The Dietetics Profession Privilege Scale: Development, Psychometric Testing, and Application Among a Diverse Cohort of Dietetics Professionals

Background: Privilege (defined as the unearned advantage or disadvantage experienced by social groups resulting from structural power differences) impacts efforts to create a diverse and inclusive dietetics profession. Yet, no current measures exist to assess and observe privilege, and the relative privilege among dietetics professionals (DPs) is unknown.

Objective: The purpose of this study was to develop and validate a scale to measure DP privilege and to use that scale to assess privilege among a sample of DPs in the United States.

Design: The initial scale was developed by the research team and the psychometrics were assessed using a 3-phase cross-sectional study exploring construct, content and face validity, and test-retest reliability.

Participants/setting: A survey with content experts (n = 18), cognitive interviewees (n = 12), and a survey of DPs (n = 900) were conducted online and over Zoom during 2021.

Statistical analyses: Exploratory factor analysis, 1-way analysis of variance, Cronbach's α, and descriptive statistics were used to assess the final instrument and identify correlates of privilege.

Results: Findings indicate that the 29-item Dietetic Profession Privilege Scale has good validity and reliability across 6 domains (ie, treatment in training, identity alignment, resource access, cultural access, financial access, and physical access). The mean (SE) privilege score among the current sample of DPs was 45 (10.2) out of 58 points, with the greatest gaps between racial and ethnic groups, where White DPs (n = 540) had a mean (SE) score of 49.7 (0.33), followed by a mean score of 41.0 among Middle Eastern/North African DPs (n = 9); mean score of 40.0 for the Native Hawaiian and Pacific Islander-identifying DP; mean (SE) score of 39.8 (0.93) among DPs with 2 or more racial or ethnic identities, including White (n = 68); mean score of 35.7 among DPs with 2 or more marginalized racial or ethnic identities (n = 6); a mean (SE) score of 35.3 (1.07) among Black or African American DPs (n = 51); a mean (SE) score of 34.3 (0.93) among Asian DPs (n = 67); a mean (SE) score of 33.4 (0.91) among Latino, Hispanic, and Chicano DPs (n = 71); and a mean (SE) 29.4 (3.42) among American Indian and Alaskan Native DPs (P < .001 for all racial and ethnic groups in which n > 10; SE not indicated for groups when n < 10). DPs with dominant group identities were found to have statistically higher privilege scores than their peers with marginalized identities in several areas, including race, gender, sexual orientation, income, socioeconomic status, neurodivergence, and ableness, and scored higher on the privilege scale than their peers with marginalized identities.

Conclusions: The Dietetics Profession Privilege Scale is a valid and reliable scale that demonstrates the ability to distinguish differences in privilege between DPs in the interest of reducing bias and achieving inclusion, diversity, equity, and access with the profession.