Reliability and construct validity of 3 psychometric trust scales for women seeking substance abuse treatment in a community setting

Abstract

Background: Women with a history of substance use disorder (SUD) constitute a unique population with gender-specific needs in treatment. Most notable is high rates of prior trauma and the need for a trauma-informed care framework. Given theoretical links between trauma and interpersonal trust, understanding quantitatively how trust may impact outcomes for women in this population requires confirmation of validity of existing psychometric instruments. Objective: This study sought to confirm reliability and construct validity of the Rotter Interpersonal Trust Scale, Wake Forest Trust in Physician Scale, and the Revised Health Care System Distrust Scale (RHCSDS) for use in women with a history of SUD seeking treatment in a community-based setting. Methods: A total of 301 participants were enrolled between August 2017 and March 2018 at an urban, community-based residential substance abuse treatment program in the mid-South. Participants were given an electronic survey containing questions about demographics/clinical characteristics, the Rotter, Wake Forest, and RHCSDS scales, Socially Desirable Response Five-Item Survey (SDRS-5), and the Adverse Childhood Experiences (ACEs) questionnaire. All participants also completed a modified protocol of the “Trust Game.” Statistical analysis was completed for each trust scale in regard to scale means and distribution, internal consistency, interscale correlation, and scale correlation to the ACE score. Results: Results confirm statistically significant (P < .001) differences in global trust and trust of health care providers compared with general population samples in prior studies. Internal consistency of scales is comparable to reliability testing in prior studies (α > .70 for all scales). Interscale correlation between individual scales is statistically significant, with the strongest relationship between the 2 health care–specific scales (r = −.740, P < .001). There was a weak, negative correlation between the ACE score and interpersonal trust (r = −.135, P = .019). Individual scales do not have statistically significant correlation with “Trust Game” scores. Discussion: Findings suggest reliability and construct validity of scales for use in this population.

Keywords:

• Substance use disorder
• trust in health care
• women substance use disorder

Acknowledgments

Study data were collected and managed using REDCap electronic data capture tools hosted at Vanderbilt University. REDCap (Research Electronic Data Capture) is a secure, Web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for importing data from external sources.

Author contributions

J.C. was principal investigator on this study, helped develop the study protocol, enrolled subjects, conducted research procedures and data collection, conducted data analysis, and contributed to and revised the final manuscript. S.A. helped develop the study protocol, enrolled subjects, conducted research procedures and data collection, and contributed to and revised the final manuscript. D.M. enrolled subjects, conducted research procedures and data collection, and contributed to and revised the final manuscript. M.D. conducted data analysis and contributed to and revised the final manuscript.

Additional information

Funding

This work was supported by the Vanderbilt Office of Medical Student Research and the Vanderbilt Medical Scholars Program. It was further supported by Center and Translational Science Awards (CTSA) funding (TL1TR002244; 5UL1TR002243-02; 3U54MD007593-10S1) from the National Center for Advancing Translational Sciences (NCATS). Additionally, the electronic data capture system REDCap used in this study is supported through NCATS and the National Institutes of Health (UL1TR000445). This study’s contents are solely the responsibilities of the authors and do not necessarily represent the official views of NCATS or the National Institutes of Health. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.