Measuring barriers to incontinence care seeking

Aims: The objective of this study was to establish the factor validity of a modified Melnyck's Barrier Scale and estimate its reliability in an ethnically heterogeneous incontinent female population. Methods: Computer assisted telephone interviews (CATI) were conducted on a nonprobability sample of 275 incontinent females (95 Caucasian, 95 African American, 80 Hispanic, 5 Other). Study participants were asked to rate the degree to which barrier items affected their seeking medical care for incontinence on a 4-point Likert scale ranging from 0 (none) to 3 (greatly). A confirmatory factor analysis was conducted to confirm the structure of the modified Melnyk's Barrier Scale and assess its fit in our racially heterogeneous incontinent female population. Cronbach's alpha coefficients were estimated to establish the reliability of the final barrier measurement model and its subscales. Results: The 14-item modified Melnyk's Barrier Scale contained 3 items that loaded on the inconvenience factor (factor loadings 0.659-0.812). Three items loaded on the relationship factor (factor loadings 0.452-0.796). Two items loaded on the site-related factor (factor loadings 0.554-0.960). Three items loaded on the cost factor (factor loadings 0.481-0.891). Three items loaded on the fear factor (factor loadings 0.457-0.624). Cronbach's alpha coefficient for the final 14-item modified Melnyk's Barrier Scale was 0.828 (Inconvenience subscale 0.79, Relationship subscale 0.68, Site related subscale 0.69, cost subscale 0.71, fear subscale 0.57). Conclusion: We offer the Barriers to Incontinence Care Seeking questionnaire (BICS-Q) to epidemiologic researchers, given its factor validity and reliability, to operationalize barriers when studying relationships between ethnicity and health care disparities.