Psychometric validation of the multidimensional disclosure to health care providers scale (MD-HCPS)

A substantial body of research has identified many health disparities in the gay and lesbian populations, along with a myriad of physical, social, and institutional factors that influence these disparities. The sexual orientation disclosure interaction is a critical component of the health care visit for lesbians and gay men that may significantly explain and predict engagement in the system, and ultimately, may contribute to these health disparities. However, the construct of disclosure has been poorly defined and measured by health care researchers. The purpose of this study was to further develop the preliminary Multidimensional Disclosure to Health Care Providers Scale (MD-HCPS) to assess gay men and women???s experiences disclosing sexual orientation to health care providers. Data were gathered from 667 participants across the U.S. using online survey methodology. Based on item analyses and exploratory factor analyses, the number of items was reduced from 119 to 62 in five subscales. Further, twelve factors were identified within the five subscales (Disclosure Attitudes and Beliefs, Initiation of Disclosure, Disclosure Communication, Positive Acknowledgment of Disclosure, and Negative Acknowledgment of Disclosure). Results also provided empirical evidence for the theoretical model on which the scale is based. Coefficient alphas for the factors ranged from .43 to .91. Five of the twelve factors had adequate reliability (.80 or greater). The remaining factors need further revision to increase their reliability. Despite its limitations, this measure has great potential to further our understanding of the influence of disclosure on health seeking behaviors of gay men and lesbians. This, in turn, can help to improve the quality of life of gay and lesbian individuals, a population that has traditionally been neglected in the literature