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Home / The International Journal of Tuberculosis and Lung Disease, Volume 27, Number 10

Open Access Adaptation and validation of a TB stigma scale for adolescents in Lima, Peru

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BACKGROUND: TB-related stigma contributes to poor clinical outcomes and reduced wellbeing for affected individuals. Adolescents may be particularly susceptible to TB-related stigma due to their heightened sensitivity to peer acceptance, yet few studies have evaluated TB-related stigma in this group. Without a validated scale, it remains challenging to measure TB-related stigma in adolescents.

METHODS: We adapted and validated the Van Rie TB Stigma Scale (VTSS) for adolescents on treatment for rifampicin-susceptible TB in Lima, Peru. The modified stigma scale was administered within a larger survey, which measured other psychosocial factors, including depression, adverse childhood experiences (ACEs), and social support. Data analysis included factor analysis, internal consistency, and convergent validity.

RESULTS: From October 2020 to September 2021, 249 adolescents (individuals aged 10–19 years) completed the survey. Preliminary confirmatory factor analysis led to removal of two items. The final 10-item scale demonstrated good internal consistency (Cronbach’s α = 0.82) and adequate model fit (χ2/df = 2.0; root mean square error of approximation: 0.06; comparative fit index: 0.94; Tucker-Lewis Index: 0.92: standardized root mean square residual: 0.05). Stigma was positively correlated with ACEs (γ = 0.13), depression (γ = 0.39), and suicidal ideation (γ = 0.27), and negatively correlated with social support (γ = –0.19).

CONCLUSION: This adolescent TB stigma scale may serve as a practical tool to measure TB-related stigma and evaluate the impact of stigma-reduction interventions in adolescents.

Keywords: adverse childhood experiences; depression; mental health; psychometrics

Document Type: Research Article

Affiliations: 1: Division of Pediatric Infectious Diseases, Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, Center for International Health Research, Rhode Island Hospital, Providence, RI 2: Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA 3: Socios En Salud – Sucursal Perú, Lima, Perú 4: Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA, Socios En Salud – Sucursal Perú, Lima, Perú

Publication date: October 1, 2023

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