Validation of the FCV-19 Scale and Assessment of Fear of COVID-19 in the Population of Mozambique, East Africa

Longitudinal validation of the Fear of COVID-19 Scale in a nationwide United States sample: An item response theory model across three inflection points of the pandemic

The COVID-19 pandemic's global emergence/spread caused widespread fear. Measurement/tracking of COVID-19 fear could facilitate remediation. Despite the Fear of COVID-19 Scale (FCV-19S)'s validation in multiple languages/countries, nationwide United States (U.S.) studies are scarce. Cross-sectional classical test theory-based validation studies predominate. Our longitudinal study sampled respondents to a 3-wave, nationwide, online survey. We calibrated the FCV-19S using a unidimensional graded response model. Item/scale monotonicity, discrimination, informativeness, goodness-of-fit, criterion validity, internal consistency, and test-retest reliability were assessed. Items 7, 6, and 3 consistently displayed very high discrimination. Other items had moderate-to-high discrimination. Items 3, 6, and 7 were most (items 1 and 5 the least) informative. [Correction added on 18 May 2023, after first online publication: In the preceding sentence, the term 'items one-fifth least' has been changed to 'items 1 and 5 the least'.] Item scalability was 0.62-0.69; full-scale scalability 0.65-0.67. Ordinal reliability coefficient was 0.94; test-retest intraclass correlation coefficient 0.84. Positive correlations with posttraumatic stress/anxiety/depression, and negative correlations with emotional stability/resilience supported convergent/divergent validity. The FCV-19S validly/reliably captures temporal variation in COVID-19 fear across the U.S.

Validation of the Spanish Version of the Fear of COVID-19 Scale (FCV-19S) in Long-Term Care Settings

Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with COVID-19, but this has not been done frequently in people living in long-term care (LTC) settings. The present study is aimed at measuring the psychometric properties of the Spanish version of the FCV-19S in residents in LTC settings, following both the classical test theory (CTT) and Rasch model frameworks. The participants (n = 447), aged 60 years or older, were asked to complete the FCV-19S and to report, among other issues, their levels of depression, resilience, emotional wellbeing and health-related quality of life with validated scales. The mean FCV-19S score was 18.36 (SD 8.28, range 7−35), with higher scores for women, participants with lower education (primary or less) and higher adherence to preventive measures (all, p < 0.05). The Cronbach’s alpha for the FCV-19S was 0.94. After eliminating two items due to a lack of fit, the FCV-19S showed a good fit to the Rasch model (χ2 (20) = 30.24, p = 0.019, PSI = 0.87), with unidimensionality (binomial 95% CI 0.001 to 0.045) and item local independency. Question 5 showed differential item functioning by sex. The present study shows that the FCV-19S has satisfactory reliability and validity, which supports its use to effectively measure fear in older people living in LTC settings. This tool could help identify risk groups that may need specific health education and effective communication strategies to lower fear levels. This might have a beneficial impact on adherence to preventive measures.

Measuring anxiety and fear of Covid-19 among older people: psychometric properties of anxiety and fear of Covid-19 scale (AMICO) in Spain

BACKGROUND

The elderly population has proven to be a particularly vulnerable group with regard to the effects of the COVID-19 pandemic. The aim of this study was to study the psychometric properties of the Ansiedad y MIedo a Covid-19 scale (AMICO) on a population-based sample of elderly people.

METHODS

A descriptive and psychometric cross-sectional study, based on questionnaires, was carried out. An exploratory and confirmatory factor analysis was performed, as well as a bivariate analysis between the different sociodemographic variables with respect to the total scale score.

RESULTS

A sample of 720 adults over 65 years of age was obtained, 52.2% of whom were women. The structure of the factor of the scale showed two factors (fear and anxiety) and was confirmed with good fit parameters. The overall reliability of the scale in terms of internal consistency was α = 0.94.

CONCLUSIONS

The AMICO scale is a valid and reliable instrument to measure anxiety and fear of COVID-19 in the Spanish population over 65 years of age. Women and subjects with a partner showed the highest values of fear and anxiety.

