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Rozzell-Voss KN, Marshall RD, Lin CY, Latner JD. The Modified Weight Bias Internalization Scale: measurement invariance by weight status and race among undergraduate women. Int J Obes (Lond) 2024; 48:1705-1710. [PMID: 39143295 DOI: 10.1038/s41366-024-01602-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 07/11/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Internalized weight bias is the belief in negative, weight-based stereotypes and the application of these stereotypes to oneself. These negative stereotypes have harmful impacts on people with overweight/obesity, and weight-based discrimination is well-documented across a variety of settings. Given poor outcomes associated with internalized weight bias, particularly among individuals with obesity, it is necessary to validate measures assessing internalized weight bias among diverse samples. The present study sets out to investigate measurement invariance properties across weight status (women with vs. without overweight/obesity) and race (White vs. Asian; White vs. bi- or multi-racial) of the Modified Weight Bias Internalization Scale (WBIS-M), an 11 item self-report measure. METHODS Participants were 746 racially/ethnically diverse women across the weight spectrum (24.9% with overweight/obesity). Confirmatory factor analyses of the WBIS-M were initially performed among the full sample, and all sub-samples. Each model showed good to excellent descriptive model fit. Subsequent analyses examined factor loadings and item thresholds of the WBIS-M to assess metric, threshold, and scalar invariance. Invariance was determined by assessing changes in Comparative Fit Index (ΔCFI ≤ -0.010), Root Mean Square Error of Approximation (ΔRMSEA ≤ 0.015), and Standardized Root Mean Square Residuals (ΔSRMR ≤ 0.030). RESULTS Based on these previously established statistical cutoffs, the WBIS-M showed invariance across weight status and racial groups in the present sample. The current results lend support for use of the WBIS-M to measure internalized weight bias in women who do and do not have overweight/obesity, and among White, Asian, and bi- or multi-racial women. CONCLUSION This may inform future studies that wish to utilize the WBIS-M, such as investigations of mean level differences in internalized weight bias. These findings may have clinical applications in the treatment and prevention of obesity, given the heightened levels of internalized weight bias and weight-based discrimination faced by individuals with higher body weights.
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Affiliation(s)
| | - Rachel D Marshall
- Department of Psychology, University of Hawai'i at Manoa, Honolulu, HI, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- University of Religions and Denominations, Qom, Iran
| | - Janet D Latner
- Department of Psychology, University of Hawai'i at Manoa, Honolulu, HI, USA
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Saffari M, Chen CY, Chen IH, Ruckwongpatr K, Griffiths MD, Potenza MN, Wang XL, Huang YT, Chen JS, Tsai CC, Lin CY. A comprehensive measure assessing different types of problematic use of the internet among Chinese adolescents: The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11). Compr Psychiatry 2024; 134:152517. [PMID: 39018815 DOI: 10.1016/j.comppsych.2024.152517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/11/2024] [Accepted: 07/05/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Problematic use of the internet (PUI) is prevalent, particularly among adolescents and young adults. Given the limited measures to assess specific types of PUI, which encompasses a broad spectrum of activities such as online gaming, social media use, pornography use, shopping, gambling, and web-streaming, Muller et al. (2022) developed the Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) to comprehensively assess different types of PUI (i.e., gaming, shopping, social media use, gambling, and pornography use). The present study aimed to validate the Chinese ACSID-11 among adolescents incorporating cross-cultural adaptations. METHODS Using forward-backward translation method, a culturally adapted version of the ACSID-11 was prepared. Then, a cross-sectional online survey was administered between September 8 and September 26, 2023. Adolescents, using a convenience sample (N = 11,492; mean age = 16.42 years [SD ± 0.91]; 59.1% male), were recruited from six schools to complete the translated ACSID-11, Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Bergen Social Media Addiction Scale (BSMAS), and Smartphone Application Based Addiction Scale (SABAS) via an online platform. Pearson correlation coefficients assessed convergent/discriminant validity. Factor structure and measurement invariance were examined through confirmatory factor analysis (CFA) and multi-group CFA. Cronbach's alpha and McDonald's omega tested internal consistency. RESULTS Associations between the ACSID-11 components and other scales supported convergent validity (i.e., ACSID-11 gaming scale with IGDS9-SF [0.37 ≤ r ≤ 0.41]; social networks use scale with BSMAS [0.24 ≤ r ≤ 0.31]) and discriminant validity (i.e., online gambling scale with BSMAS [0.16 ≤ r ≤ 0.19] and with SABAS [0.11 ≤ r ≤ 0.13]). A four-factor solution indicated good fit with comparative fit index (CFI) ranging from 0.982 to 0.958. The ACSID-11 was measurement invariant across sexes (∆CFI = -0.001 to 0.000) and different levels of related addictive behaviors (∆CFI = -0.001 to 0.000). Both Cronbach's alpha and McDonald's omega (0.63 to 0.97) were acceptable for both frequency and intensity of responses. CONCLUSIONS The ACSID-11 is an appropriate scale to assess different kinds of PUI among Chinese adolescents and students. Psychometric assessment of the measure in other cultures and among clinical samples is recommended.
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Affiliation(s)
- Mohsen Saffari
- Health Research Center, Life Style institute, Baqiyatallah University of Medical Sciences, Tehran 14345916417, Iran; Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran 14345916417, Iran
| | - Chao-Ying Chen
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; New Taipei City Tucheng Hospital (Chang Gung Medical Foundation), Department of Pediatric Internal Medicine, New Taipei City, Taiwan
| | - I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, Qufu 273165, China
| | - Kamolthip Ruckwongpatr
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, 300 George St., Suite 901, New Haven, CT 06511, USA; Connecticut Mental Health Center, 34 Park St., New Haven, CT 06519, USA; Connecticut Council on Problem Gambling, 100 Great Meadow Rd., Suite 704, Wethersfield, CT 06109, USA; Child Study Center, Yale School of Medicine, 350 George St., New Haven, CT 06511, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, 200 South Frontage Rd., SHM C-303, New Haven, CT 06510, USA.
| | - Xue Lian Wang
- Yancheng College of Mechatronic Technology, Yancheng 224006, China; International College, Krirk University, Bangkok 10110, Thailand
| | - Yu-Ting Huang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung 824005, Taiwan.
