Validating the Group-Based Medical Mistrust Scale with English and Spanish Speaking Latino Parents of Adolescents

Abstract

Background: Medical mistrust can be a barrier to health care utilization. While the Group-Based Medical Mistrust Scale (GBMMS) has been validated among diverse populations, we know little about its psychometric performance among English-Speaking (ES) and Spanish-Speaking (SS) Latinos. We aim to examine the factor structure of GBMMS among Latino parents and explore whether scale latent factor structures would be different across preferred languages.

Methods: Parents of adolescents participating in an urban academic enrichment program for low-income students completed an online survey as part of a cross-sectional study about Human Papillomavirus (HPV) prevention. We tested the validity of the GBMMS in ES and SS respondents and performed exploratory factor analysis to identify latent factors. We examined scale scores, item means, item endorsement, and residual variance across language groups.

Results: 2-factor latent structure was identified for both ES and SS groups; factors were labeled as 'Suspicion' and 'System-wide discrimination.' Scale validity was better among SS (α = 0.76). Medical mistrust scores did not vary across language groups, but variation emerged in item endorsement by language.

Discussion: Our results suggest that the factor structures of the medical mistrust construct, measured by the GBMMS, are similar across ES and SS Latinos and that the GBMMS is valid for both populations. High factor pattern loading reflects a shared mistrust of how health care systems view and treat people of their racial/ethnic background, independent of their preferred languages. Measurement of medical mistrust and identifying its underlying causes are needed within diverse populations to fully address structural- and community-level influences on health inequities.

Keywords: Cancer; Cross-Sectional Studies; Group Based Medical Mistrust Scale; Health Behavior; Health Inequities; Hispanic or Latino; Minority Health; Parents; Patient Acceptance of Health Care; Statistical Factor Analysis; Trust.