Readiness for Change in Provider Behavior for Inclusive Practices: A Measurement Development Study

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Publication Date

4-12-2024

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Presentation: 39:33

Abstract

Background: Sexual and gender diverse (SGD) communities face staggering healthcare and health disparities compared to their heterosexual and cisgender counterparts. Health outcomes are less favorable in these populations. Some of the biggest barriers are lack of knowledge and incompetence of the health provider that manifest in negative behaviors and discrimination against patients who are SGD. Inclusive practices are one way to mitigate some of the care disparities that exist with these populations. This research aimed to develop a measurement tool to investigate the readiness for change of healthcare providers to use inclusive practices with patients.

Methods: Group concept mapping (GCM) is a mixed methods approach that has been used in measurement development to directly engage the people most impacted by the target behavior, in this case, inclusive practices. Provider (n=11) and patient (n=13) stakeholders were engaged in the GCM process based on structured questions about “inclusive practice” in care. Provider participants made 69 unique statements and patient participants made 80 unique statements about what “inclusive practices” entailed. The statements were reviewed, redundancy and irrelevancy were removed by the research committee, and participant validation of content was confirmed via a de-identified survey. The statements were sorted by patient participants into piles based on their interpretation of similar meanings. The aggregated data (84 statements) was analyzed by GroupWisdomTM software to create point and cluster maps to show conceptual relationships. Data from the GCM analysis informed the final measurement development and 48 of the 84 statements matched the final items utilized in the measurement tool.

Results: The GCM process produced 84 statements. The 4-cluster map was interpreted as the best fit for the data. The final clusters were then finalized into four domains with a total of 19 items drafted into “how likely are you to..” questions. The measurement scale consists of two sections: the finalized items from the GCM process (19 items) and a section with decisional balance (2 items), self-efficacy (1 item), and temptation (2 items) questions. The score provides the respondent with one of the following stages of behavior change: pre-contemplation, contemplation, preparation, action, or maintenance stage in each domain.

Language

English

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