| | - Ching-Chung Tsai
- Department of Pediatrics, E-Da Hospital, I-Shou University, No.1, Yi-Da Road, Yan-Chao District, Kaohsiung City 82445, Taiwan; School of Medicine for International Students, College of Medicine, I-Shou University, No. 8, Yi-Da Road, Yan-Chao District, Kaohsiung City 82445, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
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Lin YC, Chen JS, Bevan N, O'Brien KS, Strong C, Tsai MC, Fung XCC, Chen JK, Lin IC, Latner JD, Lin CY. Chinese version of the Tendency to Avoid Physical Activity and Sport (TAPAS) scale: testing unidimensionality, measurement invariance, concurrent validity, and known-group validity among Taiwanese youths. BMC Psychol 2024; 12:381. [PMID: 38978147 PMCID: PMC11232183 DOI: 10.1186/s40359-024-01870-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Psychosocial factors affect individuals' desire for physical activity. A newly developed instrument (Tendency to Avoid Physical Activity and Sport; TAPAS) has been designed to assess the avoidance of physical activity. Considering cultural differences could be decisive factors, the present study aimed to translate and validate the TAPAS into Chinese (Mandarin) for Taiwanese youths, and further cultural comparisons are expected. METHODS Standard translation procedure (i.e., forward translation, back translation, and reconciliation) was used to translate the English TAPAS into the Chinese TAPAS. Following translation, 608 youths (mean [SD] age 29.10 [6.36] years; 333 [54.8%] women) participated in the study via a snowballing sampling method with an online survey. All participants completed the Chinese TAPAS and additional instruments assessing weight stigma and psychological distress. Confirmatory factor analysis (CFA) was used to examine the factor structure of the Chinese TAPAS and multigroup CFA to examine measurement invariance across gender (men vs. women) and weight status (overweight vs. non-overweight). Pearson correlations were used to examine the concurrent validity; independent t-tests between gender groups and weight status groups were used to examine the known-group validity. RESULTS Consistent with the English version, the Chinese TAPAS was found to have a one-factor structure evidenced by CFA results. The structure was invariant across gender and weight status groups evidenced by multigroup CFA results. Concurrent validity was supported by significant associations with the related constructs assessed (r = 0.326 to 0.676; p < 0.001). Known-group validity was supported by the significant differences in TAPAS total scores between gender and weight status groups (p = 0.004 and < 0.001; Cohen's d = 0.24 and 0.48). CONCLUSION The Chinese version of the TAPAS is a valid and reliable instrument assessing individuals' avoidance of physical activity and sports due to underlying psychosocial issues among Taiwanese youths. It is anticipated to be applied within a large Asian population, as well as cross-cultural comparisons, for further explorations in health, behavioral and epidemiological research and practice.
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Affiliation(s)
- Yi-Ching Lin
- Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Nadia Bevan
- School of Social Sciences, Monash University, Melbourne, 3800, Australia
| | - Kerry S O'Brien
- School of Social Sciences, Monash University, Melbourne, 3800, Australia
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Xavier C C Fung
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - I-Ching Lin
- Department of Healthcare Administration, Department of Family Medicine, Asia University, Taichung, 41354, Taiwan.
- Department of Family Medicine, Asia University Hospital, Taichung, 41354, Taiwan.
- Department of Kinesiology, Health, and Leisure, Chienkuo Technology University, Changhua, 50094, Taiwan.
| | - Janet D Latner
- Department of Psychology, University of Hawaii, Honolulu, HI, 96822, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, Departments of Occupational Therapy and Public Health, and Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, 1 University Rd, Tainan, 701401, Taiwan.
- University of Religions and Denominations, Qom, Iran.
- Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
- Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia.
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Saffari M, Wu HC, Chen JK, Bevan N, Chen JS, Chen HP, Griffiths MD, Lin CY. Psychometric Properties of the Tendency to Avoid Physical Activity and Sport Scale Among Hong Kong University Students. MEASUREMENT IN PHYSICAL EDUCATION AND EXERCISE SCIENCE 2024; 28:225-235. [DOI: 10.1080/1091367x.2024.2302607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Affiliation(s)
- Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hung-Ching Wu
- Department of Social Worker, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Nadia Bevan
- School of Social Sciences, Monash University, Melbourne, Australia
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hsin-Pao Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Faculty of Health and Life Sciences, University of Religions and Denominations, Qom, Iran
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Yangyuen S, Keawmuang S, Chaichan A. The Relationship between Weight Bias Internalization and Quality of Life among Overweight and Obese Youths in Thailand. Ethiop J Health Sci 2024; 34:185-194. [PMID: 40438444 PMCID: PMC12110192 DOI: 10.4314/ejhs.v34i3.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/17/2024] [Indexed: 06/01/2025] Open
Abstract
Background Youth with overweight and obesity are susceptible to weight bias internalization (WBI) and tend to experience impaired quality of life (QOL). However, the evidence regarding the relationship between WBI and QOL remains scarce among Thai youth. Thus, this study aimed to assess the association between WBI and QOL among Thai youth with overweight and obesity. Methods A cross-sectional design was conducted with 667 university youths with overweight and obesity from northeastern Thailand selected by a multistage sampling method. A self-reported questionnaire was used for data collection. Multivariable logistic regression was applied to examine the association between WBI and QOL. Results More than half of the youths (51.4%) were females with a mean body mass index (BMI) of 26.5 kg/m2 (SD = 2.5). More than one third (37.8%) of the participants had a high level of WBI, and 48.9% reported being dissatisfied with their body image. Our results indicate higher BMI and greater WBI, and body image dissatisfactions were strongly associated with worse QOL overall and across all domains (physical health, psychological health, social relationships, and environment) after adjusting for all covariates. Conclusions WBI, BMI, and body dissatisfaction play an important role in impaired QOL. Thus, the development of intervention strategies or programs should consider the reduction of these factors as a key component of care or treatment for youth with overweight and obesity to improve QOL.
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Lin CY, Latner JD, Rozzell-Voss KN, Huang PC, Tsai YC, Pakpour AH, Weng HC. Association of quality of life with internet use and weight stigma across individuals with obesity and those without obesity: Role of self-perception. Acta Psychol (Amst) 2024; 244:104203. [PMID: 38442432 DOI: 10.1016/j.actpsy.2024.104203] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024] Open
Abstract
Weight status, weight stigma, and internet use are important factors impacting quality of life (QoL). However, little is known regarding how these factors interact in their association with QoL, and it is important to understand how self-perceived obesity and body mass index (BMI)-defined obesity may differentially impact QoL. We aimed to assess the associations between weight status (obesity vs. non-obesity, including both self-perceived and BMI-defined), weight stigma, internet use, and QoL. Cross-sectional data from the Taiwan Social Change Survey (N = 1604; mean age = 49.22; 52.93 % women) were used. All participants were classified as having obesity or not having obesity according to both self-perceived (self-perceived as 'too fat') and BMI-defined (≧27 kg/m2 as obesity) weight status. Results showed that the group with obesity (both BMI-defined and self-perceived) had significantly more internet time and lower physical QoL than the group without obesity. Those with self-perceived obesity, but not those with BMI-defined obesity, sought health information via the internet and used social media significantly more than the group without obesity. More internet time was associated with worse physical and mental QoL for the group with obesity regardless of BMI-defined or self-perceived status. Moreover, weight stigma was associated with worse mental QoL for the group with self-perceived obesity, but not for the group with BMI-defined obesity. Accordingly, being a person with obesity (self-defined, or based upon BMI) was associated with more internet time and poorer QoL. People with self-perceived obesity may have increased experience of weight stigma and greater internet use, factors that may contribute to their impaired QoL.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Faculty of Health and Life Sciences, INTI International University, Nilai, Malaysia.
