Military barriers to care scale: a validation study

Introduction Research indicates that military members often under-access care, potentially leading to worse health outcomes. Addressing barriers to care is essential for maintaining a healthy and effective force. Recent efforts have focused on developing comprehensive, theoretically-driven scales to better understand and mitigate barriers. The aim of the current research is to (a) expand the Barriers to Care scale developed by Frank and Born ( 1 ), and (b) validate the full and short-form versions of the updated Military Barriers to Care Scale. Methods Following scale item expansion using the Theoretical Domain Framework (TDF), the Military Barriers to Care scale was completed by 2,505 Canadian Armed Forces (CAF) members. The sample was randomly split into three subsamples. First, an exploratory factor analysis (EFA) and confirmatory factor analyses (CFA) were conducted with all scale items. Second, a short-form scale was created and validated with a CFA. The identified factors were also correlated with intent to access care to assess concurrent validity. Findings Results of the EFA and subsequent refinement suggested an eight-factor model. The CFA on the full scale had decent model fit, and the CFA on the short-form scale had excellent model fit. The alphas of the eight subscales from the full scale were adequate (.67–.92). All subscales from both the full and short-form scales significantly and negatively correlated with intent to access care. Conclusion The findings are a step towards creating full and short-form theory-based, valid, and reliable measures for assessing barriers to care, which could be instrumental in improving access to care in the CAF.