Dataset Information

COVID-19 Public Stigma Scale (COVID-PSS): development, validation, psychometric analysis and interpretation.

ABSTRACT:

Objective

Amid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major component of public discourse and social phenomena. As such, we aimed to develop and validate the COVID-19 Public Stigma Scale (COVID-PSS).

Design and setting

National-based survey cross-sectional study during the lockdown in Thailand.

Participants

We invited the 4004 adult public to complete a set of measurement tools, including the COVID-PSS, global fear of COVID-19, perceived risk of COVID-19 infection, Bogardus Social Distance Scale, Pain Intensity Scale and Insomnia Severity Index.

Methods

Factor structure dimensionality was constructed and reaffirmed with model fit by exploratory and confirmatory factor analyses and non-parametric item response theory (IRT) analysis. Psychometric properties for validity and reliability were tested. An anchor-based approach was performed for classifying the proper cut-off scores.

Results

After factor analysis, IRT analysis and test for model fit, we created the final 10-item COVID-PSS with a three-factor structure: stereotype, prejudice and fear. Face and content validity were established through the public and experts' perspectives. The COVID-PSS was significantly correlated (Spearman rank, 95% CI) with the global fear of COVID-19 (0.68, 95% CI 0.66 to 0.70), perceived risk of COVID-19 infection (0.79, 95% CI 0.77 to 0.80) and the Bogardus Social Distance Scale (0.50, 95% CI 0.48 to 0.53), indicating good convergent validity. The correlation statistics between the COVID-PSS and the Pain Intensity Scale and Insomnia Severity Index were <0.2, supporting the discriminant validity. The reliability of the COVID-PSS was satisfactory, with good internal consistency (Cronbach's α of 0.85, 95% CI 0.84 to 0.86) and test-retest reproducibility (intraclass correlation of 0.94, 95% CI 0.86 to 0.96). The proposed cut-off scores were as follows: no/minimal (≤18), moderate (19-25) and high (≥26) public stigma towards COVID-19 infection.

Conclusions

The COVID-PSS is practical and suitable for measuring stigma towards COVID-19 in a public health survey. However, cross-cultural adaptation may be needed.

SUBMITTER: Nochaiwong S

PROVIDER: S-EPMC8568532 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

COVID-19 Public Stigma Scale (COVID-PSS): development, validation, psychometric analysis and interpretation.

Nochaiwong Surapon S Ruengorn Chidchanok C Awiphan Ratanaporn R Kanjanarat Penkarn P Ruanta Yongyuth Y Phosuya Chabaphai C Boonchieng Waraporn W Nanta Sirisak S Chongruksut Wilaiwan W Thavorn Kednapa K Wongpakaran Nahathai N Wongpakaran Tinakon T

BMJ open 20211102 11

<h4>Objective</h4>Amid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major component of public discourse and social phenomena. As such, we aimed to develop and validate the COVID-19 Public Stigma Scale (COVID-PSS).<h4>Design and setting</h4>National-based survey cross-sectional study during the lockdown in Thailand.<h4>Participants</h4>We invited the 4004 adult public to complete a set of measurement tools, including the COVID-PSS, global fear of COVID-19, perceive ...[more]

PMID: 34728443

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Project description:AimsTo develop and validate two new standardised measures assessing, respectively, experienced discrimination (Covid-19 Experienced DISCrimination scale, CEDISC) and internalised stigma (COvid-19 INternalised Stigma scale, COINS) in people who had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or had developed coronavirus disease 2019 (Covid-19) disease.MethodsBoth the CEDISC and the COINS were developed in Italian and tested for ease of use, comprehension, acceptability, the relevance of items and response options within a focus group session. Online cross-sectional validation survey was conducted among adults infected with SARS-CoV-2 or who developed Covid-19 disease, members of a closed Facebook discussion group in Italy. Exploratory factor analysis (EFA) with Promax oblique rotation; the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and the Bartlett's test of sphericity were used to assess the suitability of the sample for factor analysis. Reliability was assessed as internal consistency using Cronbach's alpha and as test-retest reliability using weighted kappa and intraclass correlation coefficient (ICC). Precision was examined by Kendall's tau-b coefficient.ResultsOverall, 579 participants completed the CEDISC, 519 also completed the COINS, 155 completed the retest for both scales after two weeks. The 12 items of the CEDISC converged over a 2-factor solution ('social life' and 'close relations') accounting for 49.2% of the variance (KMO = 0.894; Bartlett's test p < 0.001); the 13 items of the COINS converged over a 3-factor solution ('self-perception', 'close relations' and 'social life') accounting for 67.7% (KMO = 0.827; Bartlett's test p < 0.001). Cronbach's α was 0.848 for the CEDISC, and 0.837 for the COINS. The CEDISC showed three items (25%) with kappa between 0.61 and 0.80 and seven (58.4%) between 0.41 and 0.60, with only two items scoring 0.21 and 0.40; the COINS had ten items (76.9%) with kappa ranging from 0.41 to 0.60, and three items below 0.31. ICC was 0.906 (95% CI, 0.871-0.932) for the, CEDISC and 0.860 (95% CI, 0.808-0.898) for the COINS. Kendall's tau-b ranged from 0.360 to 0.556 (p < 0.001) for the CEDISC and from 0.290 to 0.606 (p < 0.001) for the COINS.ConclusionsBoth the CEDISC and the COINS are two valid and reliable scales to be used in studies examining the role of stigma and discrimination of people infected with SARS-CoV-2 and Covid-19 patients, and in research evaluating interventions designed to mitigate stigma in this population.