| | - Janet D Latner
- Department of Psychology, University of Hawaii, Honolulu, HI, USA.
| | | | - Po-Ching Huang
- School of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd., Taoyuan 333323, Taiwan.
| | - Yu-Cheng Tsai
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Hui-Ching Weng
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Fan CW, Huang PC, Chen IH, Huang YT, Chen JS, Fung XC, Chen JK, Yang YN, O'Brien KS, Lin CY, Griffiths MD. Differential item functioning for the Tendency of Avoiding Physical Activity and Sport Scale across two subculture samples: Taiwanese and mainland Chinese university students. Heliyon 2023; 9:e22583. [PMID: 38090014 PMCID: PMC10711117 DOI: 10.1016/j.heliyon.2023.e22583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 10/16/2024] Open
Abstract
AIMS The aims of the study were to examine the differential item functioning (DIF) of the Tendency of Avoiding Physical Activity and Sport Scale (TAPAS) among three subgroups (gender, weight status, and region) and to test the construct and concurrent validities of the scale. METHODS Using an online survey, university students (608 Taiwanese and 2319 mainland Chinese) completed the TAPAS. Rasch analysis examined if all the 10 TAPAS items fitted the same construct and displayed no substantial DIF across three subgroups: gender (male vs. female), weight status (overweight vs. non-overweight), and region (Taiwan vs. China). Concurrent validity was examined using the scores on the Weight Self-Stigma Questionnaire (WSSQ) and Weight Bias Internalization Scale (WBIS). RESULTS All TAPAS items, except for Item 10 ("Prefer to participate in physical activity in a more private setting"), fitted the same construct. None of the TAPAS items displayed DIF in any of the subgroups except for Item 10 across participants from Taiwan and China (DIF contrast = -1.41). CONCLUSION The TAPAS can appropriately assess the tendency to avoid physical activity and sport among both Taiwanese and mainland Chinese university students. However, Item 10 may need to be further examined.
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Affiliation(s)
- Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL, USA
| | - Po-Ching Huang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, Shandong, China
| | - Yu-Ting Huang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan
| | - Xavier C.C. Fung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Yung-Ning Yang
- Department of Pediatrics, E-Da Hospital, School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | | | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
- University of Religions and Denominations, Qom, Iran
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
| | - Mark D. Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, NG1 4BU, UK
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Fan CW, Chang YL, Huang PC, Fung XCC, Chen JK, Bevan N, O'Brien KS, Yeh YC, Chen HP, Chen IH, Lin IC, Griffiths MD, Lin CY. The tendency to avoid physical activity and sport scale (TAPAS): Rasch analysis with differential item functioning testing among a Chinese sample. BMC Psychol 2023; 11:369. [PMID: 37925470 PMCID: PMC10625701 DOI: 10.1186/s40359-023-01377-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 10/05/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The benefits of physical activity are well-known to prevent multiple long-term health conditions. Physical appearance and weight-related stigma may influence individuals' decision to engage in physical activity and sport. Therefore, the present study examined the psychometric properties of a newly developed instrument, the Tendency to Avoid Physical Activity and Sport Scale (TAPAS), using modern test theory. METHODS A total of 2319 university students were recruited from mainland China and they completed the TAPAS. Rasch analysis was used to examine the TAPAS' rating scaling functioning, test unidimensionality, item hierarchy, ceiling and floor effects, and differential item functioning (DIF). Moreover, the concurrent validity of the TAPAS was examined using the Weight Self-Stigma Questionnaire (WSSQ), Weight Bias Internalization Scale (WBIS), and body mass index (BMI). RESULTS Unidimensionality was confirmed except for one item. Items corresponding to attitude toward physical activity were more easily adopted compared to items corresponding to actual behavioral aspects. No ceiling and floor effects were found. No DIF existed in the TAPAS items. The TAPAS was strongly correlated with both the WSSQ and WBIS, but not BMI. CONCLUSION The study showed that overall, the TAPAS has robust psychometric properties. However, future research needs to address the misfit item and explore the feasibility of applying the TAPAS to other populations including wider ethnic groups, age ranges, and life stages.
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Affiliation(s)
- Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, 671 Winyah Drive, Orlando, FL, 32803, USA
| | - Yen-Ling Chang
- Department of Family Medicine, Cardinal Tien Hospital, No. 362, Zhongzheng Rd., Xindian Dist, New Taipei, 231403, Taiwan
| | - Po-Ching Huang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist, Tainan, 701401, Taiwan
| | - Xavier C C Fung
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd., Hung Hom, Kowloon, Hong Kong, China
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Nadia Bevan
- School of Social Sciences, Monash University, 20 Chancellors Walk, Melbourne, 3800, Australia
| | - Kerry S O'Brien
- School of Social Sciences, Monash University, 20 Chancellors Walk, Melbourne, 3800, Australia
| | - Ya-Chin Yeh
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, 452, Huanqiu Rd., Luzhu Dist, Kaohsiung, 821004, Taiwan
| | - Hsin-Pao Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan.
| | - I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, 57 Jingxuan West Rd, Qufu, 273165, China
| | - I-Ching Lin
- Department of Healthcare Administration, Asia University, Taichung, 41354, Taiwan.
- Department of Family Medicine, Asia University Hospital, Taichung, 41354, Taiwan.
- Department of Kinesiology, Health, and Leisure, Chienkuo Technology University, Changhua, 50094, Taiwan.
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist, Tainan, 701401, Taiwan.
- University of Religions and Denominations, Qom, Iran.
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist, Tainan, 701401, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist, Tainan, 701401, Taiwan.
- INTI International University, Negeri Sembilan, Nilai, Malaysia.
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Lin YC, Lin CY, Saffari M, Tsai MC, Chang YH, Strong C, Chen JK, Hsieh YP, Yang YN, Latner JD. Weight stigma is associated with body mass index among college students in Taiwan: the mediated role of internalized weight stigma. BMC Psychol 2023; 11:365. [PMID: 37915074 PMCID: PMC10621093 DOI: 10.1186/s40359-023-01414-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Weight stigma is an issue often studied in Western countries; however, such information is scarce in Asian studies. METHODS This study aimed to examine the role of internalized weight stigma as a mediator in the relationship between perceived weight stigma and changes in body mass index (BMI). The data were collected through a longitudinal online survey with two phases (n = 974; Phase 1: August and September 2021; Phase 2: November and December 2021). The Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ), and Depression, Anxiety, Stress Scale - 21 (DASS-21) were administered to assess perceived weight stigma, internalized weight stigma, and psychological distress. Hierarchical regressions were used to examine the proposed model, and Hayes' Process Macro was used to test a mediation model. RESULTS The changes in perceived weight stigma and internalized weight stigma were significantly and positively associated with changes in BMI. There were significant and positive associations between perceived weight stigma, internalized weight stigma and psychological distress over time. Change in internalized weight stigma was found to be a significant mediator in the association of change in perceived weight stigma with change in BMI for the entire sample (unstandardized coefficient = 0.04; 95% CI = 0.02, 0.06), female subgroup (unstandardized coefficient = 0.05; 95% CI = 0.02, 0.08), and male subgroup (unstandardized coefficient = 0.03; 95% CI = 0.01, 0.06). Change in perceived weight stigma also had significant effects on change in BMI for the entire sample and the female subgroup, but not for the male subgroup. CONCLUSION Because perceived weight stigma may significantly impact changes in BMI through internalized weight stigma, treatment strategies to ameliorate self-stigma may enhance the results of weight-reduction programs. Such treatment strategies should be considered for inclusion in weight-loss interventions.
