Development and Validation of the Healthcare Worker Culture of Support Scale: Preliminary Evidence of Validity and Reliability

Abstract Objective To develop and conduct preliminary testing of the reliability and validity of the Healthcare Worker (HCW) Culture of Support Scale (COS), intended to assess health worker perceptions of institutional support resources and organizational culture related to their well-being. Methods A cross-sectional survey was conducted with 533 HCWs from ambulatory clinic and rural hospital settings. The survey included validated measures and newly developed items. Exploratory and confirmatory factor analyses (EFA/CFA) were employed to determine the factor structure. Internal consistency and construct validity were assessed using Cronbach’s α and correlation with mental health outcomes. Results The COS demonstrated a robust three-factor structure: 1) Organizational Support (α = 0.83), 2) Access to Peer Support (α = 0.92), and 3) Availability of Support (α = 0.97), accounting for 84.9% of variance. Cronbach’s alpha for the overall scale was 0.94. CFA confirmed excellent model fit (RMSEA =.049, CFI =.992). Higher COS scores correlated with lower burnout (r = -.47, p