Scale Validation and Attributional Analysis of Public Stigma in Early-Pandemic COVID-19

Am J Health Promot. 2024 May 20:8901171241255761. doi: 10.1177/08901171241255761. Online ahead of print.

Abstract

Purpose: To test the validity of a COVID-19 public stigma scale and an attributional model of stigma during the early stages of the pandemic.

Design: We administered a cross-sectional survey that included scales related to COVID-19 stigma to U.S. adults.

Setting: We used Amazon MTurk online survey panel to recruit participants in June 2020.

Subjects: U.S. adults (N = 170) participated in the study. Participants were average age of 37 and majority were men (61.2%) and White (77.6%).

Measures: The Stigma Towards Disease Scale (SDS) was adapted to measure public stigma directed towards COVID-19 (SDS-C19). Additional stigma-related measures were adapted for this study.

Analysis: Factorial structure of SDS-C19 was assessed using confirmatory factor analysis (CFA). Validity of SDS was examined using Pearson correlations with other stigma measures. We evaluated the attributional model of stigma using structural equation modeling.

Results: Internal consistency of SDS-C19 was high and a three-factor model reflecting cognitive, affective, and behavioral factors was supported (χ2 [71, N = 170] =140.954, P = .00, CFI= .946, TLI = .931, RMSEA = .076, SRMR = .087). The SDS-C19 had strong correlations with other stigma-related measures. A blame-mediated attribution model was supported (χ2 [8, N = 170] = 21.793, P = .00, CFI = .976, TLI =.956, RMSEA = .101, SRMR = .058).

Conclusion: The SDS-C19 is a valid tool for assessing COVID-19 stigma. SDS-C19 and the attribution model can guide public health communication.

Keywords: COVID-19; attribution; blame; disease impact; stigma.