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. Author manuscript; available in PMC: 2010 Aug 3.
Published in final edited form as: J Health Care Poor Underserved. 2008 Aug;19(3):697–730. doi: 10.1353/hpu.0.0041

Table 1.

MEASURES OF RACIAL/ETHNIC DISCRIMINATION

Author Study population Study purpose and theoretical framework Measure development and psychometric evaluation Instrument description and examples of items
1. Amaro H., et al. (1987) 303 Hispanic women professionals via mailing of the National Network of Hispanic Women. Experience of discrimination, job stress and peer support as related to mental health. No psychometric evaluation described 109 closed-ended, self-administered questions on work, family, and health.
Work characteristics: “Have you ever experienced discrimination?” Yes/No
“How often do your peers undermine your performance?” (from (1) never to (5) always)
2. Auslander W.F., et al. (1997)

(Healthcare)		 158 (55 African American, 103 White) children with diabetes and their mothers or female guardians. Whether perceived racism in the community was a predictor of mothers’ satisfaction with medical care of their children with diabetes.
Ecological framework to examine how family and community contexts may predict satisfaction with medical care.		 Dressler’s Perceptions of Racism Scale (PRS, see #6) was modified to measure perceptions of unfair treatment by workers in multiple settings including health care.
The Cronbach’s Alpha (CA)a coefficient was 0.78		 6 questions, on a Likert-type scale
Perceptions of unfair treatment on the basis of race by city officials, restaurant workers, health care providers, and school teachers.
3. Bird S.T., et al. (2001)

(Healthcare)		 76 African American adults (59 women, 17 men) recruited from community centers and churches in northeast Ohio. Perceived race-based and socio-economic status (SES)-based discrimination in interactions with healthcare providers.

Also:
Stigma consciousness questionnaire to capture African Americans’ perceptions of being stigmatized when interacting with doctors and beliefs about how doctors view African Americans.		 Adapted from a measure of “everyday discrimination” by Williams and colleagues (item #24).

Stigma consciousness adapted from Pinel.

Stigma consciousness questions 1–7:
No psychometric evaluation

Pinel: CA=0.78		 (10 health care related items)
Question: “When getting health care, have you ever had any of the following things happen to you because of your race or color?”
1–7 experiences were listed:

  1. been treated with less courtesy than other people;

  2. been treated with less respect than other people;

  3. received poorer service than others;

  4. had a doctor or nurse act as if he or she thinks you are not smart;

  5. had doctor or nurse act as if he or she is afraid of you;

  6. had a doctor or nurse act as if he or she is better than you;

  7. felt like a doctor or nurse was not listening to what you were saying.

Response format: yes/no
Pinel: 7-point Likert-type 10-item questionnaire: ranging from 0=strongly disagree to 6=strongly agree, with 3=neither disagree or agree:
1) Stereotypes that doctors have about Blacks/AAs have not affected me personally; 2) I never worry that doctors will view my behaviors as stereotypically Black/AA; 3) I feel like doctors interpret all of my behaviors in terms of the fact that I am Black/AA; 4) Most doctors do not judge Blacks/AAs on the basis of their race; 5) My being Black/AA does not influence how doctors treat me; 6) I almost never think of the fact that I am Black/AA when I interact with doctors; 7) My being Black/AA does not influence how people of other ethnic groups act with me; 8) Most doctors have a lot more racist thoughts than they actually express; 9) I often think that doctors are unfairly accused of being racist; and 10) Most doctors have a problem viewing Blacks/AAs as equals.
4. Broman, C.L. (1996) 312 African American adults in Detroit. Krieger 1990 study rephrased to refer only to discrimination in the past three years (see item #11). No psychometric evaluation described Study, stem questions were identical to Krieger 1990 measure and the situation varied slightly from Krieger (item #11).
5. Brondolo, et al. (2005) Perceived Ethnic Discrimination Questionnaire— Community Version Study 1: 301 adults (174 African American, 82 Latino, 18 White, 7 Asian, 4 Native American, 9 mixed, 7 none reported) see in primary healthcare practices in NYC
Study 2: 340 Black and Latino college students and adults		 Study 1: To assess ethnic discrimination in any group, across varying levels of literacy, while assessing the life experiences of community-dwelling adults. Adaptation of Contrada’s PEDQ. Based on Lazarus and Folkman’s stress & coping framework
Study 2: To develop brief version of Lifetime Exposure Scale		 Study 1: Scale development: edited PEDQ (Contrada et al) to reduce vocabulary level and adapt items to experiences of community dwelling adults. Preliminary testing and interviews with small sample, then use in larger sample. Testing for construct validity
Study 2: High internal consistency reliability remained; good convergent validity with other measures of racism; good construct validity		 Study 1: 70 item questionnaire with 5 scales: Lifetime Exposure Discrimination, Discrimination in the Media, Discrimination Against Family Members, Discrimination in Different Settings ( Five point response scale—never happened to happened very often) and Past Week Discrimination (four point scale: never in the past week to 3 or more times in the past week). Internal consistency reliability exceeded CA=.75 for all scales.
BECAUSE OF YOUR ETHNICITY/RACE … How often …