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Affiliation(s)
- Yi-Ching Lin
- Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, 106320, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701, Taiwan.
- University of Religions and Denominations, Qom, Iran.
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Meng-Che Tsai
- Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yun-Hsuan Chang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Yi-Ping Hsieh
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Yung-Ning Yang
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
- School of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
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10
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Wu TY, Huang SW, Chen JS, Kamolthip R, Kukreti S, Strong C, Pontes HM, Lin IC, Lin CY, Potenza MN, Pakpour AH. Translation and Validation of the Gaming Disorder Test and Gaming Disorder Scale for Adolescents into Chinese for Taiwanese Young Adults. Compr Psychiatry 2023; 124:152396. [PMID: 37295061 DOI: 10.1016/j.comppsych.2023.152396] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/02/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE To translate and cross-culturally adapt the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A) for use in Taiwan and to validate their internal consistency, construct validity, measurement invariance, and convergent validity in Taiwanese young adults. METHODS The GDT and GADIS-A were translated into traditional (unsimplified) Chinese characters and culturally adapted according to standard guidelines. A sample of 608 Taiwanese university students were recruited online. All participants completed the GDT, GADIS-A, Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and Depression Anxiety Stress Scale-21 (DASS-21). Internal consistency was assessed using Cronbach's α and McDonald's ω. Factor structure was examined using Confirmatory Factor Analysis (CFA). Measurement invariance in gender was assessed by three nested models in CFA. Convergent validity was determined by calculating Pearson's r among the GDT, GADIS-A, IGDS9-SF, and DASS-21. RESULTS The GDT and GADIS-A showed adequate internal consistency (both α and ω = 0.90). The CFA results supported a one-factor structure for the GDT and a two-factor structure for the GADIS-A. Measurement invariance across gender was supported for both the GDT and GADIS-A. The convergent validity of the GDT and GADIS-A were acceptable. CONCLUSIONS The Chinese versions of the GDT and GADIS-A are valid and reliable tools that can be used to assess gaming disorder in Taiwanese young adults. Measurement invariance across genders was supported for both tools. The convergent validity of the GDT and GADIS-A were also satisfactory.
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Affiliation(s)
- Tzu-Yi Wu
- Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Shih-Wei Huang
- Institute of Environmental Toxin and Emerging Contaminant, Cheng Shiu University, Kaohsiung, 83347, Taiwan; Center for Environmental Toxin and Emerging-contaminant Research, Cheng Shiu University, Kaohsiung 83347, Taiwan.
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Ruckwongpatr Kamolthip
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Shikha Kukreti
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Halley M Pontes
- Department of Organizational Psychology, Birkbeck, University of London, London, United Kingdom.
| | - I-Ching Lin
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan; Department of Family Medicine, Asia University Hospital, Taichung 41354, Taiwan; Department of Kinesiology, Health, and Leisure, Chienkuo Technology University, Changhua 50094, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA.
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Sweden.
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11
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Park S, Seo K. Validity and Reliability of the Korean Version of the Weight Self-Stigma Questionnaire (WSSQ-K). NURSING REPORTS 2023; 13:835-843. [PMID: 37368340 DOI: 10.3390/nursrep13020073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/19/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Weight self-stigma refers to negative self-prejudice due to the internalization of negative social messages about one's weight. People with high self-stigma may have low self-esteem and decreased social activity. Weight-related self-stigma can create diet-related disorders since it is highly related to the recognition of body types. However, there are no tools available to measure the weight-related stigma of the general public in Korea. This study evaluated the validity and reliability of the Korean version of the Weight Self-Stigma Questionnaire (WSSQ-K). A methodological study was conducted with 150 Korean university students. Construct validity was evaluated using exploratory factor analysis. The WSSQ-K was correlated with body mass index and measures of self-esteem and weight concern to evaluate concurrent validity. Internal consistency reliability was evaluated with Cronbach's alpha. In the exploratory factor analysis, two factors were proposed: "self-devaluation" (Cronbach's α = 79) and "fear of enacted stigma" (Cronbach's α = 82). Factor loadings for the 12 items on two factors ranged from 0.539 to 0.811, which explained 53.3% of the total variance. The WSSQ-K correlated with body mass index, self-esteem, and weight concern. The findings showed that the WSSQ-K was a reliable and valid measure that could be used for evaluating weight self-stigma in normal-weight adults in Korea.
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Affiliation(s)
- Seyoen Park
- College of Nursing, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Kawoun Seo
- Department of Nursing, Joongbu University, Chungnam 32713, Republic of Korea
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12
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Lucibello KM, Sabiston CM, Pila E, Arbour-Nicitopoulos K. An integrative model of weight stigma, body image, and physical activity in adolescents. Body Image 2023; 45:1-10. [PMID: 36731346 DOI: 10.1016/j.bodyim.2023.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 02/03/2023]
Abstract
Negative weight-related experiences and internalized weight stigma have been associated with poorer body image and reduced physical activity in adolescents. However, exploring body image and physical activity as discrete weight stigma outcomes fails to consider the theoretically- and empirically-supported covariation between the two. The present study tested a novel integrated model of the associations among negative weight-related experiences and internalized weight stigma (via weight-related distress), body image (shame, authentic pride, body appreciation), and physical activity. Canadian adolescents (N = 311, Mage ± SD = 16.00 ± 1.01, 75.5% girls) completed a cross-sectional self-report survey. A structural equation model with maximum likelihood robust estimation was tested. Higher negative weight-related experiences were indirectly associated with poorer body image (i.e., higher shame; lower authentic pride and appreciation) through higher weight-related distress. Authentic pride was associated with moderate-to-vigorous physical activity. Higher negative weight-related experiences were indirectly associated with lower physical activity through higher weight-related distress and lower body-related authentic pride. These findings elucidate targetable individual mechanisms and larger systems that could improve body image and foster physical activity among adolescents who encounter negative weight-related experiences and internalized weight stigma.
