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Adaptation and validation of a TB stigma scale for adolescents in Lima, Peru.

ABSTRACT: BACKGROUND: TB-related stigma contributes to poor clinical outcomes and reduced wellbeing for affected individuals. Adolescents may be particularly susceptible to TB-related stigma due to their heightened sensitivity to peer acceptance, yet few studies have evaluated TB-related stigma in this group. Without a validated scale, it remains challenging to measure TB-related stigma in adolescents.METHODS: We adapted and validated the Van Rie TB Stigma Scale (VTSS) for adolescents on treatment for rifampicin-susceptible TB in Lima, Peru. The modified stigma scale was administered within a larger survey, which measured other psychosocial factors, including depression, adverse childhood experiences (ACEs), and social support. Data analysis included factor analysis, internal consistency, and convergent validity.RESULTS: From October 2020 to September 2021, 249 adolescents (individuals aged 10-19 years) completed the survey. Preliminary confirmatory factor analysis led to removal of two items. The final 10-item scale demonstrated good internal consistency (Cronbach's α = 0.82) and adequate model fit (χ²/df = 2.0; root mean square error of approximation: 0.06; comparative fit index: 0.94; Tucker-Lewis Index: 0.92: standardized root mean square residual: 0.05). Stigma was positively correlated with ACEs (γ = 0.13), depression (γ = 0.39), and suicidal ideation (γ = 0.27), and negatively correlated with social support (γ = -0.19).CONCLUSION: This adolescent TB stigma scale may serve as a practical tool to measure TB-related stigma and evaluate the impact of stigma-reduction interventions in adolescents.

SUBMITTER: Chiang SS

PROVIDER: S-EPMC10519385 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Adaptation and validation of a TB stigma scale for adolescents in Lima, Peru.

Chiang S S SS Zeng C C Roman-Sinche B B Altamirano E E Beckhorn C B CB Leon-Ostos K K Espinoza-Meza R R Lecca L L Franke M F MF

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease 20231001 10

<b>BACKGROUND:</b> TB-related stigma contributes to poor clinical outcomes and reduced wellbeing for affected individuals. Adolescents may be particularly susceptible to TB-related stigma due to their heightened sensitivity to peer acceptance, yet few studies have evaluated TB-related stigma in this group. Without a validated scale, it remains challenging to measure TB-related stigma in adolescents.<b>METHODS:</b> We adapted and validated the Van Rie TB Stigma Scale (VTSS) for adolescents on tre ...[more]

PMID: 37749835

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Project description:BackgroundCondom use has long been recommended as an effective method for preventing HIV/AIDS. However, a large proportion of older adults in China reported not using condoms, leading to an alarming increase in HIV prevalence among this population. Negative attitudes, especially condom-related stigma, have been identified as the main barrier. However, no condom-related stigma scale has been developed or validated for older adults in the Chinese cultural context. This study aimed to adapt and validate a condom-related stigma scale for older adults (CRSS-OA) in China, based on a scale previously developed for men who have sex with men (CRSS).MethodsBased on qualitative interviews, we adapted and revised the CRSS to better address the ageism and unique stigma faced by older adults in the Chinese cultural context. The reliability and validity of the adapted CRSS-OA were examined using a random sample of 498 older adults in Hunan Province, south-central China. Reliability was assessed by calculating Cronbach's alpha. Construct validity was assessed through exploratory and confirmatory factor analyses. Concurrent validity was assessed by examining the correlation between each factor of the CRSS-OA and two criterion scales (the HIV/AIDS Stigma Scale and the Aging Sexual Attitudes Scale). Predictive validity was evaluated by analyzing the association between condom-related stigma and engagement in condomless sexual behavior.ResultsThe adapted scale included 16 items, loading on three factors, and collectively explaining 70.646% of the variance. These factors were named "labeling condom use," "shaming condom purchase," and "violating traditional sex beliefs," demonstrating strong internal consistency with Cronbach's alpha coefficients of 0.942, 0.850, and 0.852, respectively. Concurrent validity was established by evaluating the correlation between each factor of the CRSS-OA and two criterion scales, with Pearson correlation coefficients ranging from 0.227 to 0.508 (p < 0.05). Predictive validity was assessed by measuring the scale's ability to correctly predict condomless sexual behavior, with an average predictability of 0.77.ConclusionsThe adapted CRSS-OA has proven to be a valid and cultural-adaptive tool for assessing condom-related stigma among older adults in China. Further studies are needed to explore the external validity of this scale in the future.

Project description:Peruvian adolescents are at high nutritional risk, facing issues such as overweight and obesity, anemia, and pregnancy during a period of development. Research seeking to understand contextual factors that influence eating habits to inform the development of public health interventions is lacking in this population. This study aimed to understand socio-cultural influences on eating among adolescents in periurban Lima, Peru using qualitative methods.Semi-structured interviews and pile sort activities were conducted with 14 adolescents 15-17 years. The interview was designed to elicit information on influences on eating habits at four levels: individual (intrapersonal), social environmental (interpersonal), physical environmental (community settings), and macrosystem (societal). The pile sort activity required adolescents to place cards with food images into groups and then to describe the characteristics of the foods placed in each group. Content analysis was used to identify predominant themes of influencing factors in interviews. Multidimensional scaling and hierarchical clustering analysis was completed with pile sort data.Individual influences on behavior included lack of financial resources to purchase food and concerns about body image. Nutrition-related knowledge also played a role; participants noted the importance of foods such as beans for anemia prevention. At the social environmental level, parents promoted healthy eating by providing advice on food selection and home-cooked meals. The physical environment also influenced intake, with foods available in schools being predominantly low-nutrient energy-dense. Macrosystem influences were evident, as adolescents used the Internet for nutrition information, which they viewed as credible.To address nutrition-related issues such as obesity and iron-deficiency anemia in Peruvian adolescents, further research is warranted to elucidate the roles of certain factors shaping behavior, particularly that of family, cited numerous times as having a positive influence. Addressing nutrition-related issues such as obesity and iron-deficiency anemia in this population requires consideration of the effect of social and environmental factors in the context of adolescent lifestyles on behavior. Nutrition education messages for adolescents should consider the cultural perceptions and importance of particular foods, taking into account the diverse factors that influence eating behaviors.

Dataset Information

Adaptation and validation of a TB stigma scale for adolescents in Lima, Peru.

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Adaptation and validation of a TB stigma scale for adolescents in Lima, Peru.

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