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

Bibiana Martinez; Jimi Huh; Jennifer Tsui

doi:10.3122/jabfm.2022.02.210307

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Table 1.

Sample Characteristics of English and Spanish-Speaking Hispanic/Latino Parents of Adolescents in Los Angeles, California (n = 264)

	Frequency (%) / Mean (SD)
Characteristic	Total N = 264	English N = 143	Spanish N = 121	p-value
Age				P = .26
<40 years	88 (33%)	54 (38%)	34 (28%)
41–50 years	122 (46%)	61 (43%)	61 (51%)
50 years or older	53 (20%)	28 (20%)	25 (21%)
Sex				P = .80
Female	237 (90%)	129 (90%)	108 (89%)
Male	27 (10%)	14 (10%)	13 (11%)
Nativity				P < .01^*
US born	66 (27%)	64 (48%)	2 (2%)
Non-US born	180 (73%)	70 (52%)	110 (89%)
Acculturation				P < .01^*
High	82 (31%)	77 (54%)	5 (4%)
Low	182 (69%)	66 (46%)	116 (96%)
Marital Status				P = .02^*
Married	177 (67%)	87 (61%)	90 (74%)
Single	32 (12%)	18 (13%)	14 (12%)
Divorced/Separated/Widowed	38 (14%)	29 (20%)	9 (7%)
Prefer not to answer	17 (6%)	6 (3%)	8 (6%)
Education				P < .01^*
High school diploma or less	143 (54%)	58 (41%)	85 (70%)
Some college or vocational/technical training	76 (29%)	58 (41%)	18 (15%)
College degree or above	28 (11%)	22 (15%)	6(5%)
Prefer not to answer	17 (6%)	5 (4%)	12(10%)
Employment				P = .04^*
Employed	133 (50%)	87 (61%)	46 (38%)
Unemployed	48 (18%)	22 (15%)	26 (21%)
Homemaker	59 (22%)	20 (14%)	39 (32%)
Other/Prefer not to answer	24 (9%)	14 (10%)	10 (8%)
Income				P < .01^*
Less than $20,000	68 (26%)	22 (15%)	46 (38%)
$20,000-$49,999	122 (46%)	59 (41%)	63 (52%)
$50,000-$79,999	55 (21%)	43 (30%)	12 (10%)
$80,000 or more	19 (7%)	19 (13%)	0 (0%)
Insurance				P < .01^*
Uninsured	37 (14%)	10 (7%)	27 (22%)
Private insurance	91 (35%)	73 (51%)	18 (15%)
Public insurance	120 (45%)	53 (37%)	67 (55%)
Other	16 (6%)	7 (5%)	9 (8%)

↵* P-value is statistically significant.
Abbreviations: SD, standard deviation.

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Table 2.

Means, Standard Deviations, Percent Endorsement, and p-values for 12 Items of the Group-Based Medical Mistrust Scale (GBMMS)

