Publications and Research
Document Type
Article
Publication Date
2026
Abstract
Racial health and healthcare inequities are sustained in part by health professionals’ beliefs about the benefits and costs of equity-focused action, yet no validated decisional balance measure exists for this domain. This study introduces and evaluates the Health Equity Decisional Balance (HEDB) scale. Eighty-eight health professionals completed the scale of ten proposed items assessing perceived pros and cons of engaging with health and healthcare equity work, along with a measure of Anti-Racist Efficacy (ARE) (Eschmann et al., 2023). Confirmatory factor analysis and structural equation modeling were used to test the latent structure of the scale and its predictive validity. A two-factor model retaining eights items with correlated pros and cons showed excellent fit (χ²(25)=32.98, RMSEA=.061, CFI=.982). Pros and cons were strongly and inversely related (r=−.90, p< .001), consistent with decisional balance theory. When modeled as latent predictors, pros showed a strong positive association with anti-racist self-efficacy (ARE) (β=.82, p=.037), whereas cons was not significant. Together, the factors accounted for 20% of variance in efficacy. The HEDB scale provides a brief, psychometrically sound measure of health professionals’ readiness-related beliefs about health and healthcare equity work.
Comments
This manuscript is a preprint posted on PsyArXiv, available at https://osf.io/preprints/psyarxiv/u7nyt_v2