The adaptation and psychometric validation of a stigma measure for adults diagnosed with severe vision impairment in rural Mozambique

Background People living with severe visual impairment endure stigma and discrimination, which can contribute to poor health and economic outcomes. There are few tools that measure vision-related stigma in the populations of rural Africa. The aim of this study was to assess an adapted tool for measuring stigmatizing attitudes and behaviors among a cohort of adults with severe visual impairment in rural Mozambique. Methods A cohort of 927 patients with severe visual impairment from rural Northern Mozambique were examined. As part of a wider study, an adapted stigma and discrimination tool consisting of 13 questions was administered to the cohort. 556 (60.0%) patients responded to all questions and were included in the subsequent analysis. The 556 patients were split into equivalent subsamples. An exploratory factor analysis (EFA) was conducted on the first subsample to examine the underlying constructs of the tool, followed by a confirmatory factor analysis (CFA) using the second subsample to validate the structure identified by the EFA. Results Factor analysis of the tool revealed an underlying two-factor structure that mirrored the theoretical structure of the original tool. The models showed good fit based on standard model-fit indices and good internal consistency based on Cronbach’s alpha. Conclusions The adapted tool showed good validity and reliability. These are encouraging results that can be progressed further to develop a standardized stigma and discrimination measurement among patients living with severe visual impairment in rural African settings. Trial registration Clinical trial number: not applicable.