WIP 95 - Translating and Culturally Adapting the Discrimination in Medical Settings Scale into Four Languages for Use in the Pediatric Inpatient Setting: A Pilot Study

Poster Number: WIP 95
Publication Number: WIP 95.997

Background: Discrimination has negative impacts on mental health, health behaviors, and health outcomes in adults. The Discrimination in Medical Settings (DMS) is a widely utilized measure of perceived discrimination. However, the DMS has not been extensively studied in pediatrics, the inpatient setting, or in patients/families who speak languages other than English (LOE), who are at higher risk of adverse events.

Objective: 1) Translate and culturally adapt the DMS Scale for multilingual use. 2) Pilot the DMS with patient caregivers to better understand the experiences of perceived discrimination in the pediatric inpatient setting for those who speak LOE.

Design/Methods: This mixed methods pilot study involves four steps, with iterative revision of the DMS tool at each step. 1) We made minor modifications to the English DMS Scale (e.g., adding options relating to language spoken, adding a free text to explain experience) and piloted it with English-speakers (n=7). 2) We professionally forward-translated the DMS into Arabic, Brazilian Portuguese, Haitian Creole, and Spanish. 3) Bilingual expert panelists independently reviewed professional translations and then as a group revised for accuracy, cultural relevancy, and readability, reaching consensus. 4) We piloted the tool and conducted cognitive interviews, using purposive sampling to identify patient caregivers identified in the electronic medical record as speaking Arabic, Brazilian Portuguese, English, Haitian Creole, or Spanish. We will enroll 50 caregivers of children admitted to the pediatric hospital medicine service. Descriptive statistics will report caregiver/patient demographic characteristics, frequency, and basis of discrimination experienced (e.g., race or language). Bivariate and content analysis will examine characteristic- or group-based differences in DMS scores. The Boston Children’s Hospital IRB approved this study. Anticipated timeline for completing data collection and analysis, respectively, is 12/31/23 and 3/1/24.