurement tools. We aim to validate instruments developed to measure interpersonal discrimination. METHODS: Instruments were discussed at five focus groups and with experts, and field tested in developing Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing. Data from 7501 baseline survey participants were analysed. Acceptability was assessed according to extent of missingness, construct validity using exploratory and confirmatory factor analysis, and reliability using Cronbach's alpha. Associations between each instrument and outcomes conceptually understood to be closely (community-level racism) or less closely (family wellbeing) related were quantified to test convergent and discriminant validity. RESULTS: An 8-item instrument captures experiences of discrimination in everyday life and a 4-item instrument experiences in healthcare, each followed by a global attribution item. Item missingness was 2.2-3.7%. Half (55.4%) of participants reported experiencing any everyday discrimination, with 65.7% attributing the discrimination to Indigeneity; healthcare discrimination figures were 34.1% and 51.1%. Items were consistent with two distinct instruments, differentiating respondents with varying experiences of discrimination. Scales demonstrated very good reliability and convergent and divergent validity. CONCLUSION: These brief instruments demonstrate face validity and robust psychometric properties in measuring Aboriginal and Torres Strait Islander adults' experiences of interpersonal discrimination in everyday life and in healthcare. They can be used to quantify population-level experiences of discrimination, and associated wellbeing consequences, and monitor change.
BACKGROUND: It is well established that racism is a fundamental contributor to poor health and inequities. There is consistent evidence of high exposure to discrimination among Aboriginal and Torres Strait Islander (Indigenous Australian) peoples, but impacts have not been fully quantified, in part due to limited measurement tools. We aim to validate instruments developed to measure interpersonal discrimination. METHODS: Instruments were discussed at five focus groups and with experts, and field tested in developing Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing. Data from 7501 baseline survey participants were analysed. Acceptability was assessed according to extent of missingness, construct validity using exploratory and confirmatory factor analysis, and reliability using Cronbach's alpha. Associations between each instrument and outcomes conceptually understood to be closely (community-level racism) or less closely (family wellbeing) related were quantified to test convergent and discriminant validity. RESULTS: An 8-item instrument captures experiences of discrimination in everyday life and a 4-item instrument experiences in healthcare, each followed by a global attribution item. Item missingness was 2.2-3.7%. Half (55.4%) of participants reported experiencing any everyday discrimination, with 65.7% attributing the discrimination to Indigeneity; healthcare discrimination figures were 34.1% and 51.1%. Items were consistent with two distinct instruments, differentiating respondents with varying experiences of discrimination. Scales demonstrated very good reliability and convergent and divergent validity. CONCLUSION: These brief instruments demonstrate face validity and robust psychometric properties in measuring Aboriginal and Torres Strait Islander adults' experiences of interpersonal discrimination in everyday life and in healthcare. They can be used to quantify population-level experiences of discrimination, and associated wellbeing consequences, and monitor change.
Entities:
Keywords:
Health inequalities; Measurement; Measurement tool development; Psychometrics; Social Epidemitology
Authors: Kelly L Gonzales; Carolyn Noonan; R Turner Goins; William G Henderson; Janette Beals; Spero M Manson; Kelly J Acton; Yvette Roubideaux Journal: Psychol Assess Date: 2015-07-06
Authors: Roxanne Jones; Katherine A Thurber; Jan Chapman; Catherine D'Este; Terry Dunbar; Mark Wenitong; Sandra J Eades; Lisa Strelein; Maureen Davey; Wei Du; Anna Olsen; Janet K Smylie; Emily Banks; Raymond Lovett Journal: BMJ Open Date: 2018-06-27 Impact factor: 2.692
Authors: Courtney Ryder; Jacqueline H Stephens; Shahid Ullah; Julieann Coombes; Nayia Cominos; Patrick Sharpe; Shane D'Angelo; Darryl Cameron; Colleen Hayes; Keziah Bennett-Brook; Tamara Mackean Journal: Int J Environ Res Public Health Date: 2022-08-19 Impact factor: 4.614
Authors: Katherine A Thurber; Emily Colonna; Roxanne Jones; Gilbert C Gee; Naomi Priest; Rubijayne Cohen; David R Williams; Joanne Thandrayen; Tom Calma; Raymond Lovett Journal: Int J Environ Res Public Health Date: 2021-06-18 Impact factor: 3.390