Project description:BackgroundEpidemics have historically been accompanied by stigma and discrimination. Disease-related stigma has often been shown to have severe consequences for physical, mental and social wellbeing and lead to barriers to diagnosis, treatment and prevention. The aims of this study were to investigate if a HIV-related stigma measure could be adapted and valid and reliable to measure COVID-19-related stigma, and also to investigate levels of self-reported stigma and related factors among people in Sweden with experience of COVID-19 and compare levels of COVID-19-related stigma versus HIV-related stigma among persons living with HIV who had experienced a COVID-19 event.MethodsCognitive interviews (n = 11) and cross-sectional surveys were made after the acute phase of the illness using a new 12-item COVID-19 Stigma Scale and the established 12-item HIV Stigma Scale in two cohorts (people who had experienced COVID-19 (n = 166/209, 79%) and people living with HIV who had experienced a COVID-19 event (n = 50/91, 55%). Psychometric analysis of the COVID-19 Stigma Scale was performed by calculating floor and ceiling effects, Cronbach's α and exploratory factor analysis. Levels of COVID-19 stigma between groups were analysed using the Mann-Whitney U test. Levels of COVID-19 and HIV stigma among people living with HIV with a COVID-19 event were compared using the Wilcoxon signed-rank test.ResultsThe COVID-19 cohort consisted of 88 (53%) men and 78 (47%) women, mean age 51 (19-80); 143 (87%) living in a higher and 22 (13%) in a lower income area. The HIV + COVID-19 cohort consisted of 34 (68%) men and 16 (32%) women, mean age 51 (26-79); 20 (40%) living in a higher and 30 (60%) in a lower income area. The cognitive interviews showed that the stigma items were easy to understand. Factor analysis suggested a four-factor solution accounting for 77% of the total variance. There were no cross loadings, but two items loaded on factors differing from the original scale. All subscales had acceptable internal consistency, showed high floor and no ceiling effects. There was no statistically significant difference between COVID-19 stigma scores between the two cohorts or between genders. People living in lower income areas reported more negative self-image and concerns about public attitudes related to COVID-19 than people in higher income areas (median score 3 vs 3 and 4 vs 3 on a scale from 3-12, Z = -1.980, p = 0.048 and Z = -2.023, p = 0.024, respectively). People from the HIV + COVID-19 cohort reported more HIV than COVID-19 stigma.ConclusionsThe adapted 12-item COVID-19 Stigma Scale may be valid and reliable for measurement of COVID-19-related stigma. However, specific items may need to be rephrased or replaced to better correspond to the COVID-19 context. People who had experienced COVID-19 reported low levels of COVID-19-related stigma in general but people from lower income areas had higher levels of negative self-image and concerns about public attitudes related to COVID-19 than people from areas with higher income, which may call for targeted interventions. Although exhibiting more pronounced HIV stigma levels, people living with HIV who had experienced COVID-19 reported COVID-19-related stigma of the same low magnitude as their peers not living with HIV.

Project description:ObjectiveCorrectly understanding and evaluating the level of public risk perception toward public health emergencies not only helps experts and decision-makers understand the public's preventative health behaviors to these emergencies but also enhances their risk information communication with the public. The aim of this study was to develop a risk perception scale for public health emergencies and test its validity and reliability during the coronavirus disease 2019 (COVID-19) pandemic.MethodsGuided by the theoretical model of risk perception, an initial scale was generated through literature review, group meetings, resident interviews, and expert consultation. A pretest and item screening were then conducted to develop a formal risk perception scale for public health emergencies. Finally, the reliability and validity of the scale were validated through a questionnaire survey of 504 Chinese adults.ResultsThe final scale had 9 items. The content validity index of the scale was 0.968, and the content validity index of individual items ranged from 0.83 to 1.00. Three common factors, dread risk perception, severe risk perception, and unknown risk perception, were extracted for exploratory factor analysis, and together they explained 66.26% of the variance in the score. Confirmatory factor analysis showed that the model had a satisfactory fit, where χ 2/df = 1.384, the goodness-of-fit index (GFI) = 0.989, root mean square error of approximation (RMSEA) = 0.028, root mean square residual (RMR) = 0.018, comparative fit index (CFI) = 0.995, normed fit index (NFI) = 0.982, and non-normed fit index (NNFI) = 0.990. The correlations between dimensions ranged from 0.306 to 0.483 (P < 0.01). Cronbach's α was 0.793 for the total scale and ranged between 0.687 and 0.801 for the individual dimensions. The split-half coefficient was 0.861 for the total scale and ranged from 0.727 to 0.856 for induvial dimensions. The test-retest coefficient was 0.846 for the total scale and ranged from 0.843 to 0.868 for induvial dimensions.ConclusionThe developed scale for the risk perception of public health emergencies showed acceptable levels of reliability and validity, suggesting that it is suitable for evaluating residents' risk perception of public health emergencies.

Dataset Information

COVID-19 Public Stigma Scale (COVID-PSS): development, validation, psychometric analysis and interpretation.

Objective

Design and setting

Participants

Methods

Results

Conclusions

Publications

COVID-19 Public Stigma Scale (COVID-PSS): development, validation, psychometric analysis and interpretation.

Similar Datasets

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