Socioeconomic status assessment in Lebanese primary health care centers: development and validation of the SES-PHC scale
- 1Lebanese Association of the Knights of Malta (Order of Malta Lebanon)
- 2INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban)
- 3Faculty of Public Health, Lebanese University
Abstract
Socioeconomic status (SES) is a major determinant of health outcomes among patients with chronic diseases, yet validated context-specific tools for primary health care centers (PHCCs) remain limited. In Lebanon, overlapping crises have exacerbated socioeconomic vulnerability, prompting this validation study among Lebanese patients with chronic diseases attending PHCCs. This cross-sectional study enrolled 370 adults with at least one chronic disease from eight PHCCs operated by the Order of Malta Lebanon between June and August 2024. Participants completed the SES Composite (SES-C), the Arabic-translated InCharge Financial Distress–Financial Well-Being (IFDFW) scale, and the WHO-5 Well-Being Index. Because the SES-C showed poor sampling adequacy (KMO = 0.546) and low internal consistency (Cronbach’s α = 0.579), a new scale, the SES-PHC, was developed using iterative principal component analysis. The final seven-item instrument, comprising four IFDFW items and three SES-C items, demonstrated good internal consistency (Cronbach’s α = 0.755), strong structural validity (KMO = 0.838; two factors explaining 61.491% of the variance), and strong convergent validity with the IFDFW (r = 0.852, p < 0.001). Higher SES was associated with older age, better psychological well-being, and private insurance, supporting the SES-PHC as a valid tool for identifying vulnerable patients in Lebanese PHCCs.
Related
- Development and Primary Validation of the Vienna Post-Exertional Malaise Assessment Questionnaire
- Development and temporal validation of nomograms and machine learning models for predicting overall and cancer-specific survival in primary distal cholangiocarcinoma: a SEER-based study
- Development and validation of an artificial intelligence model for basal cell carcinoma detection and section completeness assessment in Mohs micrographic surgery in an Asian cohort
- Toward a National Tuberculosis Lateral-Flow Urine Lipoarabinomannan (LF-LAM) External Quality Assessment Program in Thailand: Feasibility Demonstration Through Panel Development, Validation, and Proficiency Testing, March 2025–April 2026
- Development and validation of the Amyloidosis Area and Severity Index for primary cutaneous amyloidosis
BibTeX
@article{traboulsi2026socioeconomic,
title = {{Socioeconomic status assessment in Lebanese primary health care centers: development and validation of the SES-PHC scale}},
author = {Lina Traboulsi and Hala Sacre and Fatima Wehbi and Jihan Safwan and Sandrella Bou Malhab and Chadia Haddad and Nadine Saleh and Rachel Abdo and Maya Zakhia and Huguette Mouanes and Maria Ejreiss and Shady Naoum and Joyce Hanna and Cindy Ghata and Pascale Salameh},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-63034-9},
url = {https://doi.org/10.1038/s41598-026-63034-9},
note = {CC BY},
}
RIS
TY - JOUR
TI - Socioeconomic status assessment in Lebanese primary health care centers: development and validation of the SES-PHC scale
AU - Lina Traboulsi
AU - Hala Sacre
AU - Fatima Wehbi
AU - Jihan Safwan
AU - Sandrella Bou Malhab
AU - Chadia Haddad
AU - Nadine Saleh
AU - Rachel Abdo
AU - Maya Zakhia
AU - Huguette Mouanes
AU - Maria Ejreiss
AU - Shady Naoum
AU - Joyce Hanna
AU - Cindy Ghata
AU - Pascale Salameh
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-63034-9
UR - https://doi.org/10.1038/s41598-026-63034-9
AB - Socioeconomic status (SES) is a major determinant of health outcomes among patients with chronic diseases, yet validated context-specific tools for primary health care centers (PHCCs) remain limited. In Lebanon, overlapping crises have exacerbated socioeconomic vulnerability, prompting this validation study among Lebanese patients with chronic diseases attending PHCCs. This cross-sectional study enrolled 370 adults with at least one chronic disease from eight PHCCs operated by the Order of Malta Lebanon between June and August 2024. Participants completed the SES Composite (SES-C), the Arabic-translated InCharge Financial Distress–Financial Well-Being (IFDFW) scale, and the WHO-5 Well-Being Index. Because the SES-C showed poor sampling adequacy (KMO = 0.546) and low internal consistency (Cronbach’s α = 0.579), a new scale, the SES-PHC, was developed using iterative principal component analysis. The final seven-item instrument, comprising four IFDFW items and three SES-C items, demonstrated good internal consistency (Cronbach’s α = 0.755), strong structural validity (KMO = 0.838; two factors explaining 61.491% of the variance), and strong convergent validity with the IFDFW (r = 0.852, p < 0.001). Higher SES was associated with older age, better psychological well-being, and private insurance, supporting the SES-PHC as a valid tool for identifying vulnerable patients in Lebanese PHCCs.
SN - 2045-2322
ER -