Date of Award

2015

Document Type

Open Access Dissertation

Department

Health Promotion, Education and Behavior

Sub-Department

The Norman J. Arnold School of Public Health

First Advisor

Katrina M. Walsemann

Second Advisor

James F. Thrasher

Abstract

We evaluated the psychometric properties of two instruments used to assess ethnic discrimination among Arabs in Israel. The “Experiences of Discrimination” (EOD) scale was adapted to assess interpersonal ethnic discrimination (EOD-A) and a new measure was developed to assess perceptions of institutional group discrimination (IGD) against Arabs as an ethnic group. Then, we examined the association between each form of ethnic discrimination (interpersonal and institutional) and smoking outcomes among Arab men from Israel, and whether social support and coping efficacy moderate these associations. Data were analyzed from a cross-sectional study of Arab male current and former smokers, aged 18-64. A confirmatory factor analysis (CFA) model was estimated to assess the factor structure of the EOD-A. A split sample exploratory factor analysis (EFA) approach was used to assess the factor structure of the IGD measure. Cronbach’s alpha was calculated to assess reliability. In unadjusted linear regression models, ethnic discrimination was regressed on other constructs to assess construct validity. Next, logistic and linear regressions were estimated to assess the association between each form of ethnic discrimination and smoking status and nicotine dependence, respectively. CFA of the EOD-A produced a model with a single underlying factor and acceptable fit to the data (CFI = 0.967; TLI = 0.956). Standardized factor loadings ranged from to 0.65 – 0.77 and were all statistically significant at p<.001. Results from split sample EFA of the IGD measure support a one factor solution with good model fit (CFI = 0.986; TLI = 0.980) and factor loadings ≥ 0.68 that were statistically significant at p<.05. The results were similar across the split samples. Both measures had good internal consistency reliability (i.e., alpha = .90 and .93, for the EOD-A and the IGD measure, respectively). Construct validity for both measures was supported by positive associations with a single-item measure of ethnic discrimination, indicators of stress, and smoking status. Interpersonal ethnic discrimination was associated with a greater likelihood of being a current versus former smoker. Among current smokers, both forms of discrimination were associated with higher nicotine dependence. This association was stronger among men with low social support. Coping efficacy did not moderate the association between ethnic discrimination and smoking outcomes. We conclude that the EOD-A and the new IGD measure have good psychometric properties, which make them useful for assessing ethnic discrimination among Arab male current and former smokers in Israel. Further, ethnic discrimination, a social stressor, should be considered in efforts to improve smoking outcomes among Arab male smokers in Israel.

Rights

© 2015, Amira Osman

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