Abstract
Background: Social exclusion is a complex concept that is recognised as a key determinant of health. Many measurement tools developed looked at people from single excluded groups in isolation. We know from experience and literature that exclusion is often intersectional and multi-layered. Therefore, the aim of this research was to develop a social exclusion measurement tool for use in healthcare settings with individuals from any excluded group that would include questions to investigate socioeconomic elements and subjective experiences in their lives.
Methods: Inductive and deductive methods were used to develop the tool. Early drafts were tested with experts (both academic and experts by experience) and modified in line with feedback received. The tool was then piloted with people in the community, and this allowed us to assess the internal consistency and validity of the tool. Exploratory factor analysis was carried out as part of this evaluation.
Results: The measurement tool was initially evaluated by 17 academic and ‘real world’ experts. It was then piloted with seven experts by experience, two gatekeepers and two participants who were presumed not to be excluded, resulting in the development of the final tool. This was then tested with 276 participants (127 presumed excluded, 149 presumed not excluded). The socioeconomic characteristics of these participants were documented, and exploratory factor analysis was carried out on data relating to subjective items. A four-factor structure emerged comprising 22 items. Internal consistency of the factors was high, and their ability to discriminate between the two groups was notable.
Conclusions: A tool for measuring the social exclusion of individuals has been developed by engaging with people from a variety of excluded groups. Socioeconomic indicators were combined with subjective items. The input of experts by experience, academics and others was sought to enhance the tool. The tool was applied to two distinct samples, showing obvious differences both in the socioeconomic items, and the items included in the factor analysis. The potential use of this tool could have positive implications for people who are excluded.
| Original language | English |
|---|---|
| Article number | 35 |
| Number of pages | 15 |
| Journal | International Journal for Equity in Health |
| Volume | 21 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 15 Mar 2022 |
Bibliographical note
Funding Information:I acknowledge the enthusiasm and engagement of all participants who contributed to this research – the experts by experience, the academic and clinical experts, the online participants, the gatekeepers and the participants who were felt to be socially excluded. This last group in particular contributed wholeheartedly despite facing many challenges. in Public Health at the University of Limerick School of Medicine.
Publisher Copyright:
© 2022, The Author(s).
Keywords
- Health
- Intersectionality
- Scale development
- Social exclusion
- Tool evaluation
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health