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Affiliation(s)
| | | | - Eva Pila
- School of Kinesiology, Western University, London, Ontario, Canada
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13
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Chirawat P, Kamolthip R, Rattaprach R, Nadhiroh SR, Tung SEH, Gan WY, Pinyo M, Nabpran T, Rozzell-Voss KN, Latner JD, Lin CY. Weight Stigma among Young Adults in Thailand: Reliability, Validation, and Measurement Invariance of the Thai-Translated Weight Self Stigma Questionnaire and Perceived Weight Stigma Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315868. [PMID: 36497942 PMCID: PMC9737449 DOI: 10.3390/ijerph192315868] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 05/29/2023]
Abstract
The previous studies found that the Weight Self Stigma Questionnaire (WSSQ) and Perceived Weight Stigma Scale (PWSS) have shown well-established psychometric properties for measuring weight stigma with strong reliability and validity from different languages. However, there is a lack of an appropriate instrument in assessing weight stigma in Thai samples. This study aimed to examine the Thai WSSQ and PWSS among Thai university students. Both instruments were also assessed for their measurement invariance across gender and weight status subgroups. A cross-sectional study was conducted on 801 university students in Thailand between January 2022 and July 2022. All participants completed a demographic questionnaire and a Thai version of the WSSQ, PWSS, and Depression Anxiety Stress Scale-21 (DASS-21) via an online survey. Reliability, validity, measurement invariance, and correlational analyses were performed to investigate whether the Thai versions of the WSSQ and PWSS psychometric properties were acceptable. Both translated questionnaires demonstrated overall acceptable psychometric properties and revealed a two-dimensional structure for the WSSQ, and unidimensional structure for the PWSS. Measurement invariance was obtained across gender and weight status subgroups. Additionally, both translated WSSQ and PWSS were significantly correlated with DASS-21. The Thai-translated WSSQ and PWSS showed strong validity, reliability, and factorial invariance across different subgroups for measuring weight stigma among Thai university students.
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Affiliation(s)
- Paratthakonkun Chirawat
- College of Sports Science and Technology, Mahidol University, Sala Ya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - Ruckwongpatr Kamolthip
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70142, Taiwan
| | - Rattana Rattaprach
- College of Sports Science and Technology, Mahidol University, Sala Ya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - Siti R. Nadhiroh
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Serene En Hui Tung
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Meephiam Pinyo
- Department of Forensic Science, Royal Police Cadet Academy, Nakhon Pathom 73110, Thailand
| | - Teosagul Nabpran
- Faculty of Humanities and Social Sciences, Songkhla Rajabhat University, Songkhla 90000, Thailand
| | | | - Janet D. Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70142, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70142, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70142, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70142, Taiwan
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14
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Chen IH, Huang PC, Lin YC, Gan WY, Fan CW, Yang WC, Tung SEH, Poon WC, Griffiths MD, Lin CY. The Yale Food Addiction Scale 2.0 and the modified Yale Food Addiction Scale 2.0 in Taiwan: Factor structure and concurrent validity. Front Psychiatry 2022; 13:1014447. [PMID: 36506452 PMCID: PMC9732099 DOI: 10.3389/fpsyt.2022.1014447] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The most widely used instruments to assess food addiction - the Yale Food Addiction Scale 2.0 (YFAS 2.0) and its modified version (mYFAS 2.0) - have not been validated in a Taiwanese population. The present study compared the psychometric properties between the Taiwan versions of YFAS 2.0 and mYFAS 2.0 among university students. METHODS An online survey comprising the YFAS 2.0, mYFAS 2.0, Weight Self-Stigma Questionnaire (WSSQ) and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were used to assess food addiction, self-stigma, and physical activity. RESULTS All participants (n = 687; mean age = 24.00 years [SD ± 4.48 years]; 407 females [59.2%]) completed the entire survey at baseline and then completed the YFAS 2.0 and mYFAS 2.0 again three months later. The results of confirmatory factor analysis (CFA) indicated that the YFAS 2.0 and mYFAS 2.0 both shared a similar single-factor solution. In addition, both the YFAS 2.0 and mYFAS 2.0 reported good internal consistency (Cronbach's α = 0.90 and 0.89), good test-retest reliability (ICC = 0.71 and 0.69), and good concurrent validity with the total scores being strongly associated with the WSSQ (r = 0.54 and 0.57; p < 0.01), and less strongly associated with BMI (r = 0.17 and 0.13; p < 0.01) and IPAQ-SF (r = 0.23 and 0.25; p < 0.01). DISCUSSION Based on the findings, the Taiwan versions of the YFAS 2.0 and mYFAS 2.0 appear to be valid and reliable instruments assessing food addiction.
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Affiliation(s)
- I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, Qufu, China
| | - Po-Ching Huang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Lin
- Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan
| | - Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL, United States
| | - Wen-Chi Yang
- Division of Hematology and Medical Oncology, Department of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan
- Faculty of School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Infinite Power Ltd., Co., Kaohsiung, Taiwan
| | - Serene En Hui Tung
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Wai Chuen Poon
- Sunway University Business School, Sunway University, Selangor, Malaysia
| | - Mark D. Griffiths
- International Gaming Research Unit, Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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15
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Gan WY, Tung SEH, Ruckwongpatr K, Ghavifekr S, Paratthakonkun C, Nurmala I, Chang YL, Latner JD, Huang RY, Lin CY. Evaluation of two weight stigma scales in Malaysian university students: weight self-stigma questionnaire and perceived weight stigma scale. Eat Weight Disord 2022; 27:2595-2604. [PMID: 35474190 DOI: 10.1007/s40519-022-01398-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/01/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND This study aimed to examine the psychometric properties of the Weight Self-Stigma Questionnaire (WSSQ) and Perceived Weight Stigma Scale (PWS) among Malaysian university students. METHODS University students who were studying in a Malaysia university with a mean age of 24.0 years (n = 380; females 71.6%) were recruited through convenience sampling between 19 August and 30 September 2021. They completed a Google Form consisting of information on sociodemographic background, weight stigma, psychological distress and self-reported body weight and height. Psychometric testing was conducted using the classical test theory (including confirmatory factor analysis) and Rasch models to confirm the two-factor structure of WSSQ and the unidimensional structure of the PWS using the various fit indices. Concurrent validity of the total scores of WSSQ and PWS with psychological distress and body mass index (BMI) was also investigated. Internal consistency using Cronbach's alpha was conducted. RESULTS The confirmatory factor analyses and Rasch analyses verified the two-factor structure for the WSSQ and the single-factor structure for the PWS. Both the WSSQ and PWS showed good internal consistency and good concurrent validity as demonstrated by their significant correlations with psychological distress and BMI. CONCLUSION The WSSQ and PWS have strong validity and reliability, and they can both be used to assess weight stigma among Malaysian university students. LEVEL OF EVIDENCE V: Descriptive study.
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Affiliation(s)
- Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Serene En Hui Tung
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Kamolthip Ruckwongpatr
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701401, Taiwan
| | - Simin Ghavifekr
- Faculty of Education, University of Malaya (UM), 50603, Kuala Lumpur, Malaysia
| | - Chirawat Paratthakonkun
- College of Sports Science and Technology, Mahidol University, Sala Ya, Phutthamonthon, Nakhon Pathom, 73170, Thailand
| | - Ira Nurmala
- Department of Health Promotion and Behavioral Sciences, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Yen-Ling Chang
- Department of Family Medicine, Cardinal Tien Hospital, New Taipei, Taiwan
| | - Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Ru-Yi Huang
- Department of Family and Community Medicine, E-DA Hospital, No. 1, Yida Rd., Yanchao Dist., Kaohsiung, 82445, Taiwan.