Gender and COVID-19 related fear and anxiety: A meta-analysis

Studies conducted during the pandemic revealed strong associations between gender and COVID-19 related fear and anxiety. Females perceive coronavirus as a greater threat to personal health and population than males. The aim of the current meta-analysis is to estimate gender difference in COVID-19 related fear and anxiety. The second purpose of this study is to clarify the role of potential moderators in COVID-19 fear and anxiety. For these reasons, studies published between March 2020 and October 2021 were searched in various databases (Web of Science, SCOPUS, PubMed, and Google Scholar). In total, 315 studies met the inclusion criteria, and 60 studies for COVID-19 related fear and 23 studies for COVID-19 related anxiety were included in the current study. Cohen's d effect size values were calculated based on these individual studies showing the difference between males and females in terms of COVID-19 related fear and anxiety. Results revealed that gender has a moderate and statistically significant effect on COVID-19 related fear (ES = 0.307) and anxiety (ES = 0.316) in favor of females. Moderator analyses showed that continent variable was a statistically significant moderator of gender difference in COVID-19 related fear and anxiety. The highest effect size of gender differences in COVID-related fear and anxiety were obtained from the studies conducted in Europe. However, other moderators (the average age of sample, culture, timing, and population) were not statistically significant. Although this meta-analysis has a few limitations, the findings showed that COVID-19 outbreak negatively affected females more.

Item Response Theory Analysis of the Fear of COVID-19 Scale (FCV-19S): A Systematic Review

BACKGROUND

The COVID-19 pandemic is still ongoing and is not yet under control. Evidence regarding the impacts of COVID-19 on psychological distress has been widely reported worldwide, and one of the primary concerns regarding psychological distress is fear (ie, fear of COVID-19). Therefore, having a robust instrument for assessing fear of COVID-19 is important. The present systematic review aimed to synthesize the psychometric evidence evaluated using item response theory (IRT) on the Fear of COVID-19 Scale (FCV-19S).

METHODS

Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four academic databases (Scopus, PubMed Central, ProQuest, and ISI Web of Knowledge) were used to search target papers. Keywords used for search were "Fear of COVID-19 Scale" and its abbreviation (ie, "FCV-19S") and IRT-related terms. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist was then applied to evaluate the methodological quality of the reviewed papers. Moreover, psychometric properties using IRT methods were synthesized using a qualitative method.

RESULTS

The initial search resulted in 552 papers (73 duplicates) and 479 were screened based on their titles and abstracts. Finally, 16 papers were included for review regarding their methodological quality (via COSMIN) to synthesize the psychometric evidence for FCV-19S. The 16 papers included 21 countries with 16 language versions of FCV-19S.

CONCLUSION

All the psychometric evidence indicated that the seven items in the FCV-19S fit with the concept of fear. The FCV-19S is a strong and valid instrument for assessing fear across different languages. The seven items in the FCV-19S appear to be unidimensional in assessing fear, which indicates that all items are necessary in the FCV-19S.

Cross-cultural measurement invariance of the fear of COVID-19 scale in three Portuguese-speaking countries

This study evaluated the measurement invariance of the Portuguese version of the Fear of COVID-19 Scale (FCV-19S) across three countries: Brazil (South America), Mozambique (East Africa), and Portugal (Southwest Europe). A total of 8694 participants were recruited through convenience sampling (7430 Brazilians, 387 Mozambicans, and 877 Portuguese adults). The unidimensional structure of the FCV-19S fitted well with each country’s data. Multigroup confirmatory factor analysis showed that the FCV-19S was partially invariant across countries and fully invariant across gender and age groups, thus providing a solid basis for cross-group comparisons. Structural invariance tests revealed different levels of fear across countries and genders but not across age groups.

Psychometric properties of the Fear of COVID-19 Scale amongst black South African university students

Coronavirus disease 2019 (COVID-19) has spread widely leading to a global public health crisis of a pandemic proportion. Whilst infection rates tend to fluctuate in South Africa, COVID-19 remains a life-threatening disease with the capacity to wreak fear and concern. The present study evaluated the psychometric qualities of the Fear of COVID-19 Scale (FCV-19S) amongst black South African university students (N = 433; Female: 58%; Mage = 23.51 [SD = 4.18]). The FCV-19S demonstrated a unidimensional factor structure and acceptable internal consistency (α = 0.87), Omega (ω = 0.88) and the greatest lower bound (GLB = 0.90) reliabilities. In addition, discriminant validity was demonstrated when FCV-19S items loaded separately from ordinary fear. The FCV-19S can be used as a measure of COVID-19-related fear amongst black South African university students.