Abstract:
Diversification of the midwifery workforce is key to addressing disparities in maternal health in the United States. Midwives who feel supported in their practice environments report less burnout and turnover; therefore, creating positive practice environments for midwives of color is an essential component of growing and retaining midwives of color in the workforce. The Midwifery Practice Climate Scale (MPCS) is a 10-item instrument developed through multiphase empirical analysis to measure midwives\' practice environments, yet the MPCS had not been independently tested with midwives of color. We conducted invariance analyses to test whether latent means can be compared between midwives of color and non-Hispanic White samples. A step-up approach applied a series of increasingly stringent constraints to model estimations with multiple group confirmatory factor analyses with two pooled samples. A configural model was estimated as the basis of multiple group comparisons where all parameters were allowed to freely vary. Metric invariance was estimated by constraining item factor loadings to be equal. Scalar invariance was estimated by constraining intercepts of indicators to be equal. Each model was compared to the baseline model. The findings supported scalar invariance of MPCS across midwives of color and non-Hispanic White midwives, indicating that the MPCS is measuring the same intended construct across groups, and that differences in scores between these two groups reflect true group differences and are not related to measurement error. Additionally, in this sample, there was no statistically significant difference in perceptions of the practice environments across midwives of color and non-Hispanic White midwives (p > 0.05).
摘要:
助产劳动力的多样化是解决美国孕产妇健康差距的关键。在实践环境中感到支持的助产士报告的倦怠和营业额较少;因此,为有色人种助产士创造积极的实践环境是在劳动力中培养和保留有色人种助产士的重要组成部分。助产实践气候量表(MPCS)是通过多阶段经验分析开发的10项工具,用于测量助产士的实践环境,然而,MPCS尚未与彩色助产士进行独立测试。我们进行了不变性分析,以测试是否可以在有色助产士和非西班牙裔白人样本之间比较潜在手段。升级方法将一系列越来越严格的约束应用于具有两个合并样本的多组验证性因子分析的模型估计。配置模型被估计为多组比较的基础,其中所有参数都允许自由变化。通过将项目因子载荷限制为相等来估计度量不变性。通过将指标的截距限制为相等来估计标量不变性。将每个模型与基线模型进行比较。调查结果支持有色人种助产士和非西班牙裔白人助产士的MPCS标量不变性,表明MPCS在各组之间测量相同的预期结构,两组之间的得分差异反映了真实的群体差异,与测量误差无关。此外,在这个样本中,有色人种助产士和非西班牙裔白人助产士对实践环境的看法无统计学差异(p>0.05)。