Perceptions of Racism in Children and Youth (PRaCY): properties of a self-report instrument for research on children's health and development

Experiences of racial discrimination have been demonstrated to be related to racial and ethnic disparities in mental and physical health and healthcare. There has been little study, however, of the relationship between racism and health in children, and few psychometrically valid and reliable instruments to measure Perceptions of Racism in Children and Youth (PRaCY) exist. This paper reports on the development and testing of such an instrument, the PRaCY. Development of the instrument began with open-ended qualitative interviews, from which a proto-questionnaire was created. The questionnaire gathered information on the prevalence, attribution, emotional responses, and coping responses to 23 situations identified by participants in the qualitative phase. The proto-questionnaire was administered to 277 children between the ages of 8 and 18 years (38% Latino/a, 31% African-American, 19% multiracial/multicultural, 7% West Indian/Caribbean, and 5% Other). Item analysis resulted in two developmentally appropriate 10-item instruments (one for ages 7–13, another for ages 14–18). Internal consistency reliability was strong (alpha=0.78 for both versions of the instrument). Confirmatory factor analysis demonstrated good fit for both versions (younger-Comparative Fit Index (CFI): 0.967, Root Mean Square Error of Approximation (RMSEA): 0.047; older-CFI: 0.934, RMSEA: 0.056). Differential item functioning analyses demonstrated no group-specific biases in item response. PRaCY scores were appropriately associated with higher depressive symptom scores and elevated anxiety scores in the younger sample. Results indicate that the PRaCY is a valid and reliable instrument that measures perceptions of racism and discrimination in children and youth aged 8–18 from diverse racial/ethnic backgrounds.

[1]  C. Coll,et al.  Racism and Child Health: A Review of the Literature and Future Directions , 2009, Journal of developmental and behavioral pediatrics : JDBP.

[2]  N. Kressin,et al.  Perceptions of Race/Ethnicity-Based Discrimination: A Review of Measures and Evaluation of Their Usefulness for the Health Care Setting , 2008, Journal of health care for the poor and underserved.

[3]  Xiaojia Ge,et al.  Perceived discrimination and the adjustment of African American youths: a five-year longitudinal analysis with contextual moderation effects. , 2006, Child development.

[4]  Y. Paradies A systematic review of empirical research on self-reported racism and health. , 2006, International journal of epidemiology.

[5]  Pamela P. Martin,et al.  Racial Identity Matters: The Relationship between Racial Discrimination and Psychological Functioning in African American Adolescents , 2006 .

[6]  N. Way,et al.  Trajectories of perceived adult and peer discrimination among Black, Latino, and Asian American adolescents: patterns and psychological correlates. , 2006, Developmental psychology.

[7]  N. Krieger,et al.  Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. , 2005, Social science & medicine.

[8]  R. Clark,et al.  Brief report: Initial psychometric properties of the everyday discrimination scale in black adolescents. , 2004, Journal of adolescence.

[9]  F. Gibbons,et al.  Perceived discrimination and substance use in African American parents and their children: a panel study. , 2004, Journal of personality and social psychology.

[10]  O. Osundeko,et al.  Unequal Treatment—Confronting Racial and Ethnic Disparities in Healthcare , 2004 .

[11]  J. Eccles,et al.  The influence of ethnic discrimination and ethnic identification on African American adolescents' school and socioemotional adjustment. , 2003, Journal of personality.

[12]  Marc A Zimmerman,et al.  Racial identity, racial discrimination, perceived stress, and psychological distress among African American young adults. , 2003, Journal of health and social behavior.

[13]  J. Fleishman,et al.  Demographic Variation in SF‐12 Scores: True Differences or Differential Item Functioning? , 2003, Medical care.

[14]  김지혜,et al.  아동 발현 불안 척도(Revised Children`s Manifest Anxiety Scale)의 요인구조 분석 , 2003 .

[15]  J. Curry,et al.  The Impact of Perceived Racism: Psychological Symptoms Among African American Boys , 2003, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[16]  I. Ceder,et al.  Discrimination and Puerto Rican children's and adolescents' mental health. , 2003, Cultural diversity & ethnic minority psychology.

[17]  David R. Williams,et al.  Racial/ethnic discrimination and health: findings from community studies. , 2003, American journal of public health.

[18]  I. Meyer Prejudice as stress: conceptual and measurement problems. , 2003, American journal of public health.

[19]  C. Cutrona,et al.  Discrimination, crime, ethnic identity, and parenting as correlates of depressive symptoms among African American children: A multilevel analysis , 2002, Development and Psychopathology.

[20]  J. Nazroo,et al.  Relation between racial discrimination, social class, and health among ethnic minority groups. , 2002, American journal of public health.

[21]  L. Whitbeck,et al.  Perceived discrimination and early substance abuse among American Indian children. , 2001, Journal of health and social behavior.

[22]  Celia B. Fisher,et al.  Discrimination Distress During Adolescence , 2000 .

[23]  S. Utsey Assessing the Stressful Effects of Racism: A Review of Instrumentation , 1998 .

[24]  N Krieger,et al.  Racial discrimination and blood pressure: the CARDIA Study of young black and white adults. , 1996, American journal of public health.

[25]  Elizabeth A. Klonoff,et al.  The Schedule of Racist Events: A Measure of Racial Discrimination and a Study of Its Negative Physical and Mental Health Consequences , 1996 .

[26]  Karl G. Jöreskog,et al.  Lisrel 8: Structural Equation Modeling With the Simplis Command Language , 1993 .

[27]  S. Folkman,et al.  Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes. , 1986, Journal of personality and social psychology.

[28]  S. Folkman,et al.  Appraisal, coping, health status, and psychological symptoms. , 1986, Journal of personality and social psychology.

[29]  B. Plake,et al.  Item Bias in the Assessment of Children's Anxiety: Race and Sex Interaction on Items of the Revised Children's Manifest Anxiety Scale , 1983 .

[30]  Vipan Nikore,et al.  Spanish Translation and Reliability Testing of the Child Depression Inventory , 2004, Child psychiatry and human development.

[31]  David R. Williams,et al.  Discrimination and Health , 2004 .

[32]  B. Smedley,et al.  Unequal treatment: confronting racial and ethnic disparities in health care. , 2002, Journal of the National Medical Association.

[33]  N. Anderson,et al.  Racism as a stressor for African Americans. A biopsychosocial model. , 1999, The American psychologist.

[34]  David R. Williams,et al.  Race, Place, and Discrimination , 1997 .

[35]  M. McNeilly,et al.  The perceived racism scale: a multidimensional assessment of the experience of white racism among African Americans. , 1996, Ethnicity & disease.

[36]  D. Williams,et al.  The concept of race and health status in America. , 1994, Public health reports.

[37]  N. Krieger Racial and gender discrimination: risk factors for high blood pressure? , 1990, Social science & medicine.

[38]  L. Cronbach,et al.  Construct validity in psychological tests. , 1955, Psychological bulletin.