Development and testing of a patient-centered dental home assessment for low-income families.
Development and testing of a patient-centered dental home assessment for low-income families.
复制标题
为低收入家庭开发和测试以患者为中心的牙科家庭评估。
DOI：
10.1111/jphd.12323
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发表时间：
2019
影响因子：
2.3
通讯作者：
Lee,JessicaY
中科院分区：
文献类型：
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作者：
Rozier,RichardGary;White,BenjaminAlexander;Wang,Mian;Meyer,BeauD;Lee,JessicaY
目的本研究的目的是开发一种英语（ENG）和西班牙语（SPA）的仪器，用于评估低收入成年人对牙科家庭特征的看法。方法一个专家小组从美国儿科学会医学之家的81个项目中选择了21个项目。对早期启蒙（EHS）儿童的母亲（n= 795）进行的试点测试产生了一个扩大的36项量表，并在与ENG‐（NENG= 665）和SPA‐演讲者（NSPA= 116）的访谈中进行了现场测试。在EHS参照组（neeng‐EHS= 272）中对23个可用项目进行探索性因子分析。选择的模型在另外两个亚组（NENG‐NonEHS= 393；NSPA= 116）中进行验证性因子分析（CFA）评估。我们使用多组方法测试了测量和结构不变性。已知组效度通过两组之间的测试因子平均差异来检验，该差异由母亲是否使用单一牙科诊所定义。结果保留了包含10个项目的三因素CFA模型，因为它对所有三个亚组的拟合都很接近。不变性测试发现两个ENG子组是同质的，并将其合并。SPA组与联合ENG组在多个项目及因素参数上存在差异。提出的牙科家庭测量显示出良好的已知组效度，即使用同一家牙科诊所的人报告了更好的牙科护理体验。结论一种测量低收入成人牙科家庭概念的工具具有三个领域（可及性-综合性、同情心和健康素养护理），具有良好的效度和信度。
ObjectivesThe purpose of this study was to develop an instrument in English (ENG) and Spanish (SPA) for use in assessing perceptions of dental home characteristics among low‐income adults.MethodsAn expert panel selected 21 items from a pool of 81 items mapped to domains in the American Academy of Pediatrics’ medical home. Pilot testing with mothers (n= 795) of children in Early Head Start (EHS) resulted in an expanded 36‐item scale, which was field‐tested in interviews with ENG‐ (NENG= 665) and SPA‐speakers (NSPA= 116). An exploratory factor analysis of 23 usable items was carried out in an EHS reference group (NENG‐EHS= 272). The selected model was evaluated by confirmatory factor analysis (CFA) in two other subgroups (NENG‐NonEHS= 393;NSPA= 116). We tested measurement and structural invariances using a multiple‐group approach. Known‐groups validity was examined by testing factor mean differences between two groups defined by whether or not the mother used a single dental office.ResultsA three‐factor CFA model with 10 items was retained for its close fit for all three subgroups. Invariance tests found the two ENG subgroups to be homogenous and were combined. Several item and factor parameters in the SPA group differed from the combined ENG group. The proposed dental home measure demonstrated good known‐group validity in that people who used the same dental office reported better dental care experiences.ConclusionsAn instrument to measure the dental home concept among low‐income adults was developed with three domains (accessible‐comprehensive, compassionate, and health literate care) that demonstrated good validity and reliability.