Patient attitudes toward integrated health care: Initial scale development and a test of the influences of cultural mistrust and gender among African Americans

Author

Abby Jane Spalding Kelty, Southern Illinois University CarbondaleFollow

Date of Award

12-1-2017

Degree Name

Master of Arts

Department

Psychology

First Advisor

Greer, Tawanda

Abstract

Racial and ethnic disparities in health care continue to be problematic in the United States. Although many Americans experience the negative effects associated with health disparities (e.g., negative perceptions of care, lack of access to care, and poorer health outcomes), health disparities have been shown to be increasingly problematic for many members of African American populations. In addition, cultural mistrust of providers and health care systems have also been shown to impact perceptions of care and utilization of health care services. Recent literature suggests that integrated health care could be a possible solution to improving care, although a gap in the research currently exists regarding how members of African American populations view integrated health care. The current study was designed to fill this gap. In order to achieve this goal, the current project consisted of two studies. The purpose of Study 1 was to develop an instrument to measure attitudes toward integrated health care among African Americans. The purpose of Study 2 was to validate the integrated health care measure and to test gender as a potential moderator of the effects of cultural mistrust on attitudes toward integrated health care for a sample of African American adults. Through Exploratory Factor Analysis in Study 1, eigenvalues, scree plots, factor loadings, and orthogonal rotations were examined to identify the underlying factors and overall reliability of the Patient Attitudes Toward Integrated Health Care scale. Results from Study 1 indicated that this scale was reliable and valid among the current sample of American adults. Study 2 used Confirmatory Factor Analysis to examine the validity of the Patient Attitudes Toward Integrated Health Care scale. The results of the CFA confirmed that the Patient Attitudes Toward Integrated Health Care scale was reliable and valid among the current sample. Study 2 also used moderated regression analysis to test the hypothesis that gender would moderate the relationship between cultural mistrust and attitudes toward integrated health care. Results from the regression analysis showed that gender did not significantly moderate the effects of cultural mistrust on attitudes toward integrated health care. However, results suggested that gender significantly influenced attitudes toward integrated health care. The findings further suggested that cultural mistrust and attitudes toward seeking psychological help to be significant predictors of attitudes toward integrated health care. Although the original hypothesis was not supported in the current study, these results provide useful insight into predictors of attitudes toward integrated health care among African Americans. These results can be used to assist in improving integrated health care systems to better meet the needs of this population.