Protocol - Discrimination in Health Care
Description
The DMS scale is a 7-item instrument that assesses a person’s prior experiences of mistreatment while getting health care that were attributed to race, ancestry, national origin, sex, disability, or age. Each question is rated on a 5-point Likert scale (1-never, 2-rarely, 3-sometimes, 4-most of the time, 5-always).
Specific Instructions
The working group (WG) notes that the DMS scale has been validated for Black/African-American populations, but further testing is warranted among other racial and ethnic groups.
Availability
This protocol is freely available; permission not required for use.
Protocol
Discrimination in Medical Settings Scale
Think of your prior experiences while getting health care when answering these questions.
1. You are treated with less courtesy than other people.
[ ] 1 Never
[ ] 2 Rarely
[ ] 3 Sometimes
[ ] 4 Most of the time
[ ] 5 Always
2. You are treated with less respect than other people.
[ ] 1 Never
[ ] 2 Rarely
[ ] 3 Sometimes
[ ] 4 Most of the time
[ ] 5 Always
3. You receive poorer service than others.
[ ] 1 Never
[ ] 2 Rarely
[ ] 3 Sometimes
[ ] 4 Most of the time
[ ] 5 Always
4. A doctor or nurse acts as if he or she thinks you are not smart.
[ ] 1 Never
[ ] 2 Rarely
[ ] 3 Sometimes
[ ] 4 Most of the time
[ ] 5 Always
5. A doctor or nurse acts as if he or she is afraid of you.
[ ] 1 Never
[ ] 2 Rarely
[ ] 3 Sometimes
[ ] 4 Most of the time
[ ] 5 Always
6. A doctor or nurse acts as if he or she is better than you.
[ ] 1 Never
[ ] 2 Rarely
[ ] 3 Sometimes
[ ] 4 Most of the time
[ ] 5 Always
7. You feel like a doctor or nurse is not listening to what you were saying
[ ] 1 Never
[ ] 2 Rarely
[ ] 3 Sometimes
[ ] 4 Most of the time
[ ] 5 Always
Personnel and Training Required
None
Equipment Needs
None
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Self-administered questionnaire
Lifestage
Adult
Participants
Adults aged 21 years or older
Selection Rationale
The DMS scale builds upon other widely used scales of discrimination. Findings indicate that the DMS scale has a single factor (factor analysis) solution, good internal consistency, and test-retest reliability, as well as good convergent validity.
Language
English
Standards
| Standard | Name | ID | Source |
|---|
Derived Variables
None
Process and Review
Not Applicable
Protocol Name from Source
Discrimination in Medical Settings (DMS) scale
Source
Peek, M. E., Nunez-Smith, M., Drum, M., Lewis, T. T. (2011). Adapting the everyday discrimination scale to medical settings: reliability and validity testing in a sample of African American patients. Ethnicity & Disease, 21(4), 502-509.
General References
Bird, S. T., & Bogart, L. M. (2001). Perceived race-based and socioeconomic status(SES)-based discrimination in interactions with health care providers. Ethnicity & Disease, 11(3), 554-563.
Thorburn, S., & Lindly, O. J. (2022). A systematic search and review of the discrimination in health care measure, and its adaptations. Patient Education and Counseling, 105(7), 1703-1713. https://doi.org/10.1016/j.pec.2021.10.008
Protocol ID
280901
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX280901_Discrimination_Health_Care_Doctor_Nurse_Act_Afraid | ||||
| PX280901050000 | A doctor or nurse acts as if he or she is more | N/A | ||
| PX280901_Discrimination_Health_Care_Doctor_Nurse_Act_Better | ||||
| PX280901060000 | A doctor or nurse acts as if he or she is more | N/A | ||
| PX280901_Discrimination_Health_Care_Doctor_Nurse_Act_Not_Listen | ||||
| PX280901070000 | You feel like a doctor or nurse is not more | N/A | ||
| PX280901_Discrimination_Health_Care_Doctor_Nurse_Act_Thinks_Not_Smart | ||||
| PX280901040000 | A doctor or nurse acts as if he or she more | N/A | ||
| PX280901_Discrimination_Health_Care_Less_Courtesy | ||||
| PX280901010000 | You are treated with less courtesy than more | N/A | ||
| PX280901_Discrimination_Health_Care_Less_Respect | ||||
| PX280901020000 | You are treated with less respect than other more | N/A | ||
| PX280901_Discrimination_Health_Care_Poorer_Service | ||||
| PX280901030000 | You receive poorer service than others. | N/A | ||
Measure Name
Discrimination in Health Care
Release Date
December 14, 2022
Definition
Discrimination within the health care system can be defined as negative actions or lack of consideration given to an individual or group that occurs because of a preconceived and unjustified opinion and plays an important role in perpetuating health disparities.
Purpose
Evidence suggests that perceived racial discrimination in health care is associated with several important health outcomes, including lower satisfaction with care, reduced adherence to care, lower quality patient/provider communication, underutilization of preventive health services, prolonged symptom duration before diagnosis, and poor overall self-reported health.
Keywords
Discrimination, health care, racism, race, prejudice, health care discrimination, health care delivery, Health Disparities, ethnicity, Access to Health Care
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 280901 | Discrimination in Health Care |