The development of the Agricultural Producer Barriers to Care Scale (APBCS)

IF 3.1 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Rural Health Pub Date : 2024-12-12 DOI:10.1111/jrh.12898

Noah Hopkins MPH, Chase Reece BSHP, Nathan Hansen PhD, Christina Proctor PhD

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引用次数: 0

Abstract

Purpose

The purpose of this study was to identify and test the factor structure of the Agricultural Producer Barriers to Care Scale (APBCS), which assesses barriers to engaging with health care in rural US farmers.

Methods

Respondents (n = 1045) completed an online survey that was distributed digitally and in-person by researchers and community partners at farming events and via farm-related social media. Exploratory and Confirmatory Factor Analysis were used to assess the underlying factor structure of the APBCS, and McDonald's omega coefficients were calculated to test the reliability of each factor and the instrument as a whole. Data analysis was conducted in SPSS 28.0 and MPlus Version 7.4.

Findings

The exploratory factor analysis (n = 689) indicated a four-factor structure for the APBCS with domains of (i) formal health care challenges, (ii) cultural barriers to help-seeking, (iii) stigma, and (iv) resilience, which explained 38.408% of the overall variance. The confirmatory factor analysis (n = 231) found that a three-factor structure, where questions from “cultural barriers to help seeking” were applied to factors for stigma and resilience, was a better fit for the model than the four-factor model hypothesized by the EFA. The final APBCS showed reliability within each domain, and across the full three-factor scale.

Conclusion

The APBCS is a promising tool that shows high internal consistency and could inform researchers and practitioners about the structural and cultural barriers to engaging with health care in agricultural producers living in the United States.

Abstract Image

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农业生产者关怀壁垒量表（APBCS）的开发。

目的：本研究的目的是识别和测试农业生产者护理障碍量表（APBCS）的因素结构，该量表评估美国农村农民参与医疗保健的障碍。方法：受访者（n = 1045）完成了一项在线调查，该调查由研究人员和社区合作伙伴在农业活动中以及通过与农场相关的社交媒体以数字和面对面的方式分发。采用探索性因子分析和验证性因子分析评估APBCS的潜在因子结构，并计算麦当劳ω系数以检验各因子和仪器整体的可靠性。数据分析采用SPSS 28.0和MPlus Version 7.4软件。结果：探索性因子分析（n = 689）表明，APBCS具有四因素结构，包括(i)正规医疗挑战、（ii）寻求帮助的文化障碍、（iii）耻辱感和（iv）复原力，解释了总方差的38.408%。验证性因素分析（n = 231）发现，三因素结构比EFA假设的四因素模型更适合该模型，其中从“文化障碍到寻求帮助”的问题应用于耻辱感和恢复力的因素。最终的APBCS在每个领域和整个三因素量表中都显示出可靠性。结论：APBCS是一个很有前途的工具，显示出高度的内部一致性，可以告知研究人员和从业人员在美国农业生产者参与卫生保健的结构和文化障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

6.10%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.