Background: Autistic people face multiple barriers to health care. To recognize specific barriers in a standardized way, autistic people, health care providers, and researchers need a suitable measure. The Academic Autistic Spectrum Partnership in Research and Education successfully developed the Barriers to Healthcare Checklist—Short Form (BHC-SF). It remains unclear whether (1) a German version of the BHC-SF performs well in terms of psychometric properties and (2) the BHC-SF consists of multiple constructs (i.e., assessing structural validity). Methods: We created a translated and culturally adapted version of the 17-item BHC-SF and used it with 345 autistic people in Germany. Psychometric analyses included calculations to test for internal consistency reliability (Cronbach’s α) and construct validity (i.e., a priori hypothesis tests for correlations with previous treatment termination and statements about barriers to health care in terms of lack of knowledge, participation, autism-specific needs, lack of services, access/financing and collaboration). We conducted an exploratory factor analysis (EFA) to investigate the presence of BHC-SF subscales (i.e., structural validity) and performed reliability and validity calculations where appropriate. Results: The average BHC-SF total score was mean = 8.05 (standard deviation = 4.05), with more barriers for persons who identified as female compared with males. The BHC-SF total score revealed good internal consistency reliability (Cronbach’s α = 0.82). The assessment of construct validity mainly supported the hypothesized associations. The EFA identified four BHC-SF subscales, for which we found lower psychometric support with respect to internal consistency reliability and construct validity. Conclusions: The German version of the BHC-SF demonstrates good internal consistency reliability and construct validity. We identified four different constructs underlying the BHC-SF. The derived subscales need further psychometric testing. Use of the BHC-SF total score could potentially help health care providers and researchers systematically identify and address barriers to health care for autistic patients.
Peth et al. (Thu,) studied this question.