Abstract:
Stigma against sexual and gender minorities (SGM) populations has serious negative health effects for SGM populations. Despite the growing need for accurate stigma measurement in SGM, there are insufficient valid measurement instruments. Moreover, the lack of consistency in construct usage makes comparisons across studies particularly challenging. A critical review and comparative evaluation of the psychometric properties of the various stigma measures for SGM is necessary to advance our understanding regarding stigma measurement against/among SGMs. Based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive search was conducted in 4 bibliographic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science) for empirical articles published from 2010 to 2022 that evaluated the psychometrics properties of measurement instruments assessing stigma against SGMs. The screening, extraction, and scoring of the psychometric properties and methodological quality of selected instruments were performed by following the established standards and COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) checklist, respectively. Of the 2031 studies identified, 19 studies were included that reported psychometric properties of 17 measurement instruments. All instruments, except two, were developed for SGMs (n = 15/17). Most instruments included men who have sex with men (MSM) or gay men (n = 11/15), whereas less than half of the instruments assessed stigma among SGM women (n = 6/15). Internal consistency (Cronbach\'s alpha) and content validity was reported for all instruments (n = 17); construct and structural validity was also reported for majority of the instruments (n = 15 and 10, respectively). However, test-retest reliability and criterion validity was reported for very few instruments (n = 5 each). Based on the COSMIN checklist, we identified the most psychometrically and methodologically robust instruments for each of the five stigma types: combined stigma, enacted stigma, internalized stigma, intersectional stigma, and perceived stigma. For each stigma type, except anticipated stigma, at least one instrument demonstrated strong promise for use in empirical research; however, the selection of instrument depends on the target population and context of the study. Findings indicated a growing use of instruments assessing multiple stigma types. Future studies need to develop intersectional stigma instruments that account for the multiple and intersecting social identities of SGMs. Additionally, most existing instruments would benefit from further psychometric testing, especially on test-retest reliability, criterion validity, adaptability to different LGBTQIA + populations and cultures.
摘要:
针对性和性别少数群体(SGM)人群的污名对SGM人群具有严重的负面健康影响。尽管在SGM中越来越需要准确的柱头测量,有效的测量仪器不足。此外,结构使用缺乏一致性使得研究之间的比较特别具有挑战性.有必要对SGM的各种污名测量的心理测量特性进行严格的审查和比较评估,以增进我们对SGM之间的污名测量的理解。基于PRISMA(系统审查和荟萃分析的首选报告项目)指南,在4个书目数据库(MEDLINE,PsycINFO,CINAHL,andWebofScience)forempiricalarticlespublishedfrom2010to2022thatevaluatedthepsychometricspropertiesofmeasurementinstrumentsassessingstimageagainstSGM.Thescreening,提取,根据既定标准和COSMIN(基于共识的健康测量仪器选择标准)清单,对所选仪器的心理测量特性和方法学质量进行评分,分别。在确定的2031项研究中,包括19项研究,报告了17种测量仪器的心理测量特性。所有仪器,除了两个,为SGM开发(n=15/17)。大多数乐器包括男男性行为者(MSM)或男同性恋者(n=11/15),而不到一半的仪器评估SGM女性的污名(n=6/15)。报告了所有仪器的内部一致性(Cronbach'salpha)和内容效度(n=17);还报告了大多数仪器的结构和结构效度(分别为n=15和10)。然而,报告了极少数仪器的重测信度和标准效度(每个n=5)。根据COSMIN核对表,我们为五种污名类型中的每一种确定了最心理和方法上最强大的工具:组合污名,颁布的耻辱,内化的污名,交叉柱头,和感知到的耻辱。对于每种柱头类型,除了预期的耻辱,至少有一种工具显示出在实证研究中使用的强大前景;然而,仪器的选择取决于目标人群和研究背景。研究结果表明,越来越多地使用评估多种柱头类型的工具。FuturestudiesneedtodevelopintersectionstighageinstrumentsthataccountforthemultipleandintersatingsocialidentitiesofSGM.Additionally,大多数现有的仪器将受益于进一步的心理测试,特别是在重测可靠性方面,标准有效性,对不同LGBTQIA+种群和文化的适应性。