Attitudes toward and beliefs about obese persons across Hong Kong and Taiwan: wording effects and measurement invariance

Abstract

Background The psychosocial consequences of obesity are important but often underrated. The Attitudes Toward Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP) scales used to measure weight-related bias have little psychometric information, especially in East Asian contexts. The objective of this study was to use rigorous statistical methods to demonstrate the psychometric properties of these two instruments in Hong Kong and Taiwanese college students. Methods A convenience sample of 707 students was recruited from the universities in Hong Kong and Taiwan. Several competing confirmatory factor analyses (CFAs) were conducted to confirm the factorial structure of the ATOP and BAOP. The best fit models for the ATOP and BAOP were chosen for the examination of the measurement invariance across subcultures. We then compared configurable models with or without loading and/or intercept constrained before correlating the latent constructs between the best models for the ATOP and BAOP. Results The comparison in multiple CFAs found that the model with one factor and two correlated-wording-method factors outperformed the other models for both the ATOP and BOAP. However, the internal consistency was suboptimal (ATOP: α = .56 to .80; BTOP: α = .57 to .65) and the measurement invariance was somewhat unsupported among the Hong Kong and Taiwan samples. Moreover, after controlling wording effects, the latent construct of the ATOP was moderately associated with that of BAOP ( r = .356; p < .001). Conclusion Chinese versions of the ATOP and BAOP can be treated as a unidimensional factor for use in Hong Kong and Taiwan university students. However, further refinements of both instruments may be needed before using them to capture the social attitudes and beliefs toward obesity individuals, which is expected to advance our understanding of weight-related bias in East Asian contexts.

Psychological Pathway from Obesity-Related Stigma to Anxiety via Internalized Stigma and Self-Esteem among Adolescents in Taiwan

“…Our proposed model had satisfactory fit as indicated by the nonsignificant χ2 test (14.54 [10], p = 0.15 for SEM with multigroups on actual weight status; 15.53 [10], p = 0.11 for SEM with multigroups on self-perceived weight status) together with other fit indices (CFI = 0.93, SRMR = 0.034, and RMSEA = 0.044 for SEM with multigroups on actual weight status; CFI = 0.91, SRMR = 0.034, and RMSEA = 0.049 for SEM with multigroups on self-perceived weight status; Figure 1).…”

“…A higher score indicates stronger beliefs that people with obesity are unable to control their weight. The psychometric properties of the BAOP Chinese version were supported by confirmatory factor analysis (CFI = 0.958, TLI = 0.941, RMSEA = 0.048, and SRMR = 0.050 [10]).…”

“…Therefore, there is an existing literature gap for the nature of the relationships between different types of weight stigma and psychological distress among Asian populations, especially in an area with complex cultures such as Taiwan. Specifically, Taiwan has the Chinese culture root with a mindset of Confucianism; however, Taiwan also received Japanese culture from Japan’s colonization, and was later exposed to Westernization [9,10]. Therefore, Taiwan people, especially the youths and adolescents, are highly likely to accept the concept of slim persons as beautiful due to their exposure to Westernization.…”

Disentangling the Drivers of Obesity: An Analytical Framework Based on Socioeconomic and Intrapersonal Factors

“…Attitudes toward obesity (ATOP) and beliefs about obesity (BAOP) scales were developed in 1991 ( 78 ). The estimates of ATOP and BAOP show the extent of individuals' attitudes (positive or negative) and belief (positive or negative) about obesity.…”

The development and validation of the Motors of COVID-19 Vaccination Acceptance Scale: Psychometric evaluation among mainland Chinese university students

“…The three omitted items were the reverse-coded items. Given that prior evidence shows that wording effects have methodological impacts on the validity and reliability of an instrument (e.g., using a mixture of both positively and negatively worded items) [24][25][26], it is possible that the three omitted items are confounded by the wording effect. For example, the Kid-KINDL (a generic quality of life instrument contains both positively and negatively worded items) was found to have unsatisfactory fit indices when fitting the data with its original six-factor structure.…”