Developing a tool to measure tuberculosis-related stigma in workplaces in Indonesia: An internal validation study. (March 2023)

• Record Type: Journal Article
• Authors: Soemarko, Dewi Sumaryani; Halim, Frisca Aprillia; Kekalih, Aria; Yunus, Faisal; Werdhani, Retno Asti; Sugiharto, Agus; Mansyur, Muchtaruddin; Wingfield, Tom; Fuady, Ahmad
• Is Part Of: SSM - population health. Volume 21(2023)
• Publication Date: 2023-03
• Subjects: Tuberculosis -- Stigma -- Worker -- Tool -- Validation -- Indonesia; TB Tuberculosis -- WHO World Health Organization -- CFA Confirmatory Factor Analysis -- EFA Exploratory Factor Analysis -- ISPOR International Society for Pharmacoeconomics and Outcomes Research; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; 362.105
• DOI: 10.1016/j.ssmph.2023.101337
• Languages: English
• ISSNs: 2352-8273

Abstract

Abstract: 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 R 2 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. Highlights: This is the first tool to measure stigma towards people with tuberculosis, developed for the general worker population. The tool was adapted from Van Rie's TB Stigma Scale with adjustments and additional items relevant to the worker population. The tool is valid, consistent, reliable, and ready to use in larger-scale evaluations of TB-related stigma amongst workers.