Scale Items	Total Sample		English Sample		Spanish Sample		p-value
Scale Items	Mean (SD)	% Somewhat or Strongly agree	Mean (SD)	%Somewhat or Strongly agree	Mean (SD)	% Somewhat or Strongly agree	p-value
1. Doctors and health care workers sometimes hide information from patients who belong to my ethnic group.	2.67 (1.25)	67 (25.4%)	2.56 (1.23)	29 (20.3%)	2.80 (1.28)	38 (31.4%)	0.12
2. Doctors have the best interests of people of my ethnic group in mind.^{^†}	3.73 (1.14)	35 (13.3%)^‡	3.60 (1.16)	23 (16.1%)±	3.89 (1.09)	12 (9.9%)±	0.04^§
3. People of my ethnic group should not confide in doctors and health care workers because it will be used against them.	2.16 (1.25)	40 (15.2%)	2.00 (1.12)	13 (9.1%)	2.34 (1.38)	27 (22.3%)	0.03^§
4. People of my ethnic group should be suspicious of information from doctors and health care workers.	2.16 (1.18)	37 (14.0%)	1.99 (1.02)	11 (7.7%)	2.36 (1.31)	26 (21.5%)	0.01^§
5. People of my ethnic group cannot trust doctors and health care workers.	2.06 (1.21)	37 (14.0%)	1.88 (1.02)	10 (7.0%)	2.26 (1.38)	27 (22.3%)	0.01^§
6. People of my ethnic group should be suspicious of modern medicine.	2.07 (1.18)	37 (14.0%)	1.94 (1.10)	15 (10.5%)	2.22 (1.26)	22 (18.2%)	0.06
7. Doctors and health care workers treat people of my ethnic group like ‘‘guinea pigs.’’	2.11 (1.23)	40 (15.2%)	2.06 (1.18)	19 (13.3%)	2.17 (1.28)	21 (17.4%)	0.47
8. People of my ethnic group receive the same medical care from doctors and health care workers as people from other groups.^{^†}	3.37 (1.26)	66 (25.0%)^‡	3.42 (1.25)	35 (24.5%)±	3.31 (1.27)	31 (25.6%)^‡	0.50
9. Doctors and health care workers do not take the medical complaints of people of my ethnic group seriously.	2.61 (1.31)	69 (26.1%)	2.56 (1.30)	37 (25.9%)	2.66 (1.33)	32 (26.4%)	0.53
10. People of my ethnic group are treated the same as people of other groups by doctors and health care workers.^{^†}	3.40 (1.25)	67 (25.4%)^‡	3.29 (1.25)	41 (28.7%)±	3.52 (1.25)	26 (21.5%)^‡	0.14
11. In most hospitals, people of different ethnic groups receive the same kind of care.^{^†}	3.45 (1.22)	64 (24.2%)^‡	3.40 (1.18)	35 (24.5%)±	3.51 (1.27)	29 (24.0%)^‡	0.45
12. I have personally been treated poorly or unfairly by doctors or health care workers because of my ethnicity.	2.18 (1.32)	50 (18.9%)	2.20 (1.29)	26 (18.2%)	2.16 (1.37)	24 (19.8%)	0.78

↵† Items are reverse coded.
↵‡ Percent disagree or strongly disagree (due to item wording).
↵§ P-value is statistically significant.
Abbreviations: SD, standard deviation.

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Table 3.

Factor Pattern Loadings for Group-Based Medical Mistrust Scale (GBMMS) Items

Scale Items	English Sample		Spanish Sample
	Factor Pattern Loading		Factor Pattern Loading
	Factor 1	Factor 2	Factor 1	Factor 2
1. Doctors and health care workers sometimes hide information from patients who belong to my ethnic group.	0.611^{^‡}	−0.187	0.594^{^‡}	−0.049
2. Doctors have the best interests of people of my ethnic group in mind.^{^†}	−0.153	0.525^{^‡}	−0.107	0.634^{^‡}
3. People of my ethnic group should not confide in doctors and health care workers because it will be used against them.	0.879^{^‡}	0.143	0.748^{^‡}	−0.025
4. People of my ethnic group should be suspicious of information from doctors and health care workers.	0.893^{^‡}	0.041	0.767^{^‡}	−0.127
5. People of my ethnic group cannot trust doctors and health care workers.	0.853^{^‡}	−0.025	0.860^{^‡}	0.071
6. People of my ethnic group should be suspicious of modern medicine.	0.826^{^‡}	0.029	0.809^{^‡}	0.052
7. Doctors and health care workers treat people of my ethnic group like ‘‘guinea pigs.’’	0.626^{^‡}	−0.305	0.734^{^‡}	−0.141
8. People of my ethnic group receive the same medical care from doctors and health care workers as people from other groups.^{^†}	0.104	0.864^{^‡}	0.02	0.820^{^‡}
9. Doctors and health care workers do not take the medical complaints of people of my ethnic group seriously.	0.370	−0.486^{^‡}	0.551^{^‡}	0.186
10. People of my ethnic group are treated the same as people of other groups by doctors and health care workers.^{^†}	0.064	0.880	−0.025	0.874^{^‡}
11. In most hospitals, people of different ethnic groups receive the same kind of care.^{^†}	0.004	0.828^{^‡}	0.007	0.796^{^‡}
12. I have personally been treated poorly or unfairly by doctors or health care workers because of my ethnicity.	0.355	−0.397	0.655^{^‡}	−0.28