Linking critical consciousness and health: The utility of the critical reflection about social determinants of health scale (CR_SDH).
Linking critical consciousness and health: The utility of the critical reflection about social determinants of health scale (CR_SDH).
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DOI：
10.1016/j.ssmph.2022.101034
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Sarol J Jr
中科院分区：
文献类型：
--
作者：
Windsor LC;Jemal A;Goffnett J;Smith DC;Sarol J Jr
批判意识（CC）理论已被提出作为一个框架，以告知针对各种健康状况的健康干预措施。不幸的是，方法上的限制使得很难测试CC作为健康结果的中介。具体而言，需要标准化和广泛接受的健康相关CC的措施。本研究的目的是开发和测试一种衡量健康的社会决定因素（SDH）的批判性反思。这项措施侧重于批判性反思，这是CC的一个基本方面。以社区为基础的参与性研究原则和混合方法的设计与三个样本：（1）在SDH和CC的专家，（2）502个人完成在线调查，和（3）602人与物质使用障碍和监禁的历史。所有参与者均超过18岁。分析包括描述性频率，探索性因素分析（EFA），验证性因素分析（CFA），广义线性回归模型，相关性，和克朗巴赫的α计算。SDH量表（CR_SDH）是一个简短、一维、可靠的量表（α = 0.914）。结构效度的支持和已知群体的有效性表明，该规模区分不同级别的CR_SDH的政治观点，教育水平，卫生不公平的知识，和性别。CR_SDH是一种标准化的测量方法，可以评估SDH对卫生保健提供者和消费者健康影响的关键反映。CR_SDH可用于识别与批判性反思相关的培训需求，并为与批判性反思相关的健康干预措施和医疗保健政策的制定和测试提供信息。健康的社会决定因素助长了卫生不公平现象，使世界各国付出了重大代价。批判意识理论是一个有潜力解决健康和健康不公平的社会决定因素的框架。这项研究开发了一个标准化的工具来衡量对健康的社会决定因素的影响的批判性反思。CR_SDH可以作为治疗结果的中介。
Critical consciousness (CC) theory has been proposed as a framework to inform health interventions targeting a wide variety of health conditions. Unfortunately, methodological limitations have made it difficult to test CC as a mediator of health outcomes. Specifically, standardized and widely accepted measures of health-related CC are needed. The goal of this study was to develop and test a measure of critical reflection on social determinants of health (SDH). This measure focused on critical reflection, an essential dimension of CC. Community-based participatory research principles and a mixed methods design were used with three samples: (1) experts in SDH and CC, (2) 502 individuals completing online surveys, and (3) 602 men with histories of substance use disorder and incarceration. All participants were over 18 years of age. Analysis included descriptive frequencies, exploratory factor analyses (EFA), confirmatory factor analysis (CFA), generalized linear regression models, correlations, and Cronbach's alpha calculations. The Critical Reflection about SDH scale (CR_SDH) is a short, unidimensional, and reliable scale (α = 0.914). Construct validity was supported and known-groups validity showed that the scale discriminated different levels of CR_SDH based on political views, educational level, knowledge of health inequities, and gender. The CR_SDH is a standardized measure that can assess critical reflection about the impact of SDH on health among providers and consumers of health care. The CR_SDH can be used to identify critical reflection related training needs and inform decisions about development and testing of critical reflection related health interventions and health care policy. Social determinants of health contribute to health inequities that pose significant costs to nations throughout the world. Critical consciousness theory is a framework with potential to address social determinants of health and health inequities. This study developed a standardized tool to measure critical reflection about the impact of social determinants of health. The CR_SDH can be used as a mediator of treatment outcomes.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
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作者：
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通讯作者：
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