  • Has someone said something disrespectful, either to your face or behind your back?

  • Have others ignored you or not paid attention to you?

    Study 2: 17 item brief version was created from the 34 item Lifetime Exposure scale from the PEDQ-CV.

    BECAUSE OF YOUR ETHNICITY/RACE … How often …

  • Have people been nice to you to your face, but said bad things about you behind your back?

  • Have others hinted that you must not be clean?
6. Clark, R. (2003)

(Healthcare)		 64 Black college students Effects of perceived racism and social support on blood pressure reactivity. Modified version of the 128-item Life Experiences and Stress Scale assessed perceived racism. Perceived racism measurements:
“Overall how much do you think that INTER-ETHNIC GROUP RACISM has had anything to do with any problem you have had related to your ______ in your lifetime?” (Nine domains included: employment, law enforcement and the legal system, money and finances, education, community, family and social relationships, emotional well-being, physical health and medical care, and public assistance.) Responses ranged from 0–4 (0=less than 25% of the time, 4=between 75% and 100% of the time). Perceived racism composite (PRC) reffected the sum of all responses.
7. Clark R., et al. (2006) 217 Black youth Effects of perceived racism and coping responses on blood pressure. Modified version of the 9-item Everyday Discrimination Scale to assess racism & 4-item assessment for coping responses 6-point Likert-type scale to assess racism:
“In your day-to-day life how often have any of the following things happened to you BECAUSE OF YOUR RACE? [Responses ranged from 0 (almost everyday) to 6 (never).] Example: “you are called names or insulted”

4-item questionnaire used to assess coping response, 4-point Likert-type scale [Responses ranged from 1 (not at all) to 4 (a lot)]:

“We are now interested in how you tend to respond to these types of experiences …”

  1. “Tried to do something about it”

  2. “Accepted if as a fact of life”

  3. “Realized that you brought it on yourself”

  4. “Talked to someone about how you were feeling”
8. Contrada, et al. (2001) Perceived Ethnic Discrimination Questionnaire 361 college students (208 White, 34 Black, 31 Hispanic, 60 Asian) To develop a measure of discrimination that can be used in all ethnic groups. Based on Lazarus and Folkman’s stress & coping framework. To develop items, drew on conceptual analyses, journalistic descriptions, and qualitative analyses of subjects’ descriptions of experiences of ethnic discrimination. Examined internal consistency reliability (all alphas>.70) 22 items assess seven forms of discrimination: verbal rejection, avoidance, exclusion, denial of equal treatment, disvaluing action, threat of aggression, aggression. Four scales with 7 point response (never – very often) developed: disvaluation, threat/aggression, verbal rejection and avoidance.
Examples: How often have you been subjected to offensive ethnic comments aimed directly at you, spoken either in your presence or behind your back?
How often has it been implied or suggested that because of your ethnicity you must be unintelligent?
9. Corrigan, P., et al. (2003)

Modified Schedule of Racist Events (SRE)

(Healthcare)		 1,824 persons (285 African American, 33 Latino, 97 Native American, 15 Asian, 228 White) with serious mental illness recruited from community mental health centers. Multistate study. Compared discrimination experienced by persons with mental illness to self-reports of discrimination due to other group characteristics such as race, gender and sexual orientation. Measures were based on responses to the Discrimination Questionnaire, adapted from the Schedule of Racist Events (SRE).

