Developing a tool to measure tuberculosis-related stigma in workplaces in Indonesia: An internal validation study

Workers with tuberculosis (TB) are often stigmatized, negatively impacting their socioeconomic position, mental health, and TB treatment outcomes. There is a dearth of validated tools to assess stigma in the worker population. This study aimed to develop and validate a novel, culturally adapted tool to measure TB-related stigma among workers in Indonesia. We translated, adapted, applied, and internally validated Van Rie's TB-Stigma Scale to the worker population in varying sizes businesses (formal and informal business sectors) in Indonesia. Psychometric evaluation using exploratory and confirmatory factor analyses (EFA and CFA) was performed to check the tool's internal consistency and reliability. The translation and cultural adaptation phases resulted in a final 11-item tool. From 172 participant responses, the EFA found two loading factors relating to responses on isolation and exclusion from the workplace. The CFA confirmed that the developed model had moderate fit with R2 values for each item ranging from 0.37 to 0.84. The tool was reliable (Cronbach's alpha 0.869). This validated, consistent and reliable adapted tool is ready to use in larger scale evaluations of TB-related stigma amongst workers in formal and informal business sectors of Indonesia to develop strategies to eliminate TB-related stigma from the workplace.

Development and validation of the cervical cancer knowledge scale and HPV testing knowledge scale in a sample of Canadian women

Knowledge of cervical cancer and HPV testing are important factors in proactive and continued engagement with screening and are critical considerations as countries move towards the implementation of HPV-based primary screening programs. However, existing scales measuring knowledge of both cervical cancer and HPV testing are not up to date with the current literature, lack advanced psychometric testing, or have suboptimal psychometric properties. Updated, validated scales are needed to ensure accurate measurement of these factors. Therefore, the aim of this study was to develop and validate two scales measuring cervical cancer knowledge and HPV testing knowledge. A pool of items was generated by retaining relevant existing items identified in a 2019 literature search and developing new items according to themes identified in recent systematic reviews. Items were assessed for relevance by the research team and then refined through seven cognitive interviews with Canadian women. A web-based survey including the remaining items (fourteen for each scale development) was administered to a sample of Canadian women in October and November of 2021. After data cleaning, N = 1027 responses were retained. Exploratory and Confirmatory Factor Analysis were conducted, and Item Response Theory was used to select items. The final cervical cancer knowledge scale (CCKS) and HPV testing knowledge scale (HTKS) were unidimensional, and each consisted of eight items. CFA demonstrated adequate model fit for both scales. The developed scales will be important tools to identify knowledge gaps and inform communications about cervical cancer screening, particularly in the context of HPV-based screening implementation.

Changes in asset-based wealth across the life course in birth cohorts from five low- and middle-income countries

Background

Temporally-harmonized asset-based measures of wealth can be used to study the association of life-course wealth exposures in the same scale with health outcomes in low- and middle-income countries (LMICs). The within-individual longitudinal stability of asset-based indices of wealth in LMICs is poorly understood.

Methods

Using data from five birth cohorts from three continents, we developed temporally-harmonized asset indices over the life course through polychoric principal component analysis of a common set of assets collected consistently over time (18 years in Brazil to 50 years in Guatemala). For each cohort, we compared the harmonized index to cross-sectional indices created using more comprehensive asset measures using rank correlations. We evaluated the rank correlation of the harmonized index in early life and adulthood with maternal schooling and own attained schooling, respectively.

Results

Temporally-harmonized asset indices developed from a consistently-collected set of assets (range: 10 in South Africa to 30 in Philippines) suggested that mean wealth improved over time for all birth cohorts. Cross-sectional indices created separately for each study wave were correlated with the harmonized index for all cohorts (Brazil: r = 0.78 to 0.96; Guatemala: r = 0.81 to 0.95; India: 0.75 to 0.93; Philippines: r = 0.92 to 0.99; South Africa: r = 0.84 to 0.96). Maternal schooling (r = 0.15 to 0.56) and attained schooling (r = 0.23 to 0.53) were positively correlated with the harmonized asset index in childhood and adulthood respectively.

Conclusions

Temporally-harmonized asset indices displayed coherence with cross-sectional indices as well as construct validity with schooling.

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Temporally-harmonized asset indices are useful to assess relative importance of wealth at different life stages with health on the same scale.

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Harmonized indices using a subset of assets were correlated with cross-sectional asset indices using all available assets in five LMIC birth cohorts.

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Harmonized indices displayed construct validity, as demonstrated by its correlation with schooling.

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Harmonized indices were robust to alternate specifications such as shorter lists of assets, study years, and factor extraction procedures.

Data on the individual problems and strengths scale from the systemic therapy inventory of change. Clinical samples from Norway

These data stem from 841 clients at different couple and family therapy sites in Norway that was collected between 2010 and 2016. They all answered the Individual Problems and Strengths scale (IPS) that is a part of the Systemic Therapy Inventory of Change (STIC) system in addition to some demographic variables. In addition to the 22 items constructing the IPS scale, the data contain 14 demographic variables describing age, educational level, civil status, prior therapeutic experience, use of medicine and year of data collection. Summary statistics are provided. Male and female clients between 12 and 72 years of age answered these questions prior to or at their first session of psychotherapy. The four sites collecting the data are located at different cities in the southern part of the country and represents low and high threshold agencies.

The data can be used to test the construct validity of the measure for different populations. The data could, with a sample from the normal population, also be used for norming the scale and thus provide data to calculate cut off scores for clinical and non-clinical levels for each of the eight subscales. Further, the data could be used in combination with other measures of individual distress to test the construct validity of the scale within a Norwegian clinical sample and perhaps also within other countries.

Psychometric properties of the Chinese version of the Parent Perception of Uncertainty Scale (PPUS) among parents of children with cancer diagnosis

Objective

Parents of children diagnosed with cancer often experience high levels of illness uncertainty. This study evaluated the psychometric properties of the Chinese Version of the Parent Perception of Uncertainty Scale for Childhood Cancer (PPUS-CC) in Mainland China.

Methods

Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed using study population of 420 parents. The participants were also given the social support questionnaire and assessed using the Self-Rating Anxiety Scale, Zarit Burden Interview, and Self-Rating Depression Scale to test the association with PPUS-CC and obtain the cut-off of the scale.

Results

The Chinese version of PPUS-CC includes 14 items, and two factors were extracted by EFA, which could explain the 54.56% variances. The Cronbach's α of two factors ranged from 0.830 to 0.877. The dimensions of PPUS-CC show statistical association with other scales, and the cut-off is 42.5.

Conclusion

The Chinese version of PPUS-CC, as a reliable, valid, and easy-to-use clinical tool, can be adapted in clinical settings as a screening tool to recognize parents with high-risk psychological problems.