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701401, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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16
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Gavan L, Hartog K, Holland WC, Koppenol-Gonzalez G, Gronholm PC, Feddes AR, Kohrt BA, Jordans MJ, Peters RH. Assessing stigma in low- and middle-income countries: A systematic review of scales used with children and adolescents. Soc Sci Med 2022; 307:115121. [DOI: 10.1016/j.socscimed.2022.115121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022]
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17
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Xu P, Chen JS, Chang YL, Wang X, Jiang X, Griffiths MD, Pakpour AH, Lin CY. Gender Differences in the Associations Between Physical Activity, Smartphone Use, and Weight Stigma. Front Public Health 2022; 10:862829. [PMID: 35425758 PMCID: PMC9001944 DOI: 10.3389/fpubh.2022.862829] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Physical activity (PA) is important for health. However, there is little evidence on how weight stigma, time spent on sedentary activities (including smartphone, social media, online learning), time spent on outdoor activity, and nomophobia associate with PA among Chinese individuals with consideration of gender. The present study examined the aforementioned associations in the COVID-19 pandemic era. Methods University students (N = 3,135; 1,798 females, 1,337 males) with a mean age of 19.65 years (SD = 2.38) years completed an online survey from November to December, 2021. The online survey assessed weight stigma (using the Perceived Weight Stigma Scale and Weight Bias Internalization Scale), PA (using the International Physical Activity Questionnaire Short Form), time spent on different activities (using self-designed items for time on smartphone, outdoor activity, social media, and online learning), and nomophobia (using the Nomophobia Questionnaire). Parallel mediation models were constructed (dependent variable: PA; mediators: perceived weight stigma, weight-related self-stigma, time spent on smartphone, time spent on outdoor activity, time spent on social media, and time spent online learning; independent variable: nomophobia) and evaluated using Hayes' Process Macro Model 4 (IBM SPSS 20.0). Results Weight-related self-stigma (β = −0.06; p = 0.03), time spent on outdoor activity (β = 0.21; p < 0.001), time spent on social media (β = 0.07; p = 0.02), time spent on online learning (β = 0.06; p = 0.03), and nomophobia (β = −0.07; p = 0.01) were all significant factors explaining the PA among female participants. Perceived weight stigma (β = −0.07; p = 0.01), time spent on outdoor activity (β = 0.27; p < 0.001), and time spent on online learning (β = 0.10; p = 0.002) were all significant factors explaining PA among male participants. Conclusion Chinese healthcare providers should design programs on weight stigma reduction and outdoor activity improvement to enhance PA among university students.
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Affiliation(s)
- Ping Xu
- Department of Educational Psychology, School of Leisure Sports and Management, Guangzhou Sport University, Guangzhou, China
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan
| | - Yen-Ling Chang
- Department of Family Medicine, Cardinal Tien Hospital, New Taipei, Taiwan
| | - Xiaodong Wang
- School of Leisure Sports and Management, Guangzhou Sport University, Guangzhou, China
| | | | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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18
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Lin C, Hou W, Mamun MA, Aparecido da Silva J, Broche‐Pérez Y, Ullah I, Masuyama A, Wakashima K, Mailliez M, Carre A, Chen Y, Chang K, Kuo Y, Soraci P, Scarf D, Broström A, Griffiths MD, Pakpour AH. Fear of COVID-19 Scale (FCV-19S) across countries: Measurement invariance issues. Nurs Open 2021; 8:1892-1908. [PMID: 33745219 PMCID: PMC8186712 DOI: 10.1002/nop2.855] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/11/2021] [Accepted: 02/17/2021] [Indexed: 01/18/2023] Open
Abstract
AIM The threats of novel coronavirus disease 2019 (COVID-19) have caused fears worldwide. The Fear of COVID-19 Scale (FCV-19S) was recently developed to assess the fear of COVID-19. Although many studies found that the FCV-19S is psychometrically sound, it is unclear whether the FCV-19S is invariant across countries. The present study aimed to examine the measurement invariance of the FCV-19S across eleven countries. DESIGN Cross-sectional study. METHODS Using data collected from prior research on Bangladesh (N = 8,550), United Kingdom (N = 344), Brazil (N = 1,843), Taiwan (N = 539), Italy (N = 249), New Zealand (N = 317), Iran (N = 717), Cuba (N = 772), Pakistan (N = 937), Japan (N = 1,079) and France (N = 316), comprising a total 15,663 participants, the present study used the multigroup confirmatory factor analysis (CFA) and Rasch differential item functioning (DIF) to examine the measurement invariance of the FCV-19S across country, gender and age (children aged below 18 years, young to middle-aged adults aged between 18 and 60 years, and older people aged above 60 years). RESULTS The unidimensional structure of the FCV-19S was confirmed. Multigroup CFA showed that FCV-19S was partially invariant across country and fully invariant across gender and age. DIF findings were consistent with the findings from multigroup CFA. Many DIF items were displayed for country, few DIF items were displayed for age, and no DIF items were displayed for gender. CONCLUSION Based on the results of the present study, the FCV-19S is a good psychometric instrument to assess fear of COVID-19 during the pandemic period. Moreover, the use of FCV-19S is supported in at least ten countries with satisfactory psychometric properties.
