JOURNAL ARTICLE

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) cultural competence (CC) item set

Robert Weech-Maldonado, Adam Carle, Beverly Weidmer, Margarita Hurtado, Quyen Ngo-Metzger, Ron D Hays
Medical Care 2012, 50 (9): S22-31
22895226

BACKGROUND: There is a need for reliable and valid measures of cultural competence (CC) from the patient's perspective.

OBJECTIVE: This paper evaluates the reliability and validity of the Consumer Assessments of Healthcare Providers and Systems (CAHPS) CC item set.

RESEARCH DESIGN: Using 2008 survey data, we assessed the internal consistency of the CAHPS CC scales using the Cronbach α's and examined the validity of the measures using exploratory and confirmatory factor analysis, multitrait scaling analysis, and regression analysis.

SUBJECTS: A random stratified sample (based on race/ethnicity and language) of 991 enrollees, younger than 65 years, from 2 Medicaid managed care plans in California and New York.

MEASURES: CAHPS CC item set after excluding screener items and ratings.

RESULTS: Confirmatory factor analysis (Comparative Fit Index=0.98, Tucker Lewis Index=0.98, and Root Mean Square Error or Approximation=0.06) provided support for a 7-factor structure: Doctor Communication--Positive Behaviors, Doctor Communication--Negative Behaviors, Doctor Communication--Health Promotion, Doctor Communication--Alternative Medicine, Shared Decision-Making, Equitable Treatment, and Trust. Item-total correlations (corrected for item overlap) for the 7 scales exceeded 0.40. Exploratory factor analysis showed support for 1 additional factor: Access to Interpreter Services. Internal consistency reliability estimates ranged from 0.58 (Alternative Medicine) to 0.92 (Positive Behaviors) and was 0.70 or higher for 4 of the 8 composites. All composites were positively and significantly associated with the overall doctor rating.

CONCLUSIONS: The CAHPS CC 26-item set demonstrates adequate measurement properties and can be used as a supplemental item set to the CAHPS Clinician and Group Surveys in assessing culturally competent care from the patient's perspective.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
22895226
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"