Assessing stigma in low- and middle-income countries: A systematic review of scales used with children and adolescents

Hartog, K (通讯作者),War Child Holland, Res & Dev, Helmholzstr 61-G, NL-1098 LE Amsterdam, Netherlands.
2022-8
Introduction: Stigmatization contributes to health inequalities, impacting the wellbeing of children and adoles-cents negatively. Addressing stigmatization requires adequate measurement. Our systematic review synthesizes the content of scales used with children and adolescents in low-and middle-income countries (LMICs) across stigmas, and examines their comparability and level of cultural adaptation.Methods: Ten databases were systematically searched combining three sets of search terms: (i) stigma, (ii) scales, and (iii) LMICs. Studies conducted in LMICs, with a sample with mean age below 18 and reporting a minimum of one stigma scale, were eligible. We allocated scale items to four frameworks: (i) dimensions, or drivers of stigmatization; (ii) target variants, or types of stigmatization; (iii) socio-ecological levels, and (iv) cross-cultural equivalence, or scale adaptation to context/population. Based on percentages, we compared scale content per age cohort, stigma status, region, and stigma category.Results: Out of 14,348 records, we included 93 articles (112 scales). Most studies focused on adolescents (12-18 years). Twelve scales were used more than once, seven were used across regions, and four were employed for multiple stigmas. Physical health stigma, and HIV/AIDS-related stigma in particular, was measured most; mental health and multiple/generic stigmas least. Physical and mental health scales were generally more comprehen-sive, i.e., measuring more stigma facets. In general, scales consistently measured two of the 21 included stigma facets, namely the disruptiveness dimension and the community level. Cross-cultural equivalence was moderate; conceptual and measurement equivalence were high.Discussion: Although scales were largely comparable in how they measure stigma, they failed to reflect the complexity of the stigmatization process and fell short of existing stigma frameworks and qualitative research. Stigma research with children should work towards cross-culturally validated stigma scale sets which incorporate more facets of existing stigma frameworks, thus facilitating comparability across cultural contexts and informing intervention development and evaluation.
SOCIAL SCIENCE & MEDICINE
卷号:307
ISSN:0277-9536|收录类别:SCIE
语种
英语
来源机构
University of Amsterdam; University of Amsterdam; University of London; King's College London; University of Amsterdam; George Washington University; Vrije Universiteit Amsterdam
资助信息
We would like to thank Dr. Wim van Brakel, Medical Director at NLR International, for his support in cross-cultural equivalence rating. We thank the Dutch Relief Alliance (DRA), which is funded by the Dutch Ministry of Foreign Affairs, for financial support to author Kim Hartog. B.A. Kohrt and M. J. D. Jordans are supported by the U.S. National Institute of Mental Health (Grant no. R01MH120649). B.A. Kohrt and M. J. D. Jordans are supported by the U.S. National Institute of Mental Health (Grant no. R01MH120649).
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
8
2013以来使用计数
9
EISSN
1873-5347
出版年
2022-8
DOI
10.1016/j.socscimed.2022.115121
关键词
Stigma Discrimination Scale LMICs Systematic review Children and adolescentsx Children and adolescents Validation Cross-cultural equivalence
资助机构
Dutch Relief Alliance (DRA) - Dutch Ministry of Foreign Affairs U.S. National Institute of Mental Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH)) Dutch Ministry of Foreign Affairs U.S. National Institute of Mental Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH))
WOS学科分类
Public, Environmental & Occupational Health Social Sciences, Biomedical
学科领域
循证公共卫生 循证社会科学-综合