Development and Validation of the Vicarious Racism in Healthcare Workers Scale

Vicarious racism occurs when hearing about or observing people of the same racial and/or ethnic group experience racism. Healthcare workers may face unique experiences of vicarious racism through witnessing or hearing about racism that their patients and colleagues face. However, there are no validated measures of vicarious racism for the healthcare worker population. In this study, we developed and conducted an initial evaluation of the Vicarious Racism in Healthcare Workers Scale. We developed the 12-item scale based on a qualitative study exploring the experiences of racism among healthcare workers and existing literature on the topic. We administered the scale to a cohort of 259 healthcare workers identifying as a racialized minority to evaluate its factor structure, internal consistency, and construct validity. Factor analysis yielded two factors: racism in social networks and racism in society at-large. This two-factor solution had good model fit (standardized root mean square residual = 0.061). The internal consistencies of the overall scale, social networks subscale, and society subscale were excellent (alpha = 0.93, 0.92, and 0.89, respectively). We found evidence in support of convergent validity; scale scores were higher among Black healthcare workers compared with non-Black healthcare workers and those with greater social support needs. Scale scores were positively correlated with directly experienced racism and symptoms of posttraumatic stress, depression, and anxiety. The scale demonstrated discriminant validity; scale scores did not differ based on gender or job. The Vicarious Racism in Healthcare Workers Scale demonstrated favorable psychometric properties and may be used to assess vicarious racism in this population.