Modifications to SRE: changed focus to examine multiple sources beyond race and used global questions rather than behavior specific.

No psychometric evaluation described		 (one health care related item)
26 interview-based measures were administered:

“Do you believe that you have been discriminated against, for instance because of your mental disability, race, gender, sexual orientation, economic circumstance or some other reason?”

The next questions asked yes or no questions about the specific conditions of discrimination (one of which was race).

The last questions asked about the type of situations the discrimination occurred (setting, including housing, employment, and education).
10. Dressler, W.W. (1990) 186 25–55 yr. old African Americans. Effects of lifestyle incongruity (extent to which a high status style of life exceeds an individual’s occupational class) on blood pressure.
Effects of perceived stressors were evaluated.		 No psychometric evaluation described 3 of 16, yes or no, items from the Scale of Chronic Social

Role Stressors:

  1. “Feel you missed a promotion because you’re Black?”

  2. “Feel you’re not given real job responsibilities because you’re Black?”

  3. “Feel you are paid less than a White person?”
11. Eccles J.S., et al. (2006) 1480 African American adolescents residing near Washington D.C. Effects of racial discrimination on academic performance among African American 7th graders (longitudinal study with follow-up after completion of eighth grade) Data from Maryland Adolescents Development in Context (MADIC) Study

Parental perceptions of discrimination at work and in community by peers and teachers:

Perceived discrimination by peers: CA: 0.86

Perceived discrimination by teachers:
CA: 0.88		 5-point scale for perceived discrimination

  1. how often do you perceive poorer treatment in stores of restaurants because of your race? (ranging from 1=almost never to 5=almost daily )

  2. compared to people of other races, how many opportunities for job advancement did you get at work (15a lot fewer to 55a lot more)

Perceived discrimination by peers: examples include frequency they felt they got into fights, were not associated with, and were not picked for particular teams or activities because of their race.
Perceived discrimination by teachers: examples include how often they felt their teachers called on them less, graded them more harshly, disciplined them more harshly, discouraged them from taking a class, and thought they were less smart because of their race.
Questions also assessed adolescents’ perception of future racial job and educational discrimination, racial group cultural-capital identity, achievement motivation, future endeavors, academic achievement, and their parents’ perceptions of racial discrimination at work and in the community.
12. Green, N.L. (1995)

Perceptions of Racism Scale (PoRS)

(Healthcare)		 African American Childbearing Women: Study A, N=109; Study B, N=136. Extent racism was a factor in low-birth-weight (LBW) and preterm babies in African American women.

Racism experienced:

  • Affectively (feelings of racism)

  • Behaviorally (racist actions)

  • Cognitively (racist thoughts)

 Several items from the Business Week/Harris Poll (Jackson and Collingsworth, 1988) were revised and included in the scale.

CA:
Study A=088
Study B=0.91		 (9 health care related items)
20-item self-report inventory, of which 10 questions concern medical, 2 of life experiences of discrimination.
4-point Likert Type scale ranging from “strongly agree” to “strongly disagree”:
1) AA women experience negative attitudes when they go to a White doctor’s office; 2) Doctors treat AA and White women the same; 3) Racism is a problem in my life; 4) A pregnant White women is treated with more respect than a pregnant AA woman; 5) I am not affected by discrimination; 6) Sometimes if you are AA in a White doctor’s office it’s as if you don’t belong there; 7) Racial discrimination in a doctor’s office is common; 8) In most hospitals, AA women and White women get the same kind of care; 9) Doctors and nurses act the same way to White and AA pregnant women; 10) If an AA pregnant woman comes to a doctor’s office, it’s assumed that she is on welfare; 11) AAs have the same opportunities as Whites to live a middle class life; 12) Officials listen more to Whites than AAs; 13) If an AA woman and a White woman are applying for the same job they have the same chance of being hired; 14) There has been significant progress in ending racism in the 1980’s; 15) A White woman has more opportunities than an AA woman; 16) AA women get pregnant to receive more welfare benefits; 17) AA woman can receive they want as equally as White women; 18) Judges are harder on AAs than Whites; 19) AA pregnant woman have fewer options for health care; 20) Officials listen more to AA’s than Whites.
13. Harrell, J.P. (1994)

Racism and Life Experiences Scales—Brief Version (RaLES-B)		 139 African American/Latino Adolescents. Assessed impact of perceived racism on behavior, psychological status, & health outcomes in minority populations.

