Measurement of perceived healthcare discrimination and its implications on population health research: A systematic review protocol

Purpose Discrimination in healthcare settings significantly impacts population health, affecting individuals of racial and ethnic minoritized identities, sexual and gender minoritized identities, and individuals with disabilities. Most measures of discrimination are derived from instruments assessing everyday discrimination experiences and do not adequately capture the specific nuances of healthcare-related discrimination. This systematic review protocol outlines a planned study that will evaluate and synthesize tools designed to measure discrimination in healthcare settings in the United States (U.S.). By providing a detailed overview of these measurement tools and their psychometric properties, this review will enhance understanding of healthcare discrimination and guide policy and practice towards improving health equity. Methods A comprehensive search will be conducted across four databases (PubMed, Embase, PsycINFO, and Web of Science) and supplemented by citation tracking of reviewed articles. The review will focus on studies involving measurements of perceived discrimination within healthcare settings in the United States. The primary outcomes include the reliability, validity, and specificity of discrimination measurement instruments. Quality assessment will use the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias tool. Our systematic review will be present findings based on the Preferred Reporting Items for Systematic Review and Meta-Analyses COnsensus-based Standards for the selection of Health Measurment INstruments of outcome measurements 2024 (PRISMA-COSMIN for OMIs 2024) reporting standard. The protocol is registered with PROSPERO (Registration number: CRD42024592267. Discussion This review will synthesize existing literature and offer a comprehensive evaluation of discrimination measurement tools to guide future health equity research. This review aims to contribute to the mitigation of healthcare inequities and the promotion of health equity by offering actionable insights into the measurement of discrimination in healthcare settings.