774 Development of an obstetric discrimination scale for examining impact of racism on pregnancy outcomes

Abstract

To develop a Discrimination Scale as a Screening Tool to Assess Impact of Racism on Pregnancy Outcomes Data was collected from the Saving Our Ladies from Early Births and Reducing Stress (SOLARS) study. SOLARS is a cross-sectional study (n=62) aimed at describing Black and Hispanic women's exposure to chronic stress, coping and resiliency strategies during pregnancy and postpartum in Oakland, California. To be eligible, women had to identify as Black or Hispanic, be 18 years or older, currently pregnant or 6 weeks postpartum, singleton pregnancy, and live/work in Oakland, California. Surveys were distributed online via Qualtrics and written surveys for those in person. Previously validated surveys for discrimination, coping mechanisms, and racism were utilized to create this scale including the: Perceived Stress Scale (PSS); Experiences of Discrimination (EOD); Brief COPE Inventory; and items from the CDC Health Behavior Survey. Principle component analysis with varimax rotation to identify domains of obstetric care experiences with stress and coping strategies during pregnancy and postpartum periods. No. of components was based on Eigen values greater than 1. Emerging components were refined by selecting items with factor loadings greater than 0.62. Reliability of all items using Cronbach tests. All analyses were conducted in SPSS 24 Table 1 shows the results from the principle component analysis (n=55). 14 components emerged, accounting for 79.3% of variance. After exploring factor loadings, only four components emerged. The cumulative percentage of the explained variance across the four components was 47.3%. The principle component analysis identified 19-items and four subdomains. Cronbach for the 19-item scale was 0.60, 5 items were removed resulting in a Cronbach of 0.65. The final scale consists of three subdomains measuring stress, coping, and discrimination Development of a Obstetric Discrimination Scale would allow for an objective tool to directly measure pregnancy outcomes, maternal morbidity and mortality in relation to perceived bias and racism