Cross-cultural validation of the Pidgin-English version of the EMIC-CSS and SDS among adults in Southern Nigeria

Abstract

Background Persons affected with leprosy encounter stigma. Evaluating the extent of stigma remains a challenge due to the absence of validated instruments. This study describes the cross-cultural validation of the Nigerian Pidgin-English version of the Explanatory Model Interview Catalogue Community Stigma Scale (P-EMIC-CSS) and the Social Distance Scale (P-SDS) in communities of people affected by leprosy in Cross River State, Southern Nigeria. Methods The cultural equivalence of the P-EMIC-CSS and P-SDS was qualitatively evaluated through a process of forward translation, back translation, group discussions, and pretest assessment. A cross-sectional study of community members in Cross River State was performed to assess the measurement equivalence. Overall, 114 respondents completed the test, and 26 of them had the retest. Results Conceptual, item, linguistic, and operational equivalences of the Pidgin version of the EMIC-CSS and SDS showed good fit. The relationship between the mean scores of the EMIC-CSS and the SDS revealed a weak positive correlation (r = 0.32; p = 0.001). Internal consistency of the P-EMIC-CSS and P-SDS full scales was 0.86 and 0.89, respectively. The exploratory factor analysis for both scales suggested adequate fit as a one dimensional scale. The test–retest reliability coefficient for the EMIC-CSS and the SDS was 0.67 and 0.96, respectively. There were no floor or ceiling effects in the distribution of the EMIC-CSS; the SDS had no ceiling effect but had a floor effect. Conclusions The Pidgin versions of the EMIC-CSS and the SDS have adequate validity and reliability in assessing stigma in communities with people affected by leprosy in Cross River State, southern Nigeria.