Josée M Dussault1, Chifundo Zimba2, Jullita Malava3, Harriet Akello2, Melissa A Stockton4,5, Michael Udedi6, Bradley N Gaynes7,8, Mina C Hosseinipour2,9, Brian W Pence7, Jones Masiye6. 1. Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, USA. josee.dussault@unc.edu. 2. UNC Project, Malawi, Lilongwe, Malawi. 3. Malawi Epidemiology and Intervention Research Unit, Karonga, Malawi. 4. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, USA. 5. New York State Psychiatric Institute, New York, USA. 6. NCDs and Mental Health Unit, Ministry of Health Malawi, Lilongwe, Malawi. 7. Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, USA. 8. Department of Psychiatry, UNC School of Medicine, Chapel Hill, USA. 9. Division of Infectious Disease, UNC School of Medicine, Chapel Hill, USA.
Abstract
PURPOSE: There are no validated tools in Malawi to measure mental health stigma. Accordingly, this study evaluates the validity and reliability of a short quantitative instrument to measure depression-related stigma in patients exhibiting depressive symptoms in Malawi. METHODS: The SHARP study began depression screening in 10 NCD clinics across Malawi in April 2019; recruitment is ongoing. Eligible participants were 18-65 years, had a patient health questionnaire (PHQ-9) score ≥ 5, and were new or current diabetes or hypertension patients. Participants completed a baseline questionnaire that measured depression-related stigma, depressive symptoms, and sociodemographic information. The stigma instrument included a vignette of a depressed woman named Thandi, and participants rated their level of agreement with statements about Thandi's situation in nine prompts on a 5-point Likert scale. Inter-item reliability was assessed with Cronbach's alpha. Exploratory factor analysis (EFA) was used to assess structural validity, and OLS regression models were used to assess convergent and divergent validity between measured levels of depression-related stigma and covariates. RESULTS: The analysis of patient responses (n = 688) to the stigma tool demonstrated acceptable inter-item reliability across all scales and subsequent subscales of the instrument, with alpha values ranging from 0.70 to 0.87. The EFA demonstrated clustering around three domains: negative affect, treatment carryover, and disclosure carryover. Regression models demonstrated convergence with several covariates and demonstrated divergence as expected. CONCLUSION: This study supports the reliability and validity of a short stigma questionnaire in this population. Future studies should continue to assess the validity of this stigma instrument in this population.
PURPOSE: There are no validated tools in Malawi to measure mental health stigma. Accordingly, this study evaluates the validity and reliability of a short quantitative instrument to measure depression-related stigma in patients exhibiting depressive symptoms in Malawi. METHODS: The SHARP study began depression screening in 10 NCD clinics across Malawi in April 2019; recruitment is ongoing. Eligible participants were 18-65 years, had a patient health questionnaire (PHQ-9) score ≥ 5, and were new or current diabetes or hypertension patients. Participants completed a baseline questionnaire that measured depression-related stigma, depressive symptoms, and sociodemographic information. The stigma instrument included a vignette of a depressed woman named Thandi, and participants rated their level of agreement with statements about Thandi's situation in nine prompts on a 5-point Likert scale. Inter-item reliability was assessed with Cronbach's alpha. Exploratory factor analysis (EFA) was used to assess structural validity, and OLS regression models were used to assess convergent and divergent validity between measured levels of depression-related stigma and covariates. RESULTS: The analysis of patient responses (n = 688) to the stigma tool demonstrated acceptable inter-item reliability across all scales and subsequent subscales of the instrument, with alpha values ranging from 0.70 to 0.87. The EFA demonstrated clustering around three domains: negative affect, treatment carryover, and disclosure carryover. Regression models demonstrated convergence with several covariates and demonstrated divergence as expected. CONCLUSION: This study supports the reliability and validity of a short stigma questionnaire in this population. Future studies should continue to assess the validity of this stigma instrument in this population.
Authors: Jordi Alonso; Andrea Buron; Sonia Rojas-Farreras; Ron de Graaf; Josep M Haro; Giovanni de Girolamo; Ronny Bruffaerts; Viviane Kovess; Herbert Matschinger; Gemma Vilagut Journal: J Affect Disord Date: 2009-03-13 Impact factor: 4.839
Authors: T Shibre; A Negash; G Kullgren; D Kebede; A Alem; A Fekadu; D Fekadu; G Madhin; L Jacobsson Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2001-06 Impact factor: 4.328