Commonly Experienced Health Care Barriers Index

Abstract

The Commonly Experienced Health Care Barriers Index (Rivers et al., 2023) is an index designed to quantify barriers encountered by the general population in healthcare settings. Its development spanned three studies, adhering to recommendations for causal indicator models. The final 6-item index was evaluated using online samples of adult participants, and its reliability and validity were subsequently reported. The primary aim of this index is to pinpoint modifiable elements linked to healthcare inequities and common challenges in healthcare utilization.

Keywords

Test Responsiveness, Health Care, Barriers, Health Care Services, Treatment Barriers, Treatment Process and Outcome Measures.

Authors

Rivers, Alannah Shelby; Sanford, Keith; Brewington, Morgan; Buchanan, Ashley

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Purpose

The purpose of this index is to identify modifiable factors related to health care inequities and common problems with health care utilization.

Validity

Content Validity: To ensure maximum content validity with the fewest possible items, a preliminary pool of items was initially developed through a qualitative study. This pool was then refined to the smallest possible set of indicators that comprehensively covered the entire content domain, based on the results of a cluster analysis.

Test Responsiveness: The test showed significant differences between Black and White individuals, with a small effect size (d = .29, t(739) = 3.65, p < .001). This indicates that the scale possesses appropriate sensitivity for identifying racial health care inequities.

Convergent Validity: The scale demonstrates expected associations with various health care utilization problems (such as omitting needed care, missing prescriptions, missing appointments, and emergency room use), health experiences (including patient–practitioner alliance, medical confusion, and health-related quality of life), and life stressors (such as neighborhood violence, financial problems, and stress).

Reliability

Test-Retest Reliability: The 3-week test–retest reliability of the overall scale was notably high (r = .83, p < .001). For individual items, reliability coefficients ranged from .54 to .79.

Factor Analysis

No data is Available.

Instrument

Test Type: Original

Format: Items are rated on a 4-point Likert scale, ranging from 1 = “NOT true” to 4 = “completely true”. The administration method is electronic. The test items are available, with the location being 2024-13469-001, Table 1, Page 5.

Language Available: English

Population Group: Human (Male and Female)

Age Group: Adulthood (18 years and older)

Population Details: Respondents are adult participants located in the United States.

Test Methodology: The methodology includes Test Validity, Content Validity, Convergent Validity, Test Reliability, and Test-Retest Reliability.

Keywords

Treatment Barriers, Health Care Services, Treatment Process and Outcome Measures, Test Responsiveness.

Authors

Author ORCID Identifier:

• Rivers, Alannah Shelby: http://orcid.org/0000-0001-8826-4606

• Brewington, Morgan: http://orcid.org/0009-0002-3357-8020

Affiliation:

• Rivers, Alannah Shelby: Texas Woman’s University, School of Social Work, Psychology, and Philosophy

• Sanford, Keith: Baylor University, Department of Psychology and Neuroscience

• Brewington, Morgan: Baylor University, Department of Psychology and Neuroscience

• Buchanan, Ashley: Baylor University, Department of Psychology and Neuroscience

Email Addresses:

• Rivers, Alannah Shelby: [email protected]

Correspondence Address:
Rivers, Alannah Shelby: Texas Woman’s University, School of Social Work, Psychology, and Philosophy, P.O. Box 425470, Denton, Texas, United States, 76204-5470, [email protected]

Permissions & Fee and Test Year

Permissions: May be used for Research/Teaching.
Fee: No
Commercial: No
Test Year: 2023

References

Rivers, A. S., Sanford, K., Brewington, M., & Buchanan, A. (2024). Development of a new measure of encounters with health care barriers: The Commonly Experienced Health Care Barriers Index. Psychological Assessment, 36(1), 30–40. https://doi.org/10.1037/pas0001284

Items of the Commonly Experienced Health Care Barriers Index

This is a 6-item scale. No data is Available.

Items

• Not having enough money or insurance stops me from going to a doctor.

• Not having good transportation stops me from going to a doctor.

• Not being able to take time off work stops me from going to a doctor.

• Not having a regular doctor stops me from going to a doctor.

• Having to wait too many days for an appointment stops me from going to a doctor.

• Not liking the way I am treated at the doctor’s office stops me from going to a doctor.

Note. Items were preceded with instructional text: “At times when you are due for a medical checkup, and at times when you are sick and it would be good to visit a doctor, do any of the following issues stop you from going to a doctor?” Response options were “NOT true” (1), “a little true” (2), “moderately true” (3), and “completely true” (4).