Development of a Scale for COVID-19 Stigma and Its Psychometric Properties: A Study among Pregnant Japanese Women

Abstract

Background: Stigma towards COVID-19 may negatively impact people who suffer from it and those supporting and treating them. Objective: To develop and validate a scale to assess 11-item COVID-19–related stigma. Methods: A total of 696 pregnant women at a gestational age of 12 to 15 weeks were surveyed using an online survey with a newly developed scale for COVID-19 stigma and other variables. The internal consistency of the scale was calculated using omega indices. We also examined the measurement invariance of the scale. Results: Exploratory factor analyses (EFAs) of the scale items were conducted using a halved sample (n = 350). Confirmatory factor analyses (CFAs) among the other halved sample (n = 346) compared the single-, two-, three-, and four-factor structure models derived from the EFAs. The best model included the following three-factor structure (χ2/df = 2.718, CFI = 0.960, RMSEA = 0.071): Omnidirectional Avoidance, Attributional Avoidance, and Hostility. Its internal consistency was excellent (all omega indices > 0.70). The three-factor structure model showed configuration, measurement, and structural invariances between primiparas and multiparas, and between younger (less than 32 years) and older women (32 years or older). Fear of childbirth, mother–fetal bonding, obsessive compulsive symptoms, depression, adult attachment self-model, and borderline personality traits were not significantly correlated with the Omnidirectional Avoidance subscale but correlated with the Attributional Avoidance and Hostility subscales (p < 0.001). Conclusion: The findings suggested that our scale for COVID-19 stigma was robust in its factor structure, as well as in construct validity.

Keywords

• COVID-19
• stigma
• factor structure
• measurement and structural invariance
• construct validity