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Affiliation(s)
- Chung‐Ying Lin
- Institute of Allied Health SciencesCollege of MedicineNational Cheng Kung University HospitalNational Cheng Kung UniversityTainanTaiwan
| | - Wen‐Li Hou
- College of NursingKaohsiung Medical UniversityKaohsiungTaiwan
- Department of Medical ResearchKaohsiung Medical University HospitalKaohsiungTaiwan
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh (Centre for Health Innovation, Networking, Training, Action and Research ‐ Bangladesh)Savar, DhakaBangladesh
| | | | - Yunier Broche‐Pérez
- Psychology DepartmentUniversidad Central “Marta Abreu” de Las Villas Km 5 ½Santa ClaraCuba
| | - Irfan Ullah
- Kabir Medical CollegeGandhara UniversityPeshawarPakistan
| | | | | | - Mélody Mailliez
- ISAE‐SUPAERO (Institut Supérieur de l'aéronautique et de l'espace)University of ToulouseUniversité Fédérale de Toulouse Midi‐Pyrénées)ToulouseFrance
| | - Arnaud Carre
- LIP/PC2SUniversity of Savoie Mont BlancUniversity of Grenoble AlpesChambéryFrance
| | - Yu‐Pin Chen
- Department of Orthopedic SurgeryWan Fang HospitalTaipei Medical UniversityTaipeiTaiwan
- Department of Orthopedic SurgerySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Kun‐Chia Chang
- Jianan Psychiatric CenterMinistry of Health and WelfareTainanTaiwan
- Department of Natural BiotechnologyNanHua UniversityChiayiTaiwan
| | - Yi‐Jie Kuo
- Department of Orthopedic SurgeryWan Fang HospitalTaipei Medical UniversityTaipeiTaiwan
- Department of Orthopedic SurgerySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Paolo Soraci
- Group Cognitive Behavioral Psychology AssociationRomeItaly
| | - Damian Scarf
- Department of PsychologyUniversity of OtagoDunedinNew Zealand
| | - Anders Broström
- Department of NursingSchool of Health and WelfareJönköping UniversityJönköpingSweden
- Department of Clinical NeurophysiologyUniversity Hospital LinköpingLinköpingSweden
| | - Mark D. Griffiths
- International Gaming Research UnitPsychology DepartmentNottingham Trent UniversityNottinghamUK
| | - Amir H. Pakpour
- Department of NursingSchool of Health and WelfareJönköping UniversityJönköpingSweden
- Social Determinants of Health Research CenterResearch Institute for Prevention of Non‐Communicable DiseasesQazvin University of Medical SciencesQazvinIran
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Lin CY, Imani V, Griffiths MD, Pakpour AH. Validity of the Yale Food Addiction Scale for Children (YFAS-C): Classical test theory and item response theory of the Persian YFAS-C. Eat Weight Disord 2021; 26:1457-1466. [PMID: 32676845 PMCID: PMC8128825 DOI: 10.1007/s40519-020-00956-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 07/06/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To examine whether the child/adolescent version of the Yale Food Addiction Scale (YFAS-C) is valid to assess the Iranian adolescents who are overweight. METHODS After using an internationally standardized method to translate the YFAS-C into Persian, 1186 overweight/obese adolescents aged between 13 and 18 years participated in the present study [666 males; mean age = 15.5 (SD = 1.9) years; zBMI = 2.5 (1.0) kg/m2]. All the participants completed the Persian YFAS-C alongside Persian versions of the following scales: Eating Disorder Examination Questionnaire (EDEQ), Clinical Impairment Assessment (CIA), Binge Eating Scale (BES), Eating Attitudes Test (EAT-26), and Depression, Anxiety, Stress Scale (DASS-21). RESULTS At the scale level, confirmatory factor analysis verified the single-factor structure of the Persian YFAS-C. Additionally, the Persian YFAS-C had promising properties regarding internal consistency (KR20 = 0.81), test-retest reliability (intraclass correlation coefficient = 0.83), separation reliability (person separation reliability = 0.77; item separation reliability = 0.98), and separation index (person separation index = 2.04; item separation index = 8.01). At the item level, all items had satisfactory properties in factor loadings, corrected item-total correlation, test-retest reliability, and infit and outfit mean square. Moreover, no substantial differential item functioning (DIF) was found concerning gender (male vs. female) or weight status (overweight vs. obesity). Significant and moderate correlations were found between the Persian YFAS-C and other psychometric scales assessing eating symptomatology and general psychopathology (r = 0.352 to 0.484). CONCLUSION The Persian YFAS-C is a valid instrument that assists healthcare providers in assessing food addiction among Iranian adolescents. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Vida Imani
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Shahid Bahounar BLV, 3419759811, Qazvin, Iran.
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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20
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Abstract
Objective To develop a psychometrically reliable instrument to assess psychological distress during the COVID-19 pandemic across Arab countries. Design The new instrument was developed through the review of relevant literature. We adapted multiple items from the following tools: The Fear of COVID-19 Scale, Social Phobia Inventory, Health Anxiety Inventory, Swine Influenza Anxiety Scale and the Arabic Scale of Death Anxiety to design our new assessment tool which is called COVID-19 Psychological Distress Scale (CPDS). For psychometric analyses and validation, we conducted a cross-sectional study that solicited data through a web-based survey using the newly developed CPDS. Setting and participants This validation study was conducted in four Arab countries, including Algeria, Kuwait, Saudi Arabia and Yemen. A total of 1337 participants from these countries have voluntarily responded to our survey questionnaire that included the newly developed scale. Results The final version of the CPDS comprised 12 items. Participants from Algeria (n=447), Kuwait (n=437), Saudi Arabia (n=160) and Yemen (n=293) have completed the 12-item CPDS. Exploratory factor analysis (used on the Algerian sample) suggested a two-factor structure of the CPDS. The two-factor structure was then supported by the confirmatory factor analysis with an independent sample. Additionally, Rasch analyses showed that all the items fit well in their embedded construct; only one item showed somewhat substantial differential item functioning across gender and country. Conclusion The 12-item CPDS was found to be measurement invariant across country and gender. The CPDS, with its promising psychometric properties, might help healthcare professionals to identify people with COVID-19-induced psychological distress.
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Fan CW, Liu CH, Huang HH, Lin CY, Pakpour AH. Weight Stigma Model on Quality of Life Among Children in Hong Kong: A Cross-Sectional Modeling Study. Front Psychol 2021; 12:629786. [PMID: 33967895 PMCID: PMC8100454 DOI: 10.3389/fpsyg.2021.629786] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/12/2021] [Indexed: 11/14/2022] Open
Abstract
We proposed a model to examine the relationship among different types of weight-related stigmas and their relationship to quality of life (QoL). We recruited 430 dyads of elementary school children [mean age = 10.07 years; nboy = 241 (56.0%); noverweight = 138 (32.1%)] and their parents. Parents completed QoL instruments about their children assessing generic QoL and weight-related QoL. Children completed QoL instruments assessing generic QoL and weight-related QoL and stigma scales assessing experienced weight stigma, weight-related self-stigma, and perceived weight stigma. Experienced weight stigma was significantly associated with perceived weight stigma, and in turn, perceived weight stigma was significantly associated with weight-related self-stigma. However, experienced weight stigma was not directly associated with weight-related self-stigma. In addition, experienced stigma was negatively associated with both child-rated and parent-rated QoL. Perceived weight stigma was associated only with parent-rated weight-related QoL but not child-rated QoL. Self-stigma was associated with child-rated QoL but not parent-rated QoL. Moreover, perceived weight stigma and weight-related self-stigma were significant mediators in the association between body weight and children's QoL; experienced weight stigma was not a significant mediator. The study findings can be used to inform healthcare providers about the relationship among different types of stigmas and their influence on child-rated and parent-rated QoL and help them develop interventions to address the global trend of overweight/obesity in youth and pediatric populations.
