Perceived Community Stigma of Mothers Who Use Substances (SMUS): Initial Scale Development

Background: Mothers who misuse substances encounter stigma which can lead them to avoid seeking addiction treatment; however, there are no tools that assess their perceptions of such stigma. We therefore aimed to provide the initial development and tests for internal consistency and construct validity of a tool that measures perceived community stigma against mothers who use drugs (SMUS).Methods: The research took place from October to December 2023 in Canada. We used a mixed methods approach to develop the scale, which involved two steps. Step 1 consisted of item generation, using a qualitative and inductive approach. Step 2 involved initial psychometric analysis, using quantitative data to assess internal consistency and construct validity. Step 1 (n=27) included women who were in recovery and treatment providers, and Step 2 (n=82) included women in recovery. Thematic results from Step 1 were used to generate 14 items for Step 2.Results: In Step 1, five themes emerged regarding stigma experienced by mothers who use substances, including child services, childcare, needs of children, irresponsible and selfish, and gossip. In Step 2, the Cronbach's alpha score for the final scale items was 0.86. SMUS was also positively correlated with enacted stigma (tau= 0.15, p= 0.05) and internalized stigma (tau= 0.26, p= 0.002), indicating convergent validity of SMUS.Conclusions: This research adds value to extant research on stigma and substance misuse by developing and providing results for internal consistency and construct validity of a scale that measures perceptions of community stigma against mothers who use substances.