Cross-cultural adaptation of four instruments to measure stigma towards people with mental illness and substance use problems among primary care professionals in Chile

Abstract

Stigma toward people with mental illness and substance use problems is a significant global concern, and prevents people with these conditions from accessing treatment, particularly in primary health care (PHC) settings. Stigma is a cultural phenomenon that is influenced by particular contexts and can differ by country and region. The majority of stigma research focuses on Europe or North America leading to a lack of culturally relevant stigma research instruments for the Latin American context. The present study describes and discusses the methodology for cross-culturally adapting four stigma measurement scales to the Chilean context. The cross-cultural adaptation process included nine phases: (1) preparation; (2) independent translations; (3) synthesis 1 with expert committee; (4) focus groups and interviews with researchers, PHC professionals, and PHC users; (5) synthesis 2 with expert committee; (6) independent back translations; (7) synthesis 3 with expert committee; (8) pilot with PHC professionals; and (9) final revisions. The adaptation process included an array of diverse voices from the PHC context, and met three adaptation objectives defined prior to beginning the process (Understandability, Relevance, and Acceptability and Answer Options). The resulting, culturally adapted questionnaire is being validated and implemented within PHC settings across Chile to provide in-depth insight into stigma among PHC professionals in the country. The authors hope it will be useful for future research on mental illness and substance use stigma in similar settings across Latin America.

National Data and the Applicability to Understanding Rural and Remote Substance Use

“…Self-reported behavioral health data are known to have dependability issues, even when compared to self-reported, non-behavioral health data (World Health Organization, 2022). In behavioral health, data quality is eroded by non-response, misreporting, errors in patient self-recall, and variance presented by the reliability and validity of instruments designed to measure addiction and substance use in cultures where the tool has not been validated (Ondersma et al, 2019;Parra Videla et al, 2022).…”

Reducing stigma toward mental illness and substance use issues in primary health care in Chile: Protocol of a cluster controlled trial study

“…The study confirmed the presence of stigma toward people with MISUI. In addition, it (1) adapted and validated instruments to measure stigma among PHC providers in Chile ( 71 ), and (2) identified key elements to be considered for designing an effective intervention to reduce that stigma. In addition, it explored feasibility of the Canadian intervention.…”