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Affiliation(s)
- Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL, United States
| | - Chieh-Hsiu Liu
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsin-Hsiung Huang
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, National Cheng Kung University Hospital, College of Medicien, National Cheng Kung University, Tainan, Taiwan.,Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Stress System Activation Analysis in Greek Female Adolescents: A Bioimpedance Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1339:105-110. [DOI: 10.1007/978-3-030-78787-5_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lin CY, Wang JD, Liu LF. Can We Apply WHOQOL-AGE to Asian Population? Verifying Its Factor Structure and Psychometric Properties in a Convenience Sample From Taiwan. Front Public Health 2020; 8:575374. [PMID: 33330319 PMCID: PMC7732621 DOI: 10.3389/fpubh.2020.575374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022] Open
Abstract
Objectives: To translate and validate a recently developed quality of life instrument (WHOQOL-AGE) on geriatric population into Chinese. Method: Using cross-sectional observational design, the WHOQOL-AGE was conducted among older people through interview. Confirmatory factor analysis (CFA) was used to examine the factor structure and multigroup CFA used to examine the measurement invariance. Results: Through convenience sampling, 522 older adults (mean age = 73.42) participated in the study. Among them, 194 were males, 213 had an educational level at primary school or below, 398 were residing in the community, and 307 were aged 70 years or above. A bifactor structure (items Q1–Q8 are embedded in the factor 1; items Q9–Q13 embedded in the factor 2; and all the items embedded in an additional construct of QoL) was confirmed by the CFA in both the entire sample (χ2 = 25.4; df = 51; p = 0.999) and the subgroup sample with age 70 years or above (χ2 = 25.28; df = 51; p = 1.000). Multigroup CFAs results supported the measurement invariance for the WHOQOL-AGE across genders, having different educational levels, living in different settings and age groups. It also shows good known-groups validity. Conclusions: The promising psychometric properties of the WHOQOL-AGE were found in our convenience sample of older Taiwanese. The supported measurement invariance indicates that the older people in different conditions of gender, educational level, and living setting interpret the WHOQOL-AGE similarly. However, our results should be interpreted with cautious because of the sample representativeness.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Fan Liu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bias internalization and insomnia. Eat Weight Disord 2020; 25:1583-1592. [PMID: 31673986 DOI: 10.1007/s40519-019-00795-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/20/2019] [Accepted: 10/05/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To examine whether weight-related self-stigma (aka weight bias internalization) and insomnia are potential predictors of psychological distress and quality of life (QoL) among Iranian adolescents with overweight (OW)/obesity (OB). To examine whether weight-related self-stigma and insomnia are potential mediators in the relationship between excess weight and health outcomes of distress and QoL. METHODS All participants (n = 934; 444 males; mean age = 15.7 ± 1.2 years; zBMI = 2.8 ± 1.0) completed questionnaires on weight-related self-stigma and insomnia at baseline. Six months later, they completed questionnaires on psychological distress and QoL to assess health outcomes. Relationships among variables were tested using mediation analyses with bootstrapping method. RESULTS Weight-related self-stigma significantly mediated the effects of zBMI on psychological distress (effect = 0.22; bootstrapping SE = 0.09; 95% CI = 0.08, 0.45), psychosocial QoL (effect = - 0.64; bootstrapping SE = 0.19; 95% CI = - 1.10, - 0.32), and physical QoL (effect = - 1.35; bootstrapping SE = 0.54; 95% CI = - 2.43, - 0.26). Insomnia also significantly mediated the effects of zBMI on psychological distress (effect = 2.18; bootstrapping SE = 0.31; 95% CI = 1.61, 2.81), psychosocial QoL (effect = - 0.89; bootstrapping SE = 0.33; 95% CI = - 1.60, - 0.28), and physical QoL (effect = - 0.83; bootstrapping SE = 0.42; 95% CI = - 1.69, - 0.02). Full mediations were found in psychosocial QoL; partial mediations were found in psychological distress and physical QoL. CONCLUSIONS Weight-related self-stigma and insomnia were significant mediators in the effects of excess weight on health outcomes. Therefore, it is important to identify and treat weight-related self-stigma and insomnia for adolescents with OW/OB. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Psychological Quality of Life in People with Physical Disability: The Effect of Internalized Stigma, Collective Action and Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051802. [PMID: 32164278 PMCID: PMC7084512 DOI: 10.3390/ijerph17051802] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The main objective of this study was to examine the role of social identification, collective action and resilience in reducing the negative consequences of internalized stigma on the psychological quality of life of people with physical disability using path analysis. We propose a model with two paths: the first through social identification and collective action and the second via resilience. METHOD A total of 288 Spanish people with physical disability aged between 18 and 82 years (46.4% males; mean [SD] of age = 45.1 [12.3] responded to the questionnaire. Data were collected for three months through an online survey. RESULTS The tested model adequately fit the data. We found that the relationship between internalized stigma and the psychological quality of life of people with physical disability was mediated by resilience. However, neither social identification nor collective action mediated the association between internalized stigma and quality of life among our participants. CONCLUSIONS The results confirmed the negative association between internalized stigma and quality of life in the population with physical disability. The results show that some interactive processes, such as resilience, may contribute to decreasing the negative effects of internalized stigma. In contrast, no effects of identification with the group or collective action intention were found.
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Lin CY, Lin CK, Imani V, Griffiths MD, Pakpour AH. Evaluation of the Selfitis Behavior Scale Across Two Persian-Speaking Countries, Iran and Afghanistan: Advanced Psychometric Testing in a Large-Scale Sample. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00124-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Nejati B, Lin CY, Griffiths MD, Pakpour AH. Psychometric Properties of the Persian Food-Life Questionnaire Short Form among Obese Breast Cancer Survivors. Asia Pac J Oncol Nurs 2020; 7:64-71. [PMID: 31879686 PMCID: PMC6927153 DOI: 10.4103/apjon.apjon_43_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/06/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To assist weight control among women with breast cancer, improving their food attitudes may be an effective method. Therefore, the present study validated a short instrument assessing food attitudes (i.e., the Short Form of the Food-Life Questionnaire [FLQ-SF]) among Iranian women with breast cancer who are overweight. METHODS Women with breast cancer who were overweight (n = 493; mean ± standard deviation age = 52.3 ± 10.7 years) participated in the study. All of them completed the FLQ-SF, questions designed using the theory of planned behavior (TPB; including subjective norm, perceived behavioral control, and behavioral intention), and food frequency questionnaire (FFQ). Both classical test theory and Rasch models were used to examine the psychometric properties of the FLQ-SF. More specifically, the factorial structure of the FLQ-SF was assessed using confirmatory factor analysis (CFA), the item fit was examined using the Rasch model, and the concurrent validity was evaluated using the correlation between the FLQ-SF, TPB elements, and FFQ. RESULTS CFA results confirmed the Persian FLQ-SF has a five-factor structure. Rasch models indicated that all the FLQ-SF items fit in the construct of food attitudes. Significant correlations between FLQ-SF and other instruments (TPB elements and FFQ) supported the concurrent validity of the FLQ-SF. CONCLUSIONS The psychometric findings of the present study demonstrated that Persian FLQ-SF is a reliable and valid instrument. Therefore, the Persian FLQ-SF can be applied to assess food attitudes among Iranian women with breast cancer who are overweight.
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Affiliation(s)
- Babak Nejati
- Hematology and Medical Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Lin CY. Weight stigma, coping strategies, and mental health among children with overweight. SOCIAL HEALTH AND BEHAVIOR 2019. [DOI: 10.4103/shb.shb_26_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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