Factor analysis to validate a survey evaluating cultural competence in maternity care for indigenous women

Objective This research set out to develop and validate a tool to assess the self-reported progress of Australian publicly funded maternity services towards the goal of culturally competent maternity care for Indigenous women. The tool aimed to measure the degree to which these services had incorporated actions towards achieving 14 identified characteristics into the current fabric of their organisation. Design An online exploratory survey was distributed to consenting respondents nationally. Setting Public maternity services in each State and Territory of Australia. Subjects The survey was distributed to 149 public maternity organisations, with 85 organisational consents and 44 respondents completing the survey. Main outcome measure Construct validity of a survey designed to describe progress in working towards organisational cultural competence in maternity services was assessed by principal factor analysis and varimax with Kaiser rotation. Results The results support the two subscales identified as appropriate groups of questions to address 1) assessment of cultural competence and 2) assessment of the survey. Reliability was assessed by Cronbach’s reliability and results established evidence of a reliable survey. Conclusion The results of this study show that the survey assessing and identifying organisational cultural competence in public maternity care for Indigenous women demonstrated acceptable reliability and validity for a newly developed instrument. Responses to the survey provided participants of this study with a baseline for assessing further progress. Upon further testing and refinement, the survey can provide a validated tool to guide both national and local activity to improve the maternity experiences of Indigenous women.