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Validation of the Clinicians’ Cultural Sensitivity Survey for Use in Pediatric Primary Care Settings

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Abstract

Incorporating cultural sensitivity into healthcare settings is important to deliver high-quality and equitable care, particularly for marginalized communities who are non-White, non-English speaking, or immigrants. The Clinicians’ Cultural Sensitivity Survey (CCSS) was developed as a patient‐reported survey assessing clinicians’ recognition of cultural factors affecting care quality for older Latino patients; however, this instrument has not been adapted for use in pediatric primary care. Our objective was to examine the validity and reliability of a modified CCSS that was adapted for use with parents of pediatric patients. A convenience sampling approach was used to identify eligible parents during well-child visits at an urban pediatric primary care clinic. Parents were administered the CCSS via electronic tablet in a private location. We first conducted exploratory factor analyses (EFAs) to explore the dimensionality of survey responses in the adapted CCSS, and then conducted a series of confirmatory factor analyses (CFAs) using maximum likelihood estimation based on the results of the EFAs. Exploratory and confirmatory factor analyses (N = 212 parent surveys) supported a three-factor structure assessing racial discrimination (\(\alpha\)=0.96), culturally-affirming practices (\(\alpha\)=0.86), and causal attribution of health problems (\(\alpha\)=0.85). In CFAs, the three-factor model also outperformed other potential factor structures in terms of fit statistics including scaled root mean square error approximation (0.098), Tucker-Lewis Index (0.936), Comparative Fit Index (0.950), and demonstrated adequate fit according to the standardized root mean square residual (0.061). Our findings support the internal consistency, reliability, and construct validity of the adapted CCSS for use in a pediatric population.

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Funding

This work was supported by Agency for Healthcare Research and Quality (Grant Numbers T32 HS022242, K12 HS026395, T32 HS022242).

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Authors and Affiliations

  1. Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA

    Stephanie Loo & Keri J. S. Brady

  2. Department of Pediatrics, University of Pittsburgh/Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Maya I. Ragavan

  3. Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA

    Kevin N. Griffith

  4. Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, Boston, MA, USA

    Kevin N. Griffith

Authors
  1. Stephanie Loo
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  2. Keri J. S. Brady
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  3. Maya I. Ragavan
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  4. Kevin N. Griffith
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Correspondence to Kevin N. Griffith.

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Loo, S., Brady, K.J.S., Ragavan, M.I. et al. Validation of the Clinicians’ Cultural Sensitivity Survey for Use in Pediatric Primary Care Settings. J Immigrant Minority Health 25, 790–802 (2023). https://doi.org/10.1007/s10903-023-01469-2

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  • DOI: https://doi.org/10.1007/s10903-023-01469-2

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