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Measuring the Developing Therapeutic Relationship Between Pregnant Women and Community Health Workers Over the Course of the Pregnancy in a Study Intervention

Abstract

The Scale to Assess the Therapeutic Relationship in Community Mental Health Care (STAR) is a frequently-administered tool for measuring therapeutic relationships between clinicians and patients. This manuscript tested the STAR’s psychometric properties within a community health worker (CHW)-led intervention study involving pregnant and postpartum women. Women (n = 141) enrolled in the study completed the 12-item participant STAR survey (STAR-P) at two time points over the course of pregnancy and at two time points after delivery. The factor structure of the STAR-P proved to be unstable with this population. However, a revised 9-item STAR-P revealed a two-factor model of positive and negative interactions, and demonstrated strong internal consistency at postpartum time points. The revised STAR-P shows strong psychometric properties, and is suitable for use to evaluate the relationship developed between CHWs and pregnant and postpartum women in an intervention program.

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Acknowledgments

This research was supported by the National Institutes of Health under Grant Number 5U19ES020677. The authors thanks to the CHWs Starleen Maharaj-Lewis, Christine Dennis, Onita Harris, Courtney Schultheis, Patricia Davis, and Kimisha Sawyer for their commitment to the study subjects and aiding in data collection. Special thanks to Farah Arosemena and Dr. Hannah Covert, for their guidance and expertise during the design and implementation of the study.

Funding

This study was funded by the National Institutes of Health (5U19ES020677).

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Correspondence to Chris Mundorf.

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Lichtveld, M.Y., Shankar, A., Mundorf, C. et al. Measuring the Developing Therapeutic Relationship Between Pregnant Women and Community Health Workers Over the Course of the Pregnancy in a Study Intervention. J Community Health 41, 1167–1176 (2016). https://doi.org/10.1007/s10900-016-0198-2

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Keywords

  • STAR
  • Community health worker
  • Pregnancy
  • Psychometric scale adaptation
  • Exploratory factor analysis