Validation of Sinhalese stigma assessment and reduction of impact (SARI) scale to measure stigma related to leprosy in Sri Lanka
Introduction: Leprosy is a significant health problem that affects over 200,000 persons per year globally. Multiple social determinants impact leprosy occurrence and control, such as poverty, education, migration and stigma. Assessing stigma among persons affected will provide us with an insight into the magnitude of the problem in Sri Lanka, so that more focused activities can be undertaken to reduce it.
Objective: To translate and validate the Stigma Assessment and Reduction of Impact (SARI) scale into Sinhalese.
Methods: After determining the face and content validity, construct validity was determined using the confirmatory factor analysis (CFA) method. Cronbach’s alpha coefficient was used to assess the reliability (internal consistency) and the intra-class correlation coefficient (ICC) to verify reproducibility.
Results: Of the 147 participants recruited, 36% (n = 50) were aged below 29 years, 52.4% (77) were females. The total score of the new scale had a mean of 16.9, 95% CI 15.5–18.4 and a range of 0–36. The instrument showed better fit indices for confirmatory factor analysis for the original four-factor structure (experienced, disclosure, internalised and anticipated) after omitting 7, 12, 15and 17 items with Root Mean Square Error of Approximation of 0.117 (p <; 0.05), Comparative Fit Index of 0.727, Tucker-Lewis Index of 0.671 and Standardized Root Mean Square Residual of 0.107. Internal consistency was considered adequate (overall alpha 0.74).
Conclusions: The translated SARI scale can be used to measure stigma related to leprosy in the Sinhalese-speaking population of Sri Lanka.