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BACKGROUND: Given the stark disparities in maternal mortality and adverse birth outcomes among Black, indigenous, and other people of color, there is a need to better understand and measure how individuals from these communities experience their care during pregnancy. OBJECTIVE: This study aimed to develop and validate a tool that can be used to measure person-centered prenatal care that reflects the experiences of people of color. STUDY DESIGN: We followed standard procedures for scale development-integrated with community-based participatory approachesto adapt a person-centered maternity care scale that was initially developed and validated for intrapartum care in low-resource countries to reflect the needs and prenatal care experiences of people of color in the United States. The adaptation process included expert reviews with a Community Advisory Board, consisting of community members, community-based health workers, and social service providers from San Francisco, Oakland, and Fresno, to assess content validity. We conducted cognitive interviews with potential respondents to assess the clarity, appropriateness, and relevance of the questions, which were then refined and administered in an online survey to people in California who had given birth in the past year. Data from 293 respondents (84% of whom identified as Black) who received prenatal care were used in psychometric analysis to assess construct and criterion validity and reliability. RESULTS: Exploratory factor analysis yielded 3 factors with eigenvalues of >1, but with 1 dominant factor. A 34-item version of the person-centered prenatal care scale was developed based on factor analyses and recommendations from the Community Advisory Board. We also developed a 26-item version using stricter criteria for relevance, factor loadings, and uniqueness. Items were grouped into 3 conceptual domains representing subscales for "dignity and respect," "communication and autonomy," and "responsive and supportive care." The Cronbach alphas for the 34-item and the 26item versions and for the subscales were >0.8. Scores based on the sum of responses for the 2 person-centered prenatal care scale versions and all subscales were standardized to range from 0 to 100, where higher scores indicate more person-centered prenatal care. These scores were correlated with global measures of prenatal care satisfaction suggesting good criterion validity. CONCLUSION: We present 2 versions of the person-centered prenatal care scale: a 34-item and a 26-item version. Both versions have high validity and reliability in a sample made up predominantly of Black women. This scale will facilitate measurement to improve person-centered prenatal care for people of color and could contribute to reducing disparities in birth outcomes. The similarity with the original scale also suggests that the person-centered prenatal care may be applicable across different contexts. However, validation with more diverse samples in additional settings is needed.

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Introduction: Mistreatment by healthcare providers disproportionately affects people of color in the United States (US). The goal of this study is to adapt the global Person-Centered Maternity Care (PCMC) scale to the experiences of people of color in the US using a community-engaged approach. Methods: We conducted expert reviews to improve content validity and cognitive interviews with potential respondents were conducted to assess relevance, comprehension, and comprehensiveness. Surveys of 297 postpartum people, 82% of whom identified as Black, were used for psychometric analysis in which we assessed construct and criterion validity and reliability. The University of California, San Francisco, California Preterm Birth Initiative Community Advisory Board (CAB), which consists of community members, community-based health workers, and social service providers in Northern California, provided input during all stages of the project. Results: Through an iterative process of factor analysis, discussions with the CAB, and a prioritization survey, we eliminated items that performed poorly in psychometric analysis, yielding a 35-item PCMC-US scale with sub-scales for dignity and respect, communication and autonomy, and responsive and supportive care. The Cronbach alpha for the full scale is 0.95 and for the sub-scales is 0.87. Standardized summative scores range from 0 to 100, with higher scores indicating higher PCMC. Correlations with related measures indicated high criterion validity. Conclusions: The 35-item PCMC-US scale and its sub-scales have high validity and reliability in a sample of predominantly Black women. This scale provides a tool to support efforts to reduce the disparities in birth outcomes among people of color.