Psychometric assessment of the US person-centered prenatal and maternity care scales in a low-income predominantly Latinx population in California

Objectives: To assess psychometric properties of two scales developed to measure the quality of person-centered care during pregnancy and childbirth in the United States—the Person-Centered Prenatal Care (PCPC-US) and Person-Centered Maternity Care (PCMC-US) scales—in a low-income predominantly Latinx population in California. Methods Data were collected from October 2020 to January 2023 from surveys of low-income pregnant and birthing people in Fresno, California, participating in the “Engaging Mothers and Babies; Reimagining Antenatal Core for Everyone (EMBRACE) trial. Research staff administered the 26-item PCPC-US scale at 30–34 weeks’ gestation (n = 315) and the 35-item PCMC-US scale at 10–14 weeks after birth (n = 286), using the language preferred by the participant (English or Spanish). We assessed construct, criterion, and known group validity and internal consistency of the scales. Results 78% of respondents identified as Latinx. Factor analysis identified one dominant factor for each scale that accounted for over 60% of the cumulative variance, with most items loading at > 0.3. The items also loaded adequately on sub-scales for “dignity and respect,” “communication and autonomy,” and “responsive and supportive care.” Cronbach’s alpha for the full scales were > 0.9 and between 0.70 and 0.87 for the sub-scales. Summative scores range from 0 to 100, with higher scores indicating higher PCMC. Correlations with scores on scales measuring prenatal care quality and birth experience provided evidence for criterion validity, while associations with known predictors provided evidence for known-group validity. Conclusions The PCPC-US and PCMC-US scales, which were developed using a community-engaged process and found to have good psychometric properties in a largely high-income sample of Black women, were shown to also have good psychometric properties in a sample of low-income primarily Latinx women. Both scales provide valid and reliable tools to measure person-centered care experiences among minoritized communities to support efforts to reduce existing birth inequities.