Developed in 1992 to assess the degree to which perceived racism influenced a group of African American and Latino men to participate in a substance abuse treatment program.		 CA:
Group=0.90
Self=0.88
Validity:
Self was significant & positively correlated with immersion stage of racial identity (r=0.26) and adaptive functioning (r=0.18) group was significantly correlated with encounter (r=0.23) and internalization.
(r=0.29) subscales of the RIAS-B.		 32,
4-point
Likert type scale

Part 1—
Perceived racism-self total
How does it affect you?

Part 2—
Perceived racism-group total
How does perceived racism affect your race?
14. Jackson, J.S., et al. (1996) 623 African Americans (national sample). To investigate the consequences of racism for the physical and mental health of African Americans. Two measures of racism were used: 1) Perception of whites’ intentions; and 2) A report of racial discrimination experiences. No psychometric evaluation described Perception of White’s intentions response format:
Select one of the 3 specified options: Whites want to keep Blacks down; Whites want to see Blacks get a better break; or, Whites just don’t care one way or the other about Blacks.

Discrimination response format: yes/no
This measure asked Blacks whether they or their family member were treated badly because of their race in the past month.
15. James, et al. (1994)
Workplace Prejudice/Discrimination Inventory		 Study 1: 90 ‘minority’ volunteers from 4 different workplaces (>60% Mexican Americans)
Study 2: 46 incumbents in one organization with multiple units (about half Mexican American, half Asian American)		 Study 1: To develop a validated inventory to examine perceptions of racial prejudice and discrimination in the workplace, based on social identity theory.
Study 2:		 Study 1: 16 Items developed by examining literature, including individuals’ global perceptions of prejudice/discrimination at work and specific types of discrimination. Factor analyses revealed one primary factor with CA=.90
Study 2: Factor analysis led to one factor, CA=.93		 7 item Likert response scale
Examples: Where I work members of some racial/ethnic groups are treated better than members of other groups. At work I am treated poorly because of my racial/ethnic group.
16. Johnson, R.L., et al. (2004)

(Healthcare)		 6,299 White, African American, Hispanic and Asian adults. Examined: 1) whether racial/ethnic differences exist in patients’ perceptions of primary care provider and general health care system-related bias and cultural competence, and 2) whether these differences are explained by patient demographics, source of care, or patient-provider communication variables. Data from the nationally representative Commonwealth Fund 2001 Health Care Quality Survey was used.

No psychometric evaluation described		 (6 health care related items)
Physician Bias and Interpersonal Competence Measures (questionnaire Items): 1) Did the doctor treat you with a great deal of respect and dignity, a fair amount, not too much, or none at all? 2) I feel that my doctor understands my background and values. 3) I often feel as if my doctor looks down on me and the way I live my life.
(For both 2 & 3: Strongly agree, somewhat agree, somewhat disagree, strongly disagree)

Health System Bias and Cultural Competence Measures (questionnaire items): 1) Do you think there was ever a time when you would have gotten better medical care if you had belonged to a different race or ethnic group? 2) Thinking about all of the experiences you have had with health care visits in the last 2 years, have you ever felt that the doctor or medical staff you saw judged you unfairly or treated you with disrespect because of your race or ethnic background? 3) Thinking about all of the experiences you have had with health care visits in the last 2 years, have you ever felt that the doctor or medical staff you saw judged you unfairly or treated you with disrespect because of how well you speak English?
(For questions 1–3, yes or no response)
17. Krieger, N. (1990)

(Healthcare)		 51 African American and 50 White women, aged 20–80, who resided in Alameda County, CA. To determine the feasibility of asking questions pertaining to race-and gender-based treatment plus response to unfair treatment, and to assess their predictive value regarding self-reported high blood pressure. No psychometric evaluation described (one health care related item)
Phone interview: Ever experienced discrimination response format: yes/no

  1. If you feel you’ve been treated unfairly, how do you usually respond-do you:

    “Accept it as a fact of life?” “Try to do something about it?”

  2. And if you’ve been treated unfairly, do you: “Talk to other people about it?” “Keep it to yourself?”

  3. Have you ever experienced discrimination, been prevented from doing something, or been hassled or made to feel inferior in any of the following 5 situations because of your race or color?

    “At school,” “getting a job,” “at work,” “at home,” “getting medical care.”
18. Krieger, et al. (2005)

(Healthcare)		 Cohort of working class adults, 159 African American, 249 Latino, and 208 White participants To assess the validity and reliability of the “Experiences of Discrimination” measure. Examined scale reliability through factor analysis, testing of internal consistency reliability (CA=.74), test-retest reliability (0.70), and found highest correlation with underlying discrimination construct compared to other self-report discrimination measures (see items above)
19. Landrine, H., et al. (1996)

Schedule of Racist Events (SRE)

(Healthcare)		 153 African American students, staff and faculty at a university. Assessed frequency encountered racial discrimination, and degree to which a racist event was appraised as stressful, in past year and lifetime.

Theoretical framework: Life Events (Dohrenwend, 1978) and Daily Hassles.		 This measure was modeled after the PERI-LES and other similar scales that assess frequency of stressful events in people’s lives.

Recent discrimination (past year):
CA=0.95, split-half reliability: 0.93

Lifetime discrimination:
CA=0.95, split-half reliability: 0.91

Appraisal of stress:
CA=0.92, split-half reliability: 0.92		 (one health care related item)
18 item self-report inventory measures, on a 6-point Likert-type scale, the frequency African Americans have experienced specific racist events in a wide variety of settings, including one item regarding health care setting (e.g., racism experienced by institutions, neighbors, peers, and teachers). Each question was asked three times: once for the frequency of the racist event in the past year, once for the frequency of the event during one’s entire lifetime, and once for the appraisal of the stressfulness of the events.
Examples:
“How many times have you been treated unfairly by institutions (schools, universities, law firms, the police, the courts, the Department of Social Services, the Unemployment Offices and others) because you are Black?”
How many times have you been treated unfairly by people in helping jobs (doctors, nurses, psychiatrists, case workers, dentists … therapists …)

Frequency: “never” to “almost all the time”
Stress: “not at all” to “extremely”

“How many times in the past year?”
“How many times in your entire life?”
“How stressful was this for you?”
20. Landrine H., et al. (2006)

(Healthcare)		 1569 adults (868 college students and 701 community adults; 780 Whites, 406 Latinos, 174 African American, 94 Asian Americans, 95 Other racial background) To measure perceived ethnic discrimination in health research General Ethnic Discrimination Scale modeled on the Schedule of Racist Events (SRE) that measures discrimination as a type of stress.

Recent discrimination (past year):
CA=0.94

Lifetime discrimination:
CA=0.94

Appraised discrimination:
CA=0.95

(split-half reliability for each scale: 0.91)		 18-item measure of perceived ethnic discrimination, on a 6-point Likert-type scale, the frequency the sample has experienced specific racist events in a wide variety of settings, including one item regarding health care setting (e.g., racism experienced by institutions, neighbors, peers, and teachers).

Each question was asked three times: once for the frequency of the racist event in the past year, once for the frequency of the event during one’s entire lifetime, and once for the appraisal of the stressfulness of the events.

Examples:
“How many times have you been treated unfairly by institutions (schools, universities, law firms, the police, the courts, the Department of Social Services, the Unemployment Offices and others) because of your race/ethnic group?”
How many times have you been treated unfairly by people in helping jobs (by doctors, nurses, psychiatrists, case workers, dentists … therapists …) because of your race/ethnic group?

Frequency: “never” to “almost all the time”
Stress: “not at all” to “extremely”

“How often in the past year?”
“How often in your entire life?”
“How stressful was this for you?”
21. Lillie-Blanton, et al. (2000)
(Healthcare)		 Nationally representative sample of 3,884 Whites, African Americans and Latinos To assess the public’s attitudes about racial and ethnic differences in health care Survey was designed and analyzed by the authors. (three health care related items)
Have you felt a doctor or health provider judged you unfairly or treated you with disrespect because of race or ethnic background?
22. Mays and Cochran (1997) 232 African American women and 73 African American men in college, university, in junior college, in Los Angeles, CA. Frequency of discrimination as related to psychological distress. Frequency of discrimination:

  • Based on race-ethnicity, gender or both: in general: personally experienced

  • As perpetrated by three sources (African American men, women, White men): against African American person of same gender as respondent; personally experienced

  • As perpetrated by other African Americans against African Americans lacking economic resources: in general; personally experienced

No psychometric evaluation described		 Frequency of discrimination response format: for each item, 7-point Likert-type scale, ranging from “never” to “fairly often.”

Degree of upset and relation to perpetrator, for each type of personally experienced discrimination, response format: 7-point Likert-type scale. Upset: ranging from “not at all” to “upset a great deal.”

Relationship to perpetrator: “mostly by those I know well” to “mostly by complete strangers”
23. McNeilly, M.D., et al. (1996)

Perceived Racism Scale (PRS)

(Healthcare)		 165 African American College students, and 25 members from the community. This measure of African Americans experience of racism provides an assessment of frequency of exposure to multiple types of racist events and an assessment of emotional and behavioral coping responses to racism across a variety of situations. CA range: 0.88–0.96
Frequency of exposure=0.96
Emotional and behavioral coping responses=0.92

Test-retest reliability: range 50.05–0.78		 (one health care related item)
51 items

Measures frequency of exposure (past year; over one’s life) to types of racist incidents, and includes dimensions of emotional and behavioral coping responses. These exposures and responses are measured with respect to their occurrence in three situational domains: on the job, in academic settings and in the public realm (overt and subtle), & measurement of exposure to racist statements which can occur across settings. One item regarding health care: “I have been denied hospitalization or medical care”

Dimension 1. Frequency of exposure to types of racist events
Types include: Individual and institutional, overt and covert, attitudinal and behavioral, temporal component assesses incidents occurring:

  • over the past year

  • over one’s life

Dimension 2. Emotional responses to perceived racism
Emotions include feeling: Angry, frustrated, sad, powerless, hopeless, ashamed, strengthened.
Dimension 3. Behavioral coping responses to perceived racism
Coping behaviors include: Speaking up, accepting it, ignoring it, trying to change things, keeping it to myself, working harder to prove them wrong, praying, avoiding it, getting violent, forgetting it, other.
Domains—Each dimension is assessed across the following domains:
Employment domain, academic domain, public domain, racist statements
24. Peterson, et al. (2004) 1,979 full time medical school faculty. 82% White, 8% Black, 1% Mexican Americans, 1% Puerto Ricans, 0.3% Native Americans, 7% Asian or Pacific Islanders, 1% Hispanic Americans To assess experiences of discrimination of minority faculty in academic medicine Not described Do you perceive any racial/ethnic biases or obstacles to the career success or satisfaction of faculty by race/ethnicity in your academic environment? (1=no, never – 5= yes, frequently)
In your professional career, have you ever been left out of opportunities for professional advancement based on race/ethnicity? (1=no; 5=yes)
In your professional career, have you personally encountered racial/ethnic discrimination (unfair or injurious distinction or treatment by a superior or colleague? (1=no; 2=yes)
If yes to latter, respondents asked “How much of a problem has this been for you?,” “Have you encountered racial/ethnic remarks?”, “To what extent have these experiences had a negative effect on your confidence as a professional?”, and “To what extent have these experiences negatively affected your career advancement?”
25. Ren, X.S., et al. (1999)

(Healthcare)		 The National Survey of Functional Health (NSFH)
White=1525
African American=134
Hispanics=46
Asian or Others=42		 Analyzed self-perceived unfairness (discrimination due to racial identity or to low SES) was linked to self-assesses health status. Mail out survey adapted from Krieger, 1990 (item #12): added 2 more scenarios, and changed “discrimination” to “unfair treatment.”

CA coefficient of 0.83		 1-Item: “Have you ever experienced unfair treatment, been prevented from doing something, or made to feel inferior because of race in 7 different situations: at school, getting a job, at work, getting medical care, getting housing, from the police or in the courts, and on the street or in a public setting?”
26. Ryan, A.M., et al. (2006)

(Healthcare)		 666 adults residing in New Hampshire (78 African American, 112 Black immigrants, 476 Latino immigrants) Relationship between perceived discrimination and health (specifically blood pressure) Data from the 2002–2003 New Hampshire Racial and Ethnic Approaches to Community Health 2010 Initiative (NH REACH) (one health care related item)
Questions adapted from the Reactions to Race module from the 2002 Behavior Risk Factor Surveillance System

  1. How often do you feel discomfort or anger by the way others treat you in your everyday life because of your race? (constantly; once/day; once/week; once/month; once/year; never; other, specify)

  2. Do you feel that racial discrimination diminishes your ability to achieve your goals fully? (yes/no)

  3. Do you feel that you have been receiving less than the best health care because of your race? (yes, often; yes, some of the time; no, none of the time; don’t know)
27. Salgado de Snyder, V.N. (1987) Mexican immigrant women
N=140, ages 17–49 (M=25.7 yrs) with a mean of 9.5 years of education, married for the first time in LA county.		 Assessed acculturative stress, individual stressors and their relationship to levels of depressive symptomatology. CA coefficient of 0.65 1 of 12 yes or no items on an acculturation scale, if the subject experienced stressor in the past 3 months. If the answer was yes, subjects were asked to further respond on a 4-point Likert type scale for degree of stressfulness (0—not very stressful, 4—very stressful).
28. Thompson, V.L. (1996) 200 African American adults. To learn whether perceived racism produces symptoms of subjective distress noted in relationship to other stressful life events. Also, to find whether racial identification mediated the psychological impact of perceived experiences of racism.

Stressful Life Events (Lazarus)		 Racism:
Inter-rater reliability= 89.6%		 Racism Measure:
Participants reported whether they had ever experienced and whether they had experienced racism in the last 6 months. Racism was described as an unfavorable, unfair, or insulting event or action that occurred due to their skin color or group membership. Three examples were provided if, and only if, a participant requested it (e.g. Loss of job due to race, refusal of housing due to race, or derogatory names that were racial in nature). Participants were asked to provide a written description of the most recent racial incident within 6 months. The raters were trained by the primary investigator to categorize racial incidents. Descriptions were categorized as minor, moderate and major.
29. Thompson, C.E., et al. (1990)

Racism Reaction Scale (RRS)		 European American (EA) college students (n=70); African American college students in Southern California (n=87); Total (N=157). The study aim was to examine the experiences of African American college students attending predominantly EA universities. The measure for racism was designed to capture the individual level of suspicion about being singled out for differential treatment or being personally threatened. The instrument used consisted of the CMI.

CA of 0.86		 The CMI questionnaire consisted of 2 subscales:

  • The Education and Training subscale was designed to measure the degree to which the respondent agrees that EAs are to be trusted by AAs within the context of education and training.

  • The Interpersonal subscale was designed to measure the extent to which respondents agree that AAs should mistrust EA’s in interpersonal situations.

Respondents on both subscales were instructed to respond to a 7-point Likert-type scale (ranging from 1=strongly disagree to 7=strongly agree):
“Professors treat me differently than they do other students”
“Professors don’t expect me to perform as well as other students”
30. Trivedi, A.N., et al. (2006)

(Healthcare)		 54,968 adults (African American, White, Latino, Asian, AI) Perceived discrimination in health care and use of preventive health services Data from the 2001 California Health Interview Survey (CHIS) Phone interview:

  1. Thinking of your experiences with receiving health care in the past 12 months, have you felt you were discriminated against for any reason?

  2. What do you think was the reason you were discriminated against? (10 response options included age, race, language, health and disability, weight, insurance, income, gender, medical beliefs, multiple reasons, and other).
31. Utsey, S.O. (1996)

Index of Race Related Stress (IRRS)		 African American adults with a wide range of demographic backgrounds:

College students (CS) & community residents (CR) (pilot n=377); CS, CR and drug treatment clients (Study 1, n=302); CS&CR (Study 2, n=153).		 Race-related stress operationalized as the occurrence and perceived magnitude of specific events of racism and discrimination potentially experienced in daily lives.

  • Cultural

  • Institutional

  • Individual

  • Collective

Daily hassles (Lazarus and Folkman ’84) integrated with Essed’s (’90) concept of every day racism.		 Initial items included on the IRRS was based on informal interviews with African Americans from diverse backgrounds, a review of the literature, and the personal life experiences of the researcher (an African American male).

CA Study 1:
Cultural racism=0.87;
Institutional racism=0.85
Individual racism=0.84
Collective racism=0.79
CA Study 2:
Cultural racism=0.89;
Institutional racism=0.82
Individual racism=0.84
Collective racism=0.74		 46 item,
5-point Likert-type scale

If an individual was the victim of a racist or discriminatory act, they were to indicate their reaction to the event on the basis of the following response choices: 0=this event has never happened to me, 1=this event happened but did not bother me, 2=this event happened and I was slightly upset, 3=this event happened and I was upset, 4=this event happened and I was extremely upset. Individuals responded only to the events that they experienced.

“Whites or other non-Blacks have treated you as if you were unintelligent and needed things explained to you slowly or numerous times”

Stress = general concept like emotion, but operationalized according to the perceived magnitude of the interactions with the environment that taxed or exceeded the person’s resources.
32. Utsey—brief version (IRRS-B) (1999) College students (25 European Americans for comparison group and 239 African Americans) To develop a shorter version of the IRRS. CA’s:
Cultural racism=0.78;
Institutional racism=0.69
Individual racism=0.78

Confirmatory factor analyses supported a three factor model; the brief measure had higher factor loadings, more robust fit indices, and adequate CA.		 22 item subset from the original items, as described above.
33. Vines, A.I., et al. (2001)
Telephone-Administered Perceived Racism Scale (TPRS)

(Healthcare)		 476 employed African American women: randomly selected members of an urban HMO. Perceptions of and responses to racism among working African American women. Some of the items were used from the Perceived Racism Scale (see item # 17)

The emotional and behavioral responses were related to on the job and public experiences, and subscales for active and passive coping responses were utilized.

Alpha reliability values: 0.75 to 0.80 for the active and passive emotions subscale

0.59–0.69 for passive behaviors subscale

>0.76 for both active behaviors subscales

0.82, 0.90, 0.88 & 0.82 for past experiences, concern for child(ren), experiences of racism (personal), and experiences of racism (group)		 Experiences of racism (as a group and at the individual level), emotional responses, behavioral responses and past experiences of racism:
Components of TPRS:

Personal: Respondent discriminated when needing medical care

Group: Blacks are paid less

Passive emotions: Hopeless and powerless

Active emotions: Angry, frustrated, sad

Passive behaviors: Does not speak up or try to change things

External active behavior: Working harder to prove them wrong

Internal active behavior: Praying

Concern for child(ren): Being punished more harshly than others in school

Past experiences of racism: Frequency of past experience. Stress of past experience.
34. Williams D.R., et al (1997) 520 Whites and 586 African Americans from the Detroit Area Study. Racial differences in SES, acute and chronic indicators of perceived discrimination, and general measures of stress account for differences in self-reported measures of physical and mental health.

Essed (Everyday events).		 Two measures of race-related stress: major discrimination and everyday discrimination. Both were framed in the context of “unfair” treatment rather than racism.

CA=0.88 for Everyday Discrimination		 Discrimination, as measure of major experiences, is a count of 3 items:

  1. Do you think you have ever been unfairly fired or denied promotion?

  2. For unfair reasons, do you think that you have ever not been hired for a job?

  3. Do you think you have ever been unfairly stopped, searched, questioned, physically threatened or abused by police?

    Everyday discrimination (chronic, routine, and relatively minor experiences): Sums nine items on everyday situations. E.g. being treated with less courtesy than others; they think you are dishonest; they are afraid of you.
a

Cronbach